Barefoot/Navicular - Studies?

[RachelFerd]

Not wanting to open the can of worms debate here, but can anyone point me in the direction of any published studies into barefoot rehabiliation of navicular syndrome horses? I couldn't find anything in the standard equine veterinary journals I have access too, but am interested if anything is available?

 

[Oberon]

I am not aware of published studies.

We have Project Dexter in the UK - which is ongoing.

Robert Bowker has done research and articles in the US, but I'm not aware of anything being properly peer reviewed etc.

James R Rooney is a vet who published a book called The Lame Horse, which eluded to shoes being the cause of navicular in many horses and that taking the shoes off could be a treatment. This was in the 1970s, but his ideas were largely ignored then and no further time was invested in the theory.

Strasser mentioned studies in her books - most regarding work from Universities from Germany and Austria....but I didn't pay much attention .

 

[cptrayes]

I don't think there are any. We have tried, and failed, to find any. You might also like to know that there are no scientifically valid studies of using remedial shoeing or medication to treat navicular either, because those that exist generally have tiny numbers and no control group of unshod horses.

 

[RachelFerd]

I am mainly asking as I am doing a project on navicular for my degree. I am mainly meant to be using peer-reviewed studies to reference, rather than personal accounts or websites. Which is not to say I can't comment on barefoot treatment, I would just have been able to talk in more detail if there were studies available.

I am also interested personally - I have access to many radiographs and MRI scans of navicular syndrome horses, and I have also seen disected a few particularly bad cases who have been PTS. I guess I would love to have more information on the 'how' and 'why' these horses who are making a successful rehabilitation are coming sound - based on imaging, not just the evidence that they are now functionally sound.

I am no expert in any sense or form, but am making my way through about 25 published studies at the moment, so gathering a lot of information! I also have a horse myself who was x-rayed to reveal some excessive wear and tear on the navicular for her age (only about 1/10 lame at her worst however) - she is shod in raised heel shoes to improve the foot-pastern axis, and has been sound since - probably the same work could be done by barefoot trimming, but if the conventional treatment is working, I am not keen to change anything. I think it is very important not to completely disregard conventional treatment in the first instance, as it can have positive results too.

 

[Oberon]

I think it is very important not to completely disregard conventional treatment in the first instance, as it can have positive results too.

I guess that depends on your view as to how it develops in the first instance and what a positive result is.

Years ago I would have been all about the remedial shoes and wedges because I believed they would work and make a horse better.

Knowing what I know now, I wouldn't be willing to go conventional and patch over an unhealthy hoof in the hope of staving off lameness and degeneration a little while longer, all the while worrying about when another wheel is going to drop off.

I'd pull the shoes and let the hoof remodel and build tissue and strength at the back - which is where the party is.

But we both have to do what we think is best

 

[cptrayes]

Rachel a barefoot trimmer would never trim the toe off a navicular horse to raise the heel. They would work the heels to make the heels grow higher and put the hoof pastern axis right that way.

Your mare shod in wedges is, unfortunately, quite likely to go lame again at some point when her feet have adjusted to the wedges. There are a lot of vets and farriers who think that wedges simply crush the heel even more and long term cause even more damage for navicular issues. The good news is that even then, a barefoot rehab would still be likely to put her right. A number of horses arrive at Rockley every year either fresh out of, or wearing, wedges.

You will have seen Rockley referred to a lot on this forum. Can I suggest that you contact Nic Barker and discuss your dissertation with her? She is very generous with her time.

Please do tell us if you come across any peer reviewed studies where they actually have a control group of horses who are not shod, so that there is a valid comparison with how much remedial shoes actually help. And also long term would help, rather than the very short term that most studies seem to be.

I'm not having a go, I'd really like to see it if it exists.

The only study I am aware of where the horses had no shoes was one about medication, I can't remember which one (but Nic will know the study I mean). ALL the horses had their shoes taken off, so that the shoeing could not influence the results. Then the horses were divided into groups and each group given a different therapy. ALL the horses improved to some extent and no-one made the connection that it could possibly have something to do with their shoes being off.

If your dissertation is only going to be allowed to include peer reviewed work then I'm afraid that it is going to be seriously unbalanced

 

[RachelFerd]

Not a disseration, I am not going that in depth. Only a series of short projects, essays and presentations on the topic.

But it is a requirement that I am mainly working with peer-reviewed studies. It is very interesting the very positive bias given to barefoot as a valid treatment on this forum, compared to the reaction of several vets I have talked to. Not discrediting it in the slightest, just very confused as to the very limited published material about the approach. I realise that project dexter is an ongoing work, and will be very interesting once fully written.

I don't really want to turn this thread into one about my own horse or other people's perceptions of how to keep her sound when they know very little about her. I can assure you she is quite happy as she is!

Anyway, I guess the answer to my question is that there isn't anything available... yet. Certainly not in time for my november deadline anyway. I am genuinely interested when there is something.

As regards corrective shoeing - it is published opinion that if a horse responds straight away to corrective shoeing OR improved foot balance (which applies also to barefoot horses) and that there is no more than usual wear and tear on x-ray, that it is not a case of navicular disease, rather that it is an alleviation of caudal foot pain caused by poorly balanced feet. I am more interested in the more severe cases with visible changes on x-ray who have been diagnosed specifically with navicular disease and how they might be able to come sound by shoe removal - because anecdotally they have, but I am just wondering 'how'?!

 

[cptrayes]

As regards corrective shoeing - it is published opinion that if a horse responds straight away to corrective shoeing OR improved foot balance (which applies also to barefoot horses) and that there is no more than usual wear and tear on x-ray, that it is not a case of navicular disease, rather that it is an alleviation of caudal foot pain caused by poorly balanced feet. I am more interested in the more severe cases with visible changes on x-ray who have been diagnosed specifically with navicular disease and how they might be able to come sound by shoe removal - because anecdotally they have, but I am just wondering 'how'?!

After studying dozens of these cases now, my impression is as follows.

Barefoot rehabs work with "navicular disease" (bone degradation) because the pain is not caused by changes to the navicular bone. For any horse with changes on xrays there is another one that is perfectly sound that has the same changes. All vets know this and yet many persist in writing off horses on the basis of xrays.

When MRI is done, the navicular bone changes are almost always accompanied by soft tissue injury to the ddft, the collateral ligaments and/or the impar ligaments. I know of only one, third hand, that had degraded bone with no soft tissue damage. The soft tissue damage is what causes the pain.

A barefoot rehab enables the horse to build a foot which completely matches its requirement for foot balance and allows the injuries to heal.

Wedges work, temporarily, with ddft injuries because they slacken off the ddft by shortening the distance it has to travel. Bar shoes often help because they allow the frog to come into work where it cannot in normal shoes.

 

[cptrayes]

But it is a requirement that I am mainly working with peer-reviewed studies.

Then your study will be seriously biased, since there is currently no peer reviewed research into barefoot rehabs. And those studies that do exist are for remedial shoeing and/or medication, with pathetic numbers and/or without barefoot control groups, so I question their value in any case.

It is very interesting the very positive bias given to barefoot as a valid treatment on this forum,

It's not a bias! It's people reporting that horses that vets and farriers have told them will never work sound again being brought sound, time after time after time.

Bias would be if we fail to report the failures. We don't. The only one which I know of personally also had a bone chip.

compared to the reaction of several vets I have talked to.

We are still struggling to get an awful lot of vets to understand that ordinary horses can work without shoes, never mind that we can cure ones that their medicines and remedial shoeing can't. It will be a long long time before you find it difficult to find sceptical vets.