Navicular: can the damage be reversed?

Sorry don't want to hijack the thread with my personal experience but seeing as you asked cptrayes -

Yes he had both MRI and X-ray. He has always does a bit of everything, mainly low level endurance, fun rides, drag hunting, and flatwork, and I've always taken care to gradually build up the work with his feet in mind. He has good conformation though you're right that if you were going to fault him it would be that his heels are low. This year we increased the endurance distances but I cannot emphasise how slowly we did so; I was training with another barefoot pony so in both our interest to take it easy. Has always lived out, feet appear incredibly healthy and strong, this year he has had a supplement due to increased work load too. Quite different to the pony you describe hunting above!

Yep doing LOTS of walking right now; he had a few months off completely (one month wearing gel hoof boots in the day and on straw bed at night so his feet never touched anything hard), gradually reintroduced turnout, and then once comfortable with 24/7 turnout again we then started with e.g. 5 mins walk on no surface or ten mins in hand on a good grass covering.

Naturally a toe lander. Definitely not laminitis, and we are based in Thames valley.

He has improved with the above, but is still not right on a circle on concrete. Vet check and further discussion next month....

Just out of interest, how much approximately is a rockley rehab?! Not for him, just interested.
 
Morgan123 said:
Sorry don't want to hijack the thread with my personal experience but seeing as you asked cptrayes -

Yes he had both MRI and X-ray. He has always does a bit of everything, mainly low level endurance, fun rides, drag hunting, and flatwork, and I've always taken care to gradually build up the work with his feet in mind. He has good conformation though you're right that if you were going to fault him it would be that his heels are low. This year we increased the endurance distances but I cannot emphasise how slowly we did so; I was training with another barefoot pony so in both our interest to take it easy. Has always lived out, feet appear incredibly healthy and strong, this year he has had a supplement due to increased work load too. Quite different to the pony you describe hunting above!

Yep doing LOTS of walking right now; he had a few months off completely (one month wearing gel hoof boots in the day and on straw bed at night so his feet never touched anything hard), gradually reintroduced turnout, and then once comfortable with 24/7 turnout again we then started with e.g. 5 mins walk on no surface or ten mins in hand on a good grass covering.

Naturally a toe lander. Definitely not laminitis, and we are based in Thames valley.

He has improved with the above, but is still not right on a circle on concrete and further discussion next month....

Just out of interest, how much approximately is a rockley rehab?! Not for him, just interested.
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I think Rockley is about 175 a week, half claimable on most insurances.

The whole problem, I think, is that toe first landing is not natural and he should not be doing it. But working out why he does and what can be done to put it right is another question altogether.

Going back to your first question about what I would do, I would be walking him for an hour a day two days in three on a road in hand if he was mine, unless he is hopping lame in walk.

With his history, I would suspect that some time ago he got a bit of thrush or something that caused him to land toe first. Then that caused more heel pain and it became a vicious circle. Clearly, though, you have an uncommon case given how well he has worked previously.

When you get him right will you come back and let us know what worked?
 
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Not about horses but I decimated L1 in my spine 2 years ago, it literally burst with the force of the impact. I have had untold xrays and 2 MRIs. The bone has definitely remodeled, well whats left of it anyway! The fragments have gone and the small wedge shaped bit thats left is a totally different shape, it was VERY rough for a long time and is now pretty smooth. My pretty good orthopaedic specialist told me that 18 months after a trauma bone goes though a dramatic remodelling phase. Might not be relevant for horses, but surely if a human spine can remodel, even when its really damaged and under a lot of pressure from the other bits that aren't healed, then surely a navicular bone could??
 
