Navicular oedema and no soft tissue damage

[j1ffy]

Sorry guys...yet another navicular thread!!

My 6yo has been barefoot and self-trimming with a brief exception when he went away to be backed at 3. As he's grown, he's occasionally had flares but has always landed centrally and heel-first, been good on all surfaces and developed a good digital cushion. Definitely not hammered on hard surfaces or overworked.

He had a break in Dec / Jan while I was on holiday and was lame when I got back on - seemed ok on flat surfaces and soft surfaces, but really struggled on a camber or hard rutted ground, far worse on the off-fore. My brilliant hoof guy couldn't see anything, x-rays showed perfect hoof balance but small sidebones and possible changes to the navicular bone in the off-fore. Vet said I could continue riding on the soft and we could Bute for a couple of weeks to see if he came right, but I said no thanks - lets get a MRI.

MRI was last Monday and mild to moderate oedemas irregularity of the distal border of the navicular bone on the off-fore, similar but less pronounced on the near-fore. No damage to any soft tissue - I double-checked with the MRI vet who confirmed the DDFT and collateral ligaments had nothing on them at all.

As I've had a navicular horse in the past (went to Rockley) and therefore became part of the 'navicular community' I'm pretty familiar with the research and usual diagnosis, and the usual barefoot rehab mantra that soft tissue injury precedes navicular bone issues. Chilli's MRI has had me and my hoof guy scratching our heads. The vet recommendation is steroid injections, 3-6 months paddock rest and a cycle of shoeing in wedges to ease the pressure on the oedema.

He's not had any treatment yet but Chilli's very happy in himself and totally sound on his (now soft) field, seems happier walking the road to and from his field and is only lame when he does a tight turn on a camber.

Has anyone else had a similar diagnosis? If so, how did the condition progress and what treatment worked?

 

[ycbm]

Am i right in thinking he's a PRE with upright angles and a muscly body on small feet?

I would be tempted to think that he has just put too much pressure on his feet as his body builds up with maturity, inject some steroids to calm the inflammation down, and start again as if he was very unfit, possibly after some time off.

I have a similarly odd case with "navicular syndrome" symptoms in both hind feet, but slightly deformed pastern bones to explain it.

I hope you get Chilli back to full health soon.
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[HelenBack]

Yes me. My horse had mild changes to the navicular bone in both feet and bone oedema in the left fore only. No soft tissue damage. The vet said that she didn't think the bone changes were all that significant and she might expect to find that in other horses of his age so the bone oedema was the main relevant finding.

My horse was shod at the time and his feet had got into a shocking state without me realising, I should have seen the mess they were in sooner but you can't change things. Anyway he had terrible imbalances and all sorts so I took his shoes off and he went out for the winter to let his feet sort themselves out. I did do some hand walking in boots with him but stayed off him for about six months I think.

He did have a steroid injection at some point but it made no difference and I think the main thing that helped was time. He was OK in the end though, although he has other problems now.

I think the rest will probably be the main thing that will help your horse but I don't see any harm in trying the steroid, even though it didn't help mine, as with a bit of luck it might just help the inflammation come down.

It's probably also worth saying that in my horse's case he has hock arthritis and we wondered if the forelimb issues were secondary to that but he's older and has done quite a lot so hopefully this isn't the same in your case.

 

[j1ffy]

Am i right in thinking he's a PRE with upright angles and a muscly body on small feet?

I would be tempted to think that he has just put too much pressure on his feet as his body builds up with maturity, inject some steroids to calm the inflammation down, and start again as if he was very unfit, possibly after some time off.

I have a similarly odd case with "navicular syndrome" symptoms in both hind feet, but slightly deformed pastern bones to explain it.

I hope you get Chilli back to full health soon.
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His angles actually aren't very upright, his hooves are pretty normal and standard sized (unlike Pocholo, my previous navicular horse). His action on the other hand is very Spanish - high knee action and he hits the ground pretty hard when worked up so your diagnosis is probably right.

So sorry to read about Ludo, it's a freak-ish thing for him to have and I really hope you can find a way to manage it. It would help if vets stopped talking about 'navicular disease' (which the vet hospital used when giving me the MRI results) and talked more about the actual issues.

Yes me. My horse had mild changes to the navicular bone in both feet and bone oedema in the left fore only. No soft tissue damage. The vet said that she didn't think the bone changes were all that significant and she might expect to find that in other horses of his age so the bone oedema was the main relevant finding.

My horse was shod at the time and his feet had got into a shocking state without me realising, I should have seen the mess they were in sooner but you can't change things. Anyway he had terrible imbalances and all sorts so I took his shoes off and he went out for the winter to let his feet sort themselves out. I did do some hand walking in boots with him but stayed off him for about six months I think.

He did have a steroid injection at some point but it made no difference and I think the main thing that helped was time. He was OK in the end though, although he has other problems now.

