Navicular/Denerving - what would you do? (sorry quite long)

[Ludi-doodi]

A friend has a 16.2hh 16yo TB X Warmblood who has recently been diagnosed with navicular. Upon MRI they found the tendons/ligaments in the feet to be quite badly damaged too. The vet has said denerving or retirement on bute each day to manage the pain are the only options. He indicated that in his experience, on average, under the retirement/pain management option, he'd be comfortable for about 12 months before things got too bad to continue.

Since then both the farrier and friend's instructor has said denerve is the way to go. They both have experienced many horses who have continued to work happily after the op.

Friend is quite confused as she felt denerving might restrict the activity he'd be able to do, nerves growing back, op not working etc etc. Also at 16 is it fair to put him through the Op? He's lightly competed at Unaff Prelim and is hacked/schooled 2-3 times a week. Until now has never had any issues healthwise whatsoever

So long story short under these circumstances, what would you do?

 

[Paint it Lucky]

I am not really a fan of de-nerving mainly because it just masks the problem and the nerves will eventually grow back (normally takes a year or two), then you'll probably find the horse more lame then he was initially. Saying that I don't think 16 is too old to have operations. Taking the shoes off completely works well for some horses with navicular and would be worth considering, one of the causes of navicular is lack of blood flow to the feet, removing shoes gets the blood going again and so aids healing. How lame is he now? Good luck whatever your friend decides, it is not a nice thing to have to go through.

 

[kirstyl]

Sounds awful. I personally wouldn't want to ride a horse that had been de nerved, just sounds very dangerous for both horse and rider. I know a lot of horses manage to continue working for many years but 16 isn't a bad age to retire, and I have to say if it was my horse in this situation, I would continue carefully with what I had been doing and monitor situation and retire / put to sleep when I felt it was necessary. I feel for your friend, terrible situation to be in x

 

[Maesfen]

I've known several hard working horses (hunters, show jumpers) that have had this done and it always seems to need doing again in about 18 months or less when the nerves have grown back and that is only if the horse is a good candidate for another op', many aren't and sometimes, the first op' isn't a success either.
The work this horse is being asked to do doesn't seem too strenuous so if they want/need another season out of the horse if it recovers well enough then I see no harm but they will have to always be aware that the horse can't feel its feet as a normal horse does.
But I must stress, that this is the beginning of the end of a working life; to have the op' is only delaying the inevitable for a year or two at most as the op can only be done a couple of times at most I believe. When the horse is too uncomfortable/pain relief doesn't work there is only one answer; it just depends if they want to put the horse through that now or not.

 

[nic83]

My horse has also recently been diagnosed with navicular and DDFT.

De nerving was never an option discussed by my vet, so it may not have been appropriate in his case, but its not something I would have considered anyway.

I didn't have great options and my horse is not one to box rest so I explored the barefoot option, and this is what I have pursued - he is currently away at Rockley farm on specialist rehabilitation livery. Their research showed good results and I felt this was his best option. Its early days to see if it works for him but if it does it would hopefully be a longer term solution and if it doesn't he is having a far better quality of life there than he would be still on box rest.

There are options to explore before making a final decision

 

[muff747]

My TBx gelding was diagnosed when he was twelve, we caught it very early he only had damage to NB in left fore. Had all the remedial farriery for the next six years until too lame to ride. Next course would be denerve but I chose to try barefoot. I began riding him again and hacking out for a couple of hours in Epic boots when necessary and was able to stop all pain relief and biotin supplements. He has been barefooted for five years now and his feet look fantastic, hard and thick walls.
My yard owners TB had been denerved for last couple of years but has recently had to be put down. He had bruised his sole but was not lame because he couldn't feel it and it developed into an abcess. Because he wasn't lame it was not detected until it had infected the coffin bone.
Please ask her to at least try the barefoot route. My gelding had typical flat thin soled feet and would quickly go lame after losing a shoe. It was not an easy decision or an easy route but if you are prepared to give it 100%, it does offer a new lease of life to any horse who's feet are not suited to iron shoes.
Wish her good luck and all my best wishes. She can pm me for any help and support at any time. I've been where she is, feeling sceptical about barefoot, but I am so glad I tried, I probably wouldn't have my boy now.

 

[cptrayes]

I'd look at rockleyfarm.co.uk and rockleyfarm.blogspot.com and see just how many horses that vets have said will never work again are sound and in full work after a barefoot rehab. It doesn't have to be at Rockley, but it's an easy option because of their perfect facilities. I did one here at home last year and he is winning dressage and show classes, hacking out on stony Welsh hills and jumping at home. He was 24 hours off being put to sleep and like most of Rockley's success stories adequan, tildren, HLA and bar shoes had already failed to bring him sound.

Her vet is WRONG, plain and simple. Denerving or buted retirement are NOT the only options.

ps studies show that it will probably have been the tendon damage that came before the navicular bone erosion. It is normal to have both if the bone shows changes. He will probably also have a toe first landing. Fix the toe first landing with a barefoot rehab and the horse probably has about an 80% chance of coming sound.

