Is it possible to confuse Navicular syndrome & mild laminitis?

swellhillcottage

swellhillcottage

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Me again wanting to pick more brains :)

As in the title really - 5 year old Connemara pone diagnosed with Navicular Syndrome 2 weeks ago no more than 1/10 left fore 3/10 right fore nerve blocked positive to the heel block - bar shoes applied and looking good 3 days post application - turn out in small paddock and left overnight with pretty poor old grass already grazed by sheep , next morning said pony could barely walk,red hot feet with raised front digital pulses all whilst on 2 bute a day for the navicular syndrome - Laminitis flag raised so brought him in and did the usual of soaking hay etc - pony now looks 1000% better admittedly he's been off grass for 2 days and still on the bute.

I have always been careful with him and grass because he is such a greedy scoffer and he is a native and in hind sight the grass in the paddock was not as poor as I thought :(

Is it possible that he could have been suffering with low grade laminitis for a while rather than Navicular syndrome - it wouldn't surprise me if he didn't have both though tbh :(


Original Navicular post here.
http://www.horseandhound.co.uk/foru...r-Syndrome-in-a-Connemara-5-YR-old-how-common

S x
 
Hi Swell just been to look at your first post but it didn't really go into how long pony was lame prior to diagnosis or conditions pony kept in . Have you looked at The Rockley Farm blog as a go to for information on navicular and on generally hoof health. It may be that your right and your pony if he was just diagnosed on nerve blocks might have low grade laminitis instead but seems odd for a vet not to investigate it first particularly in a young piggy pony did the vet discuss laminitis or other possibilities? Why was laminitis ruled out/not considered? Anything else on the hock issue? Either way the first thing you've got to deal with is the lamintis and there's lots of information on the Rockley Blog about managing grass sensitive horses, can you turn him out in a school or anything so he can move without pigging?
 
They tend to look quite different on Xray? I assume he was Xrayed to get the navicular diagnoses? But symptoms and nerve block wise they can look similar- or they can have both!
 
With an ex rockley horse and in touch with several other people with ex rockley horses, grass sensitivity ( not as far as full blown laminitis) is a massive factor in keeping these horses sound. Many get worse on their injured foot when they are feeling the grass. It could be that there was low grade laminitis episodes in the past or even just sensitivity at certain times of the year that so easily gets blamed on hard ground.

The horses I am thinking of have been diagnosed via mri and have clearly visible injuries so not a misdiagnosis but maybe more than one thing going on.
 
X rays do not tell you that a horse has anything wrong with it. It is widely quoted that fifty per cent of horses will have changes on x Ray and very few will ever suffer navicular syndrome (which only means 'pain in the back half of the foot'). Only MRI will give you a proper navicular diagnosis.

Yes, if you only have x rays and nerve blocks to go on, lameness from any cause in the foot can be mistaken for navicular.
 
Xrays will show most chronic laminitis I think? And any fractures/keratomas can be ruled out too obviously, which with a horse blocking to the foot there could be. Id want my horse blocking to the feet to be xrayed to check anyway even if you don't get the full picture
 
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ycbm said:
X rays do not tell you that a horse has anything wrong with it. It is widely quoted that fifty per cent of horses will have changes on x Ray and very few will ever suffer navicular syndrome (which only means 'pain in the back half of the foot'). Only MRI will give you a proper navicular diagnosis.

Yes, if you only have x rays and nerve blocks to go on, lameness from any cause in the foot can be mistaken for navicular.
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but we are talking about laminitis?
 
rara007 said:
Xrays will show most chronic laminitis I think? And any fractures/keratomas can be ruled out too obviously, which with a horse blocking to the foot there could be. Id want my horse blocking to the feet to be xrayed to check anyway even if you don't get the full picture
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Wow great response! Grass sensitivity is a very real possibility with this pony.

Pony x-rayed clear so was just blocks and flexion tests that led to a diagnosis - he not insured so mri not an option realistically :(
Pony normally turned out from 6am until around 2ish then brought into fenced area which is almost grazed bare with additional dry hay - scoop of mollichaff show shine and a cup of lamicare balancer.
This has been his routine since early March when he started to come back in to work after having growing time - I noticed there was a problem at the end of April having him x-rayed early May and full work up beginning of June:)
I had him x-rayed without vet looking at him I had a gut feeling something was wrong with his feet by his behaviour when shod and the odd potteryness I felt after shoeing and him not being overly forward - to be fair the vet didn't look at him before x -rays and then when I presented him for the work up 3 weeks later no Laminitis was never discussed, I wonder if its worth having his bloods done?
Farrier coming tomorrow as he has snapped the bar off on one of his bar shoes:( Farrier and I have had a chat and he thinks misdiagnosis is not impossible and will reavaluate tomorrow :)

