New Navicular Treatment - Tildren

[josephinebutter2]

Hi!

Has anyone tried this?

I understand this is give once only via an IV drip and supposed to be a very effective treatment for medular navicular i.e. the one where the inside of the bone degenerates.

My horse has just been diagnosed with this and my vet thinks this would be a good treatment.

Thanks!

 

[baybeejay01]

I have heard that it is very good in some cases and not suitable for all - I think the worse the condition is, the better the prognosis. My horