Navicular disease and severe lameness??

[spla]

Hi everyone, I am new to the navicular world with my horse only just getting a diagnosis last week so I'd like to pick your brains please (I'm desperate for some good news stories)

My 19 year old gelding has been on/off mildly lame on his left fore for the past 7 weeks. Vet came out last week, couldn't find anything obvious in either of his legs so we decided to nerve block/xray. He was positive on flexion and came sound with a PD nerve block. X ray of the hoof showed changes to the navicular bone (X-ray is below). The vet gave a steroid injection into his coffin joint and I got natural balance shoes on in front. According to the vet it was a very "textbook" navicular diagnosis.

Over the next 8 days he improved and got to the stage (2 days ago) where he was sound in walk and in trot on soft ground but still slightly off in trot on concrete. Last night, out of the blue, he became extremely lame, not bearing weight on that same leg. Really struggling to move around in the stable. This morning he was similar however he does improve a lot after walking, even after just a few strides (although still obviously lame in walk and as soon as he stands still for 30 seconds he is very sore/hardly weight bearing to move off again) Vet does not think the navicular could have caused him to be this severely lame and suspects an unrelated problem, likely an abscess. It just seems to me the odds of him getting something on the same leg within a week are crazy. Have you ever known navicular to cause severe lameness? Does the improvement after walking suggest this could be caused by the navicular issues? I'd love to hear any of your insights!!

(He has been living out during the day and stabled at night).

 

[Shay]

I've not seen Navicular cause such significant lameness so quickly. I've owned one and observed another on the yard. Could it be lami from the steroids? Or connected to the shoeing? Non weight baring within days of shoeing might suggest a nail prick?

 

[ycbm]

Your vet seems to be VERY out of date.

There is no such thing as a 'classic navicular diagnosis' from x rays of the navicular bone alone any more. Navicular is now described as a syndrome because of the number of structures that can be involved.

The vast majority of lameness in the navicular area is now known to be caused by soft tissue damage which can only be diagnosed buy MRI scan.

It is also reckoned that a high proportion of sound horses will show navicular bone changes. The condition of the bone is not relevant unless it's severe. Yours doesn't look brilliant but it still may not be the cause of the lameness.

Lameness can be sudden and severe if a ligament or tendon has had some sudden damage, but it's far more common to come on slowly.

From your symptoms I'm suspicious you had nothing more than a grumbling abscess and it will erupt soon. Given the age of the horse I would test for Cushings.

If the low grade lameness returns and continues, the most likely way of resolving it is a barefoot rehab.

Hope that helps.

 

[splashgirl45]

i would be very concerned that it could be laminitis after a steroid jab. my old mare had symptoms that fitted with navicular but her navicular bone was almost perfect , we didnt mri but treated her as if it was soft tissue damage and i wouldnt have steroid injections as she had cushings and i was worried it might cause laminitis. she came right after box rest for 10 days and then in a pen in the field for 2 days and on the 3rd day she decided she wanted the whole field so i didnt try and keep her in the pen anymore, i hacked her in walk for ,i think, about 4 weeks but cant now remember , i was supposed to start with a short while in hand but she was leaping about so vet said ride her ...

 

[Zuzzie]

Your vet seems to be VERY out of date.

There is no such thing as a 'classic navicular diagnosis' from x rays of the navicular bone alone any more. Navicular is now described as a syndrome because of the number of structures that can be involved.

The vast majority of lameness in the navicular area is now known to be caused by soft tissue damage which can only be diagnosed buy MRI scan.

It is also reckoned that a high proportion of sound horses will show navicular bone changes. The condition of the bone is not relevant unless it's severe. Yours doesn't look brilliant but it still may not be the cause of the lameness.

Lameness can be sudden and severe if a ligament or tendon has had some sudden damage, but it's far more common to come on slowly.

From your symptoms I'm suspicious you had nothing more than a grumbling abscess and it will erupt soon. Given the age of the horse I would test for Cushings.

If the low grade lameness returns and continues, the most likely way of resolving it is a barefoot rehab.

Hope that helps.

I agree wholeheartedly with this post. Over the years I've had 2 horses diagnosed with navicular. Both horses were competing in dressage and as a result of the diagnosis their careers were ended and they became happy hackers. Some time later, both horses came sound. I now believe they had soft tissue damage which just took time to resolve. Its a well known fact that Xrays will show changes to the navicular bone in both lame and sound horses!

 

[spla]

Your vet seems to be VERY out of date.

There is no such thing as a 'classic navicular diagnosis' from x rays of the navicular bone alone any more. Navicular is now described as a syndrome because of the number of structures that can be involved.

The vast majority of lameness in the navicular area is now known to be caused by soft tissue damage which can only be diagnosed buy MRI scan.

It is also reckoned that a high proportion of sound horses will show navicular bone changes. The condition of the bone is not relevant unless it's severe. Yours doesn't look brilliant but it still may not be the cause of the lameness.

Lameness can be sudden and severe if a ligament or tendon has had some sudden damage, but it's far more common to come on slowly.

From your symptoms I'm suspicious you had nothing more than a grumbling abscess and it will erupt soon. Given the age of the horse I would test for Cushings.

If the low grade lameness returns and continues, the most likely way of resolving it is a barefoot rehab.

Hope that helps.

Thanks all for your feedback. I have recently relocated and this is a new vet, first time getting him out was for this. Although he is from a specialised equine clinic and YO/the whole yard have used him happily for years... I wish I could have MRI'ed but it is I just can't afford it (quoted £1500 and no insurance due to his age). I know there is something more/unknown going on and it is killing me not knowing exactly what.

He is on box rest and he has improved a lot today, is now happily putting weight on the leg. At about a 2/10 lame in walk but still severely 7-8/10 lame in trot but is at least readily moving around the stable. He will let me lift the bad leg but no chance of getting the other front leg lifted as he won't put his weight completely on the bad leg.

Legs and feet are still ice cold with no swelling but he has quite a pronounced digital pulse it that one bad leg only which makes me worried about the laminitis?? He doesn't have the characteristic stance though and is standing square. He has no (diagnosed) metabolic issues so the steriods should not have been an issue (although he does get grass mumps after turnout and now im stressing that this is maybe a symptom of some underlying metabolic problem).

Surely if an abscess was making him this lame there should be at least some heat in the hoof by now?

I will get either the vet or farrier out on Monday to have another look.

 

[SEL]

Digital pulse in one leg is often abscess. Can you hot poultice?

I had my horse with advanced arthritis go hopping lame on Thursday night. The vet was due out for jabs on Fri anyway but somewhere between me fiddling around with the hoof pick, a poultice and the horse having a strop when his fieldmate went in the problem vanished. I did have that 'is this the end?' thought when I found him but an old YO used to poultice every lame leg and that's kind of stayed with me!!

 

[spla]

Update: 4 weeks later (of very mild lameness) we finally got a burst abscess. Horse now appears sound. The first day of hot poulticing resulted in a lottttt of puss.

 

[Meowy Catkin]

That's great news that it burst. Abscesses that linger on and on are just awful.