I dont mind going through more Rockley blogs as have spent a lot of the time going through there website lately :)

Amicus nothing more on hock - will sort front end if possible then go backwards ;)
 
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It does sound like lami is worth not discounting given the timings, and it might not have shown up anything on xray at that point. Some horses are also just very sensitive to grass, you could try leaving in the fenced area for a bit?
 
ester said:
It does sound like lami is worth not discounting given the timings, and it might not have shown up anything on xray at that point. Some horses are also just very sensitive to grass, you could try leaving in the fenced area for a bit?
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Ester we are cross posting sorry! - yes he is stabled atm then after tomorrow will try fenced area again -I am just very surprised at the severity of the lameness given what grass he is has been on since March and what he consumed that day but I wonder if he was borderline all of this time whether that extra 12 hours sent him over the edge given he has a very low pain threshold also ;)
 
rara007 said:
Xrays will show most chronic laminitis I think? And any fractures/keratomas can be ruled out too obviously, which with a horse blocking to the foot there could be. Id want my horse blocking to the feet to be xrayed to check anyway even if you don't get the full picture
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Yes I'm sorry I worded that badly. What I meant was that you cannot get a diagnosis of navicular syndrome worth anything from x rays and nerve blocks alone, you can only guess what structures are actually causing the lameness unless the bones are in a terrible mess, or broken.


I'd also like to add that laminitis usually has to be pretty severe before it causes rotation, so most cases of that won't show on x Ray either.
 
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How stressful, I really feel for you. In my experience foot issues are tricky to diagnose, so I certainly wouldn't be surprised if you ended up with an alternative diagnosis, and as it is, 'navicular' is fairly vague and is describing the symptoms rather than the cause.

Also of course one of the options for bony changes in the feet are steroids, which would be really bad news if it's laminitis. Tread lightly! What treatment plan have you been given by the vets for the navicular diagnosis? How successful were the nerve blocks? Also what is his foot conformation like? If nothing showed on X-ray I would keep pushing for alternatives.

Because of no insurance it'll probably have to be a deductive diagnosis. I would be tempted to do a week's intensive lami care - box rest on soaked hay and a seriously deep bed. And cold hose his feet/stand them in buckets of really cold water. You could take off his shoes and pad them too. With laminitis, the sooner and more intensive the treatment, the better the outcome - navicular doesn't have quite the same urgency, so maybe just treat as lami and see if he comes sound? OOh also may be worth getting a cushings test done.
 
Pigeon said:
How stressful, I really feel for you. In my experience foot issues are tricky to diagnose, so I certainly wouldn't be surprised if you ended up with an alternative diagnosis, and as it is, 'navicular' is fairly vague and is describing the symptoms rather than the cause.

Also of course one of the options for bony changes in the feet are steroids, which would be really bad news if it's laminitis. Tread lightly! What treatment plan have you been given by the vets for the navicular diagnosis? How successful were the nerve blocks? Also what is his foot conformation like? If nothing showed on X-ray I would keep pushing for alternatives.

Because of no insurance it'll probably have to be a deductive diagnosis. I would be tempted to do a week's intensive lami care - box rest on soaked hay and a seriously deep bed. And cold hose his feet/stand them in buckets of really cold water. You could take off his shoes and pad them too. With laminitis, the sooner and more intensive the treatment, the better the outcome - navicular doesn't have quite the same urgency, so maybe just treat as lami and see if he comes sound? OOh also may be worth getting a cushings test done.
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Thank you Pigeon :) this evening 56 hours since lami bout - he has been in his box since on just hay and supplements etc he looks relatively sound , legs look tight, feet cool and I had to really look for pulse so I turned him out In the school and he had a lovely trot and canter around looked loose and comfortable - admitted still on a bute am and pm - it was a really mild bout of lami I think for him to be so normal today but I am treating this as a lami problem and I will see what happens. Farrier coming again tomorrow.
I get the steroids thing and that atm. is not going to be on the agenda, pumping drugs into him is the last alternative - if he doesn't come sound in the short term I am going to turn him away to see what happens as he is only 5 bless him :)

Treatment plan for Navi was bar shoes and bute :(

Pigeon the nerve blocks were successful but I did notice he was not completely sound yes certainly an improvement is that normal - I keep thinking I wish I had videoed it - next time and it may save me money if I want a 2nd opinion!!!
He hasn't had a blood analysis I will ask for one asap :)
Just to be clear in a straight line including flexions this chap is sound its on a circle he isn't so whatever it is it is has hopefully been caught early or is not too bad fingers X
 
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