Navicular - Tildren, Navilox etc

[roxy007]

Hi - my mare has navicular problems diagnosed in all four feet which apparently is very unusual. She has competed internationally and has had bit of hard life by way of lots of hard work and concussion on her feet and legs but that was way before we got her. I've had her for four years and althugh she came with ligament and tendon probs she has got over these and came sound enough for light hacking. Last April she became lame for no apparent reason and after all the usual things, rest, bute for short term etc she was referred to a specialist who diagnosed this around christmas time. She has been improving with a fab remedial farrier but when I queried trialling either tildren or navilox etc the junior vet I saw yesterday when she was back for review basically brushed it aside and said neither had any scientifically proven benefit. Could anyone who has used either with good or bad results get in touch. I really want to look into this in more detail but first need to know how they both work basically in the body, how long any improvement is likely to last and what the side effects/risks are in the use of either. Or - are there any other treatments being trialled that a horse like this could be a candidate for. She is not particularly old at just 15 this year and although she is doing well with remedial farriery and some amazing shoes I can't see the harm in trying to improve her more if its possible. Any help much appreciated. I had heard there was a new treatment around that was being trialled just now but not able to find out much about it and think it may be being targetted at younger horses but again as I say its very difficult to find out much more at the moment

 

[ihatework]

Navilox is an old drug that the general consensus is does begger all for navicular. Very few vets will now prescribe this as it is generally seen as a waste of money.

Tildren is a much newer drug and is out of the main trial phase and now has a British license. It works by altering the ratio of bone modelling cells. Controlled trials have shown good results in some horses, but it is not a cure all treatment and doesn't work on all horses.

The trouble with navicular is that is is so difficult to pin point what is the clinically relevant injury/source of pain within the hoof.

I have a horse that had a diagnosis of 'navicular syndrome' 2 years ago, for a variety of reasons I decided not to go the full MRI route which would be the ideal scenario. He had minor changes on his xray, the main change was consistent with the increased lameness on one particular foot. However some associated soft tissue damage was thought likely too.
We threw a variety of treatment at him all at once (tildren, shockwave, synequin, changed shoeing) and the horse was completely sound and back in work within 2 months, and doing light dressage/sj on a surface within 6 months.

Did the tildren work? I haven't got a clue I'm afraid.

It cost approximately £500 a time, I had the vet infuse the horse at my stables. The main known side effect would be mild colic symptoms, mine was a little off colour but others I have seen treated haven't had a problem.

 

[BigRed]

Ben and Jerrys- what a good, concise answer !

Hayzdaze, if you aren't happy with what your young vet said, why not speak to the head vet and ask for a clearer reason why you can't try these drugs.

 

[roxy007]

I will speak to the vet we have been dealing with when he returns to the practice tomorrow but wanted to have some facts to hand before i stumbled in with half a story ......lol

Are there any other known treatments etc that anyone knows of. I know its not good news and I don't need reminded of that

but I feel we've come this far and if there is a chance I would like to give my girl that chance. She is not hopping lame by any means and copes well without bute but if there was a chance she could become more sound then why not

 

[warmbloodkwpn]

We have used tildren very successfully, and I have heard alot of positive anecdotal evidence. Young vets straight out of uni tend to cite the textbooks (I know I've got one for a daughter!!). There is limited empirical support as yet but I know many experienced equine vets are using it. So I would give it a go, but it does cost £4-500. If you can afford it, it is worth getting MRI scans done first, then you'll know the extent of the problem. Good luck.

 

[alsiola]

There is some quite convincing evidence that Tildren works. There is a good review paper here:
http://linkinghub.elsevier.com/retrieve/pii/S0737080608000683
It will cost to look at it but your vet may have free access so you can direct them there.

 

[alsiola]

Or another paper here, with a free abstract that sums up the important bits:
http://avmajournals.avma.org/doi/abs/10.2460/ajvr.68.3.329

 

[roxy007]

Just had this from my vet after e mailing him - really disappointed as it was something to maybe give her a bit of hope :-(

My personal experience with the drug is not good, infact I cant tell you of a single case where it’s made a difference

 

[cjdjivanovic]

It's only anecdotal evidence, but a friend had her horse treated with tildren and it worked - she was delighted. If your vet is so against it, try and get your horse referred for a second opinion; it sounds like he is against tildren in any circs, ie doesn't just think it's inappropriate for your horse but is agin it full stop; and that seems strange.

 

[roxy007]

Been told that Gallium Nitrate is of the same family of drugs except the gallium acts also as an anti inflammatory. Anyone had any experience with this?

 

[apc2614]

My mare has been diagnosed after an MRI with palmar cortical collapse of the navicular bone in her off fore - she's been lame on and off since April. We were going to have a Palmar Digital Neurectomy but my vet suggested we throw all of the non-aggressive treatments at her first! Anyway she is now sound and has just had her first Tildren last Saturday. She is running about like a lunatic and we had a long hack on Sunday for 90mins and a very excited and sound canter on the way home (somewhat unexpected) so we are on top form. We've ordered Gallium from George Ebey and we are also having xrays before she has new (possibly egg-bar) shoes at the beginning of July. We are also trying Navilox - so the poor girl is rattling!

I'd be interested in finding out about the Calcium Dobesilate trials underway which are mentioned on another post - does anyone know about these?