 

[Ludi-doodi]

Thanks for all your replies. I'l pass them on to her. I don't believe barefoot is an option for this horse, he is an extremely sensitive lad and looks like his leg has dropped off if he so much as looses a shoe! I doubt he'd manage the transition to barefoot well and combined with the discomfort he's in currently because of the original issue it would be a step too far for him I fear.

 

[maggiesmum]

See if you can at least get her to have a chat with Nic at Rockley, if I had a pound everytime I've heard my horse can't cope with barefoot i'd be a very rich woman.
If the diet and environment is set up correctly even the most sensitive of horses can cope, personally I'd never de-nerve, I think its barbaric and should be banned.

 

[cptrayes]

Ditto Maggiesmum.

I evented a horse that two farriers told me would never cope without shoes. He could not stand on a bare foot to have the other one shod, he had to be done one side at a time. It only took him a couple of weeks to get over the "I'm going to die if I have to walk on a stone" phase, and I just left him mostly in the field until that bit was past.

 

[Oberon]

Thanks for all your replies. I'l pass them on to her. I don't believe barefoot is an option for this horse, he is an extremely sensitive lad and looks like his leg has dropped off if he so much as looses a shoe! I doubt he'd manage the transition to barefoot well and combined with the discomfort he's in currently because of the original issue it would be a step too far for him I fear.

I'm afraid you are making that decision without the knowledge to back it up. Just whipping the shoes off isn't the answer.

Rehabbing a horse with such a pathology by going barefoot requires specialist knowledge.

If the owner doesn't have the right specialist knowledge and support she'd be as well to put the horse on the waiting list for Rockley Farm.

Barefoot is the third option for horses like this - but it's the option most vets and farriers are either ignorant of or unwilling to mention.

But it is the ONLY option where you could find this horse back in full time work in just a few months....

This is a horse from my yard.

http://www.progressivehorse.co.uk/html/shoko.html

He is back competeing.

Please don't slice the nerves in this poor horse's foot or PTS - give him this last chance. But please do it the right way.

 

[riding_high]

my horse has done his DDFT, it's basically stretched (best way the vets described it to me!) so much over the years that it now has no elasticity. i was told by one vet that i should pts as it will only get worse.
another vet allowed me to give him the summer of being a horse and enjoying life on bute. 18 months later he is still going strong, he is arthritic, got old scar tissue in 1 leg, DDFT gone in one leg, other problems in another leg, he basically has 1 good leg!

i decided that he wasn't being used so may as well try the barefoot route, it's been just over a year and he's doing ok, yes he's footy over stones but he's not hurting.

he's a big horse and i tried him barefoot a few years ago and he was crippled just walking up the field so i put shoes back on. this time shoes were causing more discomfort for him to the point he was crippled within an hour of taking them off he was freer in his movement (obviously still lame) and has since got better and better.

i can't ride him anymore but my kids ride him in from the field and he feels like he has a purpose in life.

i think trying the barefoot route would be good, i wouldn't de-nerve though, i've seen a horse that was de-nerved and she was always lame, had no awareness of where her foot was and would trip, it's since grown back and she is the same as before she had it done, so it served of no use to her.

 

[AmyMay]

Personally, I would never de-nerve a horse.

There have been some very positive posts on here about barefoot rehab at Rockley (I think that's what it's called). However, if the tendons and ligaments are buggered too, I would probably opt for the retirement.

 

[Ludi-doodi]

Personally, I would never de-nerve a horse.

There have been some very positive posts on here about barefoot rehab at Rockley (I think that's what it's called). However, if the tendons and ligaments are buggered too, I would probably opt for the retirement.

And this is the issue and why I don't think the shoeless route will make much of a difference IN THIS CASE. Anyways not my decision but my friends and I know she has read this thread.

Thanks everyone for commenting

 

[amandap]

Op, have a read of todays post on the Rockley Farm blog. http://rockleyfarm.blogspot.com/2011/07/navicular-never-just-bolt-from-blue.html?spref=fb

 

[Pale Rider]

I'm afraid you are making that decision without the knowledge to back it up. Just whipping the shoes off isn't the answer.

Rehabbing a horse with such a pathology by going barefoot requires specialist knowledge.

If the owner doesn't have the right specialist knowledge and support she'd be as well to put the horse on the waiting list for Rockley Farm.

Barefoot is the third option for horses like this - but it's the option most vets and farriers are either ignorant of or unwilling to mention.

But it is the ONLY option where you could find this horse back in full time work in just a few months....

This is a horse from my yard.

http://www.progressivehorse.co.uk/html/shoko.html

He is back competeing.

Please don't slice the nerves in this poor horse's foot or PTS - give him this last chance. But please do it the right way.

^^^THIS^^^

 

[AmyMay]

But it is the ONLY option where you could find this horse back in full time work in just a few months....

Being realistic I would think that this is highly improbable where this particular horse is concerned. I'm not saying don't give it a go, far from it.