I think the rest will probably be the main thing that will help your horse but I don't see any harm in trying the steroid, even though it didn't help mine, as with a bit of luck it might just help the inflammation come down.

It's probably also worth saying that in my horse's case he has hock arthritis and we wondered if the forelimb issues were secondary to that but he's older and has done quite a lot so hopefully this isn't the same in your case.

That's helpful, thank you. The vet did do flexion tests and Chilli's fetlocks and hocks look good so hopefully nothing that's developed there yet..!

 

[pistolpete]

It’s such a puzzle as he’s been so good up to now. The rest has to be worth doing frustrating as it is and maybe he will becoming wonderfully mysteriously sound. I would have bodywork done too as any subtle compensating could be going on. Fingers firmly crossed.

 

[j1ffy]

It’s such a puzzle as he’s been so good up to now. The rest has to be worth doing frustrating as it is and maybe he will becoming wonderfully mysteriously sound. I would have bodywork done too as any subtle compensating could be going on. Fingers firmly crossed.

Thank you, fingers crossed!! He's such a happy soul and loves to exercise his brain.

He had physio jus couple of weeks ago and his shoulders were tight, which we'd predicted given the lameness. He'll get plenty more while we rehab, she's very local and always happy to pop in

 

[Boulty]

Obviously no direct experience of this but would be tempted to either rest him or do light inhand work on surfaces he’s comfortable with for a few months with no sharp turns / movements that might aggravate things. Would be tempted to ask your vet / physio if laser therapy might be helpful with the bone oedema. Definitely helped with the swelling when the idiot sliced his jaw down to the bone last year and our laser person at work gets some awesome results.

See how he is in a few months. If all ok again would chalk it up as one of those things. We did have an extended period of horrible frozen ground that I think would have been in the period you were away. If he’s gone charging around like a loon on it I wonder if he could have caused deep bruising that would then have led to oedema (just musing… probably not right but just a random thought) Not quite sure what I’d do if it doesn’t settle down though.

I’ve spent quite a lot of time trying to figure out WHY the fuzzball lands so laterally and what to do about it. Our mutual awesome hoof nerd scratched his head about it and asked various colleagues and eventually concluded doing anything too aggressive might lame him so leave well alone (he also has sidebone but probably to a greater degree, can send you X-rays if you wanted to compare). He’s moving straighter & has better feet in general since being on a track. We never really figured out what was causing the compensation other than possibly the sidebone. He still doesn’t deal well with rutted ground so I boot him as a precaution when things freeze and that seems to work for him.

 

[Michen]

Boggle has bruised front feet (diagnosed via MRI) as a youngster. Despite having done basically nothing and I’d been careful with ground.

I’d have to dig up the report, there was definitely no mention of the navicular but I’m sure it would have turned into similar words as to what you’d received if it had continued.

I rested him for most of the summer and I think took his shoes off.. can’t actually remember. Either way he turned out mostly fine bar a short lameness stint in one fore when I stupidly ran him on harder ground than ideal.

ETA found report if helpful. Attached.

I forgot my ex racer also had the navicular bruising diagnosis. His feet were terrible, under run etc. I’m afraid the prognoses wasn’t good and they advised steroid injections which, if I remember correctly, had a success rate of bringing them sound for “up to 12 months”. He was PTS but he had a lot going on and the front feet were not the worst of it. His were undoubtedly caused by terrible angles and it was a surprise to us all that there were no soft tissue structures involved.

 

[Michen]

Attached also report for the diagnosed navicular bone bruising- hope it’s useful in some way.

I ignored the advice and took his shoes off. Did turn him away and he seemed much better in front but the rest of the issues were just too much.

If I was in this position again with this diagnosis I would be turning the horse away for a year in the field minimum.

 

[j1ffy]

@Michen You've been through the mill there. It sounds like your ex racer had the classic navicular hooves - low heels, long toes, likely torn DDFT as well I've copied Chilli's report below, it looks quite different

@Boulty I'll ping over the x-rays for comparison! Our mutual vet friend has also been helpful. Your boy's lateral landing is odd, maybe it was a compensation while he grew and not just the change to a track system? Who knows! Glad he's better now though

My vet (finally) called last night. He was basically saying that Chilli has navicular disease, it's usually degenerative, hard to say how long he'll stay in work for...all the usual navicular stuff. I reminded him that I've managed my other PRE with navicular for the last 12 years without a lame day! We agreed to focus on treating the oedemas so Chilli will have cortisone injections asap, rest for at least 3 months, probably more, and potentially Osphos - the latter doesn't have great success rates but he reckons that when it works, it works well and is low risk (whereas Tildren has a higher colic risk). To be fair to him he did say his hooves are great and just to keep the toes short, I had expected him to push remedial shoeing.

He also said I could ride in walk in the arena if that's something I'd like to do. It's not, so I won't!

MRI report:


ETA the remodelling of the coffin and pastern joints were viewed as not clinically significant and the side bone was considered an incidental finding.