Mt barefoot horse had huge sidebones my vet who was older and very experienced just said its the body's response to work and that they supported the feet. he had a navicular cyst,sidebone and some ringbone and the advice was to gallop him twice a week, that was about 1985 he was 14 and a grade A showjumper. It worked never a day lame and jumped 1.40's til he was 22. my vet said we will look him at again if he ever goes lame, he didn't. he also advised no rest breaks and to ride him at least five days a week which he did until he retired at 23. I had the same advice from the same vet regarding false ringbone in a thoroughbred, grade B showjumper and he evented and hunted to at least 24. never a day lame but always kept him fit. In both cases we only found it because of x rays for another issue. he hated interfering and always advised work and correct foot balance. His reasoning was that the body normally repairs itself.
 
Morgan123 a toe first landing is not ideal and heel first is to be encouraged but some horses will be much harder to get landing that way due to other conformation issues higher up the limb. We have one at home - she is deep through the barrel, with little short legs and a "gogo gadget" trot, plus a more upright than ideal shoulder and offset knees! She is also my daughter's pony and therefore not exactly encouraged to work correctly through from behind.. As a result of all this she is toe first unless she gets to really powering along. I expect her to have issues later in life, not because she is barefoot but because she is not landing correctly despite a decent trim. However I expect her to last longer than she would if she was shod...
As to remodelling, Tnavas I don't think ANYONE has said that a bone will return to "pre damaged" state. Only that it will CHANGE. Clearly callus remains at a fracture site, but as others have said who cares as long as it works? As a vet I have spent many happy hours watching bones change. You should see the spectacular things that happen when you remove a bone plate from a healed femoral fracture in a dog... At which stage all the stresses go back to being transmitted through the bone instead of at least partly though the plate. Yes you can still see it was once broken, but they are back to working sheep.
Horses with navicular changes taken barefoot will continue to show evidence of the disease process, but changes will take place and if the horse is sound as a result I don't think I care too much if the navicular bone does not look "normal".
old hand I love your comment on incidental findings on x rays. I have had some interesting conversations with people where bony changes were found on sound horses having PPE xrays... I'm pretty sure if you x rayed me I would have some spectacular changes due to previous breaks and general wear and tear but I am functionally sound..
But somehow I think all this is falling on deaf ears...
 
cptrayes said:
One thing is not in doubt, and that's that the lateral cartilages in working barefoot horse are much bigger than those in shod ones, as a general rule. Presumably whatever creates that size could theoretically lead on to side bone, but at the moment yours is the only horse I have heard that connection made about.

It should also be noted that ossification of the lateral cartilages is an entirely normal part of the aging process of a horse.
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Except when found on a barefoot 6 year old with bi lateral sidebone on both front feet ! Explain that!

I agree that their could be a correlation between heel pain and Navicular - but what came first the chicken or the egg?

Bone may smooth but if the remodeling is in the way of ligaments and tendons it will cause problems. Which is why splints that are high and to the rear of the splint bone cause more problems than those lower down and forward. The ligaments and tendons are affected.
 
Tnavas said:
I agree that their could be a correlation between heel pain and Navicular - but what came first the chicken or the egg?

Bone may smooth but if the remodeling is in the way of ligaments and tendons it will cause problems. Which is why splints that are high and to the rear of the splint bone cause more problems than those lower down and forward. The ligaments and tendons are affected.
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Very good question Tnavas. Is heel pain a cause or a symptom...
So if bone cam smooth, that is not remodelling? As your original assertion was that bone remodelling DID NOT HAPPEN.
I don't think anyone is arguing that remodelling that gets in the way of ligaments and tendons is NOT an issue. Bone remodelling can certainly be disordered, and can cause problems in and of itself (my right ankle will attest to that). We have argued only that the remodelling seen in the navicular is real, and often correlates with an improvement in the lameness seen with the disease.
 
Tnavas said:
Except when found on a barefoot 6 year old with bi lateral sidebone on both front feet ! Explain that!

I agree that their could be a correlation between heel pain and Navicular - but what came first the chicken or the egg?

Bone may smooth but if the remodeling is in the way of ligaments and tendons it will cause problems. Which is why splints that are high and to the rear of the splint bone cause more problems than those lower down and forward. The ligaments and tendons are affected.
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NOBODY has said that side bone is normal in a six year old, though actually another thread running at the moment will tell you that it's quite common. I've had a five year old Arab with it myself, completely unnoticed until he was x rayed due to an abscess.

An experiment was done with cadaver legs set in a rig to work heel first or or toe first, by a guy called Rooney.

That experiment showed that if the foot landed heel first, the foot wore out with no tendon damage. In the feet that landed toe first, the ddft became damaged and then AFTER that the damage to the ddft resulted in damage to the navicular bone. Heel pain comes first. It causes a toe first landing. The toe first landing causes the damage which results in noticeable lameness.
 
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Tnavas said:
You can write sarcastic comments all you like - Barefoot is just no shoes! It is not the be all and end all of hoof care and there is still a desperately large number of 'barefoot trimmers' out there with seriously limited knowledge damaging feet far more than they help.

Bone remodels all the time but you cannot lose areas of extra deposits just because you believe it so. If you break your arm at any age - the fracture is healed by an additional layer of bone - which when a body is autopsied is still there as clear as a bell that the bone was damaged.

Splints may go down a little as they settle - but they don't go.

The best thing for a shin sore horse is the fact that the body puts down an extra layer of bone - which you can see many years later on many a race horse. Some trainers even encourage the horse to become sore as the new layer of bone strengthens the leg.

AND may I remind you that thousands of years ago - before shoes were even invented - that horses suffered from Navicular, Ringbone, Laminitis - and WOW not a shoe in sight - I wonder how that could have happened.

HORSES ARE PRONE TO THESE PROBLEMS BY THEIR CONFORMATION!
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I think you are over-simplifying navicular.

It is a syndrome with many components to it such as bone remodelling/degeneration to soft tissue damage. Often a combination of these - with some genetic predisposition thrown in if you're unlucky. Bad shoeing, by far, contribute the most to damage in this area of the hoof by constriction. This is the very part of the hoof that needs the most movement and space to allow for soft tissue movement in order to be healthy.

Time out of shoes is the best cure. My farrier and my vet said so. They recommended a qualified trimmer with lots of experience of rehabbing such cases. That was good enough for me and the horse came sound.

There's no use chucking anecdotes at me Tnavas. The proof is in the horse in front of me.
 
I think the thing with barefoot horses having issues, even at a young age is to consider that the problems haven't necessarily occurred because the horse is barefoot, and that it may well have had the same problem - potentially sooner- if it were shod. You can decide that keeping them bare is best for them/less likely to cause issues but it doesn't mean stuff can't still go wrong.
 
My pennies worth. As someone who picked this thread to read for information purposes only, I find it a shame that some posters respond without reading another thread properly. It is also becoming somewhat antagonistic as well. The issue over bone returning to its previous state seems to have been misunderstood. Bone will show it has been damaged but that doesn't mean it can't be as functional as before when repaired. My horse is shod. It works for him. I had a crash update course in feet when mine attempted to remove his front leg in a haynet. As a big, developing horse, I learnt that any changes made to trim/shoes/wedges etc would bring about a very quick change.

As someone who is genuinely interested, could I ask that the post is kept informative and not quarrelsome? There are posters on here with a great deal of knowledge and I am grateful that they are sharing this.
 
cinnamontoast said:
Blimey, if only a barefoot trimmer can trim, I'd best speak to my farrier who's been trimming since he qualified!
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You've obviously been lucky but I have had some horrific experiences with several Hertfordshire farriers and a barefoot horse despite years of 'experience' on their part.

There is only one person in the area (who happens to be a UKNHCP trimmer) that I will now trust with my horses. There are plenty of farriers and trimmers I won't.

Going back to whether navicular syndrome is more prevalent in barefoot or shod horses I know of more in shod horse BUT that's because I know of more people with shod horses generally in real life.

I also know a bit more background on some of the other horses that were barefoot that went through Rockley. Some were generally tricky horses and when returned it took a long time and significant changes to their management and environment for them to be able to function at their best. Without all these pieces in place they were not a sound horse.