However, as the OP clearly states that the tendons and ligaments are damaged too, the most likely future for this horse is the field - and it is this (the ligament and tendon damage), rather than the navicular, which will most likely cause the horse's early demise.

 

[aran]

interesting.
my horse has navicular - no tendon involvement (higher grade navicular would involve the tendons and ligaments). True navicular disease is inflammation/pitting of the navicular bone with/or without surrounding soft tissue involvement - you need scans etc to determine.
he also doesn’t load toe first and doesn’t have a navicular walk

OP: with soft tissue involvement I wouldn’t de-nerve - the damage would continue to the soft structures but you can't tell (also any hoof problem cant be seen - bruise/puncture etc)
Barefoot Management is always something to try (no luck for my - now happily retired 13yr old!). But remember tendons and ligaments are very avascular so don't repair well (if at all) - therefore it would depend how severe the damage is.

 

[criso]

Being realistic I would think that this is highly improbable where this particular horse is concerned. I'm not saying don't give it a go, far from it.

However, as the OP clearly states that the tendons and ligaments are damaged too, the most likely future for this horse is the field - and it is this (the ligament and tendon damage), rather than the navicular, which will most likely cause the horse's early demise.

If you look at the breakdown of the horses at Rockley a fair proportion of them had damage to the soft tissue structures, (including mine who had damage to the DDFT, DSIL and Collateral ligament in both feet). Of course you can only be sure of the ones who are MRI'd, I know one of the horses down there who belongs to a friend of mine who has presumed soft tissue damage but hasn't been MRI'd .

You're right in that the last research done on this showed very poor prognosis for DDFT and Collateral Ligament damage but Rockley does seem to be rehabbing these.
I tried it as a last resort, personally wouldn't nerve block but that is my choice, and my horse is now in full work and competing.

 

[cptrayes]

Research has shown around an 80% failure rate in conventional treatments of taking horses with tendon and ligament damage inside the foot and returning them to full work. In other words, the 20% that are considered manageable by conventional means have already been removed, making the starting point much harder and yet there is STILL a FOUR TIMES better success rate!

Rockley Farm (and plenty of people around the country, me being one) have takes a horse which has already failed with the conventional treatments, and we typically return about 80% of them to full work.

The more the lameness is related to soft tissue injury and the less to bone/joint issues, the MORE likely it is that a barefoot rehab will restore the horse to full work.

 

[Luci07]

Interesting to read about the barefoot option and how it is done by experienced people. It has been a long time since I had to deal with nervicular - and thankfully in my case, horse returned pretty much back to normal. However, the treatments suggested (i,e bute or cutting the nerves) are normally the real "end of the line" suggestions so I wondered what else your friend had tried?

Having said that, and never having experience of looking at barefoot properly I would be very tempted to research that more thoroughly as there have been quite a few success stories on this forum about it - particularly as your friend isn't really asking a lot from her horse anyway.

 

[Oberon]

The horse in the OP has many pathologies and without seeing the horse in person it is impossible to tell what it's chances are.

With regards to navicular - it is often the case where it is damage caused by years of foot balance which is not appropriate for the horse. That's not to say that the farrier is at fault - but that perhaps, the horse required a balance at odds to a traditional foot shape.

When the shoes are removed and (supported by an appropriate diet and trim) the horse is allowed to grow the foot it wanted to in the first place, the navicular symptoms tend to disappear.

The tendons and ligaments which are also damaged - navicular is found with a toe-landing horse. Getting a horse comfortable enough to land heel-first (as nature intended) will relieve pressure on the tendons and ligaments and allow them to heal.

I might add that traditional treatments such as heart bar shoes attempt to recreate this. Barefoot just does the same thing much more cheaply

 

[monstermunch]

I would definately not consider something as severe as de nerving. They always grow back eventually and merely mask the problem that exists. i would definately consider taking this horse bare foot. If your other options are not very good you have nothing to loose and eveything to gain. I would really urge you to talk to Nic from Rockley farm. When there seems to be no light at the end of the tunnel there are always other options, and Nic will happily give you experienced and well thought through advice. my mare has been lame for 3 years with colateral ligament damage and is an extremely fiit sore horse. 2 weeks at Rockley farm and the difference in her was phenominal. It's not easy but well worth the time in researching the bare foot option.

 

[Chestnuttymare]

I can only speak from my own experience...due to illness/medical problem, i have no feeling in my left foot (and leg etc) although it is numb it is quite uncomfortable, it is hard to explain but I also don't know exactly where I am putting my foot. After 3 years I am sort of used to it, but it feels heavy and horrible. It might be different for a horse but i really don't know so for that reason I wouldn't do it.

The other thing is that a horse i know has navicular, mri scans, tildren injections, remedial shoeing, all of which worked for a while then it got bad again. Out of desperation the owner removed the shoes and the change was evident overnight. We couldn't believe it. Might not be a bad thing to give it a go before doing something drastic. Really nothing to lose, it's certainly cheaper

Would be good to hear if she goes for it and how they get on.