 

[ycbm]

Has anyone any idea how the chip fracture happened?

I'm wondering if he had an absolute mad fling on some hard ground while you weren't watching and damaged both feet, one worse than the other.
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[j1ffy]

Has anyone any idea how the chip fracture happened?

I'm wondering if he had an absolute mad fling on some hard ground while you weren't watching and damaged both feet, one worse than the other.
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They don't seem to think it's clinically significant but yes, that's my theory. I think it's the only thing that fits with the chips and oedemas and he was out on the very frozen ground during his (and my) holiday.

 

[tyner]

@Michen You've been through the mill there. It sounds like your ex racer had the classic navicular hooves - low heels, long toes, likely torn DDFT as well I've copied Chilli's report below, it looks quite different

@Boulty I'll ping over the x-rays for comparison! Our mutual vet friend has also been helpful. Your boy's lateral landing is odd, maybe it was a compensation while he grew and not just the change to a track system? Who knows! Glad he's better now though

My vet (finally) called last night. He was basically saying that Chilli has navicular disease, it's usually degenerative, hard to say how long he'll stay in work for...all the usual navicular stuff. I reminded him that I've managed my other PRE with navicular for the last 12 years without a lame day! We agreed to focus on treating the oedemas so Chilli will have cortisone injections asap, rest for at least 3 months, probably more, and potentially Osphos - the latter doesn't have great success rates but he reckons that when it works, it works well and is low risk (whereas Tildren has a higher colic risk). To be fair to him he did say his hooves are great and just to keep the toes short, I had expected him to push remedial shoeing.

He also said I could ride in walk in the arena if that's something I'd like to do. It's not, so I won't!

MRI report:
View attachment 107728

ETA the remodelling of the coffin and pastern joints were viewed as not clinically significant and the side bone was considered an incidental finding.

Not to derail the thread, but wow, this is a nice and detailed report from your vet. Very helpful and clear analysis that helps present a view of the way forward. Is this normal to recieve? I have not got anything like this from mine. Now I'm thinking I should be demanding one.

 

[Hormonal Filly]

Not to derail the thread, but wow, this is a nice and detailed report from your vet. Very helpful and clear analysis that helps present a view of the way forward. Is this normal to recieve? I have not got anything like this from mine. Now I'm thinking I should be demanding one.

My horses MRI report was extremely technical but you should get a report from a MRI with their findings on. Sometimes it goes to your vet (if you’ve been referred to have the scan done)

Everything crossed @j1ffy I’m probably being naive but strange how such a young horse can get navicular, could it just of been him running around on hard ground? I always thought of it as a ex racer or poor foot angle issue. Especially as he’s been barefoot. Usually less pressure than shod etc.

If it’s worth mentioning my friends 8yo ISH (did some BE before she bought him) had a very similar diagnosis a couple of years ago. She took him barefoot, gave him some time off. He would occasionally have a lame step out of the stable but she sold him as a happy hack, he passed a vetting. He’s now shod again and no further issues.

 

[PinkvSantaboots]

My Louis had changes in the navicular bone and bruising of the surrounding soft tissue one front leg was worse than the other, he had osphos and steroids in the navicular bursa I also took his shoes off and he was basically living out and was sound after about 3 months rest, brought him back into work and his been fine ever since is still barefoot that was about 4 years ago his 18 now, I've not had any other treatment for it but I am careful on hard ground and I don't jump at all.

 

[j1ffy]

Chilli had his steroid injections this afternoon so we're now on a 12 week countdown to vet reassessment to see if he's sound.

@Hormonal Filly and @Pinkvboots - I have another navicular horse who I sent to Rockley Farm for barefoot rehab 12 years ago, age 6. He's been in full work and barefoot ever since (and done everything to the limits of his scope - affiliated dressage, unaffiliated SJ and ODEs, long distance rides on all surfaces), and Chilli's been on the same barefoot regime since he started work. Both vet and hoof guy say it's not to do with his hoof balance or shape as both are very good, and there's no soft tissue damage.

I asked the vet today if it could have been caused by galloping around on frozen ground but he said that would usually show up in the pedal bone. His view was I could drive myself mad trying to work out what's caused the issue and we'd never know, we just need to manage it as best we can!

@tyner - my understanding is yes, you should get a report like that from a MRI. Frankly having paid £1500 for it, I'd have been pretty p*ssed off not to!

 

[_hrriddell]

@j1ffy hi, hope you don’t mind me jumping on to this but my horse has just been diagnosed with the same as yours and I’m really struggling to find anyone with similar experiences! I think in my horses case it was triggered by an intense jumping session as he has oedema in both his pedal and navicular bones. He is quite a bit older than yours though (16). Id love to be able to do riding club stuff again, low level dressage and ODEs.

How did your horse turn out? Is there anything in particular you did that you’d say helped? Thank you