As for whether shoes cause it per say, when mine was having foot problems (soft tissue damage to the back of the foot caught before they caused changes to the bone), the professionals treating him at the time were clear that he had a weak foot generally and they believed being shod at under 2 years as an ex racer would have contributed to the poor development of his feet.
 
I guess that an unshod horse kept in a small paddock and not exercised muchor its feet given regular attention is going to end up with long toes and weak heels, so they would be subject to foot problems as any horse shod all year round and not given a break from shoes.

If you read Dr. Deb Bennett's articles, she describes how a foot in shoes will gradually "creep forward" and that farriers are aware of it. She doesn't advocate barefoot, but she does say that horses should have a rest from shoes every year.
 
Orangehorse said:
If you read Dr. Deb Bennett's articles, she describes how a foot in shoes will gradually "creep forward" and that farriers are aware of it. She doesn't advocate barefoot, but she does say that horses should have a rest from shoes every year.
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Not only Dr Bennet but the oldest farriery books say that is the case. Sadly, many farriers and owners seem to have glossed over this very fact. Shoeing horses all year round is a new thing. Never did that when I was a kid growing up in Lincolnshire. We had shoes in the summer and bare in the winter.

I suppose now that competitions are year round, shoes are a necessity.

This is why I decided that for me, at least, shoes are not a necessity and I prefer to keep mine barefoot. I'm not saying it's right or wrong. It's just how I prefer to do things.

Some people prefer to shoe. That is no business of mine.

When it comes to criticising what people want to do, I do have a problem with that.
 
I have never actually heard a farrier advise anyone to remove shoes due to the "evils" of shoeing, if one takes it to its logical conclusion everyone should aim for barefoot and only use shoes as a last resort, not the other way round.
One of the jobs of a farrier is to trim young horses, and if they can t do that, or do a paddock trim, then no way would I want them shoeing my horse. We don t have any trimmers round here, there is no demand, the standard of farrierry locally is very good, world class even, with few exceptions.
 
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Orangehorse said:
I guess that an unshod horse kept in a small paddock and not exercised muchor its feet given regular attention is going to end up with long toes and weak heels, so they would be subject to foot problems as any horse shod all year round and not given a break from shoes.
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Exercise is the key to improving shoe sick feet it simply does not work as well if you just turn the horse out in the sort of turnout most horses in livery have .
The first yard I worked on still turned out hunters on the hill in summer they were hacked to gate we met the farrier the shoes came off and they where just left on a huge area of hill and moor .
They came in fit , a good weight and with great feet I think we caught them once for a trim during their feral holiday these horse were really moving and foraging and it did them a lot of good , if you brush over the lack of proper twice daily checks .
A shoeing break within each year is vital IMO but that does not mean you won't be able to work the horse at some level during this time.
 
My farrier suggested that he removed my horse's shoes last December to give his feet a rest. I was concerned as I thought they would get bruised. He said if that was all that was worrying me to go ahead. Since then I have ridden in boots/barefoot and he has been sound all along.
 
Bonkers2 said:
I have never actually heard a farrier advise anyone to remove shoes due to the "evils" of shoeing, if one takes it to its logical conclusion everyone should aim for barefoot and only use shoes as a last resort, not the other way round.
One of the jobs of a farrier is to trim young horses, and if they can t do that, or do a paddock trim, then no way would I want them shoeing my horse. We don t have any trimmers round here, there is no demand, the standard of farrierry locally is very good, world class even, with few exceptions.
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How do you know there aren't many trimmers?
 
My friend has a good farrier. He doesn't cover my area but he was my farrier when I stabled my horse at her yard. He was the one who suggested barefoot for my navi horse.

He always advocated a rest from shoes. He never mentioned diet because he didn't like to voice his opinion but when asked, he had a wealth of knowledge about nutrition. His apprentices do now ask about diet and unsurprisingly say that grains and high sugar/starch diets are no good for feet.

I think its fair to say, each farrier or trimmer is an individual and you can't gauge and benchmark each farrier or trimmer because there is no benchmark or standard gauge.

As long as your horse is sound and healthy, perhaps, stick to your guns. We are dealing with such variables, even anecdotes can be extrapolated as useful evidence.

I will say this though... allow nature to resolve any issues. If she can't then look to support her.
 
Bonkers2 said:
if one takes it to its logical conclusion everyone should aim for barefoot and only use shoes as a last resort, not the other way round.
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I'm really struggling to see anything wrong with this suggestion.

Even if they do no harm, why pay for shoes if the horse and you don't need them?
 
I think whoever made the comment about not taking horses out of shoes for a break every year has hit upon a key issue... Having horses in shoes year round is a new development and there is no doubt you can see changes in the shape and balance of a foot (particularly the heels) after even a short spell out of shoes. Many horses with a weak caudal foot (if you believe in such a thing) would benefit from even 6 weeks out of shoes. I know all the farriers I dealt with in the UK used to recommend it (that was 20+ years ago though).
That of course then spills into a discussion about the benefits to long term soundness of giving horses a proper, decent spell every year (as in several weeks letting down in a paddock, not just 2-3 weeks off in their usual routine, just not being ridden which I suspect some people now consider to be a "spell"). There is no doubt that a proper spell benefits the whole of the body not just the feet.
I found myself thinking about this thread at 3 a.m. believe it or not... Thinking about the fact that the examples Tnavas quoted about shin thickening and splints are actually examples of bone remodelling in and of themselves! Bone is much more dynamic than we give it credit for, and not all bone remodelling is pathogenic. Then of course there are examples of where REMOVAL of stress is pathological, as in disuse atrophy (which is why we remove bone plates from fracture sites - when all the mechanical stress is being borne by the plate not the bone, the bone will weaken). Because of course there is normal stress, and abnormal stress.
Anyway - I hope we can keep this civil, as others have expressed.
I can't now recall who said it about horses staying sounder for longer barefoot even if they have other issues which predispose them to lameness - this is certainly what I hope to achieve with our delightful but distinctly wonky legged little mare. She is a case study in progress as we speak since she looks set for an endurance career.. I can only imagine the concussion and toe first landings she would exhibit with shoes on... Even with good hoof balance. She is just built to land that way, and it is a constant work in progress to minimise that.
 
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Once upon a time horses were turned out for a period of time - hunters all summer, we turned horses away for two weeks. Shoes came off but the hunters had grass tips fitted to protect toes.

I also remember a vet telling me that the majority of horses will Xray showing some damage to the Navicular bone - some may never have any problems, some it will develop more. What causes the lameness? Soft tissue damage or bone damage? Does one lead to the other?
 
See, I don't think 2 weeks is long enough without shoes to make any real difference to the feet.
As for which causes pain, my long ago understanding of bone innervation and pain is that pain only arises from bone when either there is significant bone destruction (infection, neoplasia) or major disruption of the periosteum (fracture, bone exposure to the air).
So, bony changes which are gradual in onset and which the periosteum can accommodate are not painful per se.
Pain in arthritis for example: the bone may appear significantly deformed but the pain comes from the degradation of joint fluid and the abnormal movement of cartilage as a result of the bone deformity affecting the way the joint behaves.
Soo.. I would say the pain in navicular results from the soft tissue damage in the DDFT and the soft tissues of the heel, not from the changes to the navicular bone itself. Of course, you also get degeneration of the cartilage over the navicular bone which will be painful, but for this discussion cartilage would actually be classified as a soft tissue...
As for which leads to the other... I don't think I'd like to be definitive on that! Better brains than mine struggle with that one. Personally... toe first landing leads to compression of the bone by the DDFT, which then leads to changes in the shape of the bone, which then leads to damage to the ligaments supporting the navicular bone.
Correcting the toe first landing and improving the strength of the caudal foot and digital cushion removes the pressure from the bone caused by the DDFT, allowing the bone to remodel, allowing the ligaments to improve.
There's more to it than that of course, involving among other things impaired blood supply and the action of the altered bone on the caudal part of the coffin joint.
 
OwnedbyJoe that does seem to be where the evidence is certainly from what is available on line.

To me, contraction of the heels either by shoeing or caudal hoof pain will cause damage to that area... the bone itself is a weird little thing that sort of acts as a fulcrum for the tendon. It's when the space the tendon has to work in is pinched or compromised in some way, that is when problems start to occur. It could be nothing at first, just toe dragging perhaps or tripping occasionally but then it starts to get more serious as the soft tissue around the tendon and the bone constricts movement and gets inflamed.

I wish I knew how to post images on this new forum, then I could illustrate what I mean.

Anyway, it's completely reversible as if you remove the constriction (shoes) or pain (thrush/infection in the area) then the heels can start to work again and they expand and the inflammation will go down and the structures will get stronger with exercise and there wil be space for all the foot mechanism to work freely again. That's why removing shoes works, if indeed shoes have caused the constriction/contraction.

however, if there are other issues like a frog infection then that needs addressing too.
 
Tnavas said:
I also remember a vet telling me that the majority of horses will Xray showing some damage to the Navicular bone - some may never have any problems, some it will develop more. What causes the lameness? Soft tissue damage or bone damage? Does one lead to the other?
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The Rooney experiments I mentioned above shows that the tendon damage eventually leads on to bone damage to the navicular. The tendon damage comes first.

The fact that fifty per cent of horses can have bone damage with no lameness and that there is precious little correlation between bone damage and level of lameness, and the MRI results coming thick and fast now, all show that lameness originating in the navicular area is almost always caused by a soft tissue injury.

Fix the soft tissue injury and the reason why it happened - the toe first landing - and most horses come sound again.
 
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Bonkers2 said:
I have never actually heard a farrier advise anyone to remove shoes due to the "evils" of shoeing, if one takes it to its logical conclusion everyone should aim for barefoot and only use shoes as a last resort, not the other way round.
One of the jobs of a farrier is to trim young horses, and if they can t do that, or do a paddock trim, then no way would I want them shoeing my horse. We don t have any trimmers round here, there is no demand, the standard of farrierry locally is very good, world class even, with few exceptions.
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My farrier has suggested taking shoes off on several occasions. He is always telling me that shoeing is actually not good for the long term health of feet and should be done only if a horse really needs them. He said that on the old days, horses would routinely be turned away, depending on their job (e.g. hunters turned away for the summer) and their shoes removed, and that their feet were much better as a result. If a horse on my yard is being shod and he feels it would do well without shoes, he will always tell me and I will pass that on to the owner to make a decision. We only have one horse shod all round on the yard. Two are shod with just fronts and the rest are barefoot.
 
Tnavas said:
Once upon a time horses were turned out for a period of time - hunters all summer, we turned horses away for two weeks. Shoes came off but the hunters had grass tips fitted to protect toes.

I also remember a vet telling me that the majority of horses will Xray showing some damage to the Navicular bone - some may never have any problems, some it will develop more. What causes the lameness? Soft tissue damage or bone damage? Does one lead to the other?
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I don't think that is cause to think it's a bone disease/issue. How long must there have been constriction of the soft tissues to contribute to bony changes to that bone? The horse was probably showing signs of pain long before. It would be interesting to hear the vets recount of what the horses' feet were like at the time of the x-ray. Were they shod? Were they already receiving remedial shoeing? On bute trial?

Because when mine was diagnosed he was about to have pads and was already wearing shoes that were thicker at the back to lift the heel! He was on bute to relieve the pain. He toe-dragged. Stood on the banks of his bed. Now I know better, that was madness! I get why the farrier thought lifting the heel would relieve the pain but he was putting more pressure on the toes and all the foot needed was more space in the heels for everything to FIT in properly.

Anyway, he was sound enough to hunter trial 10 months later. On very dry ground with no shoes on and came 3rd.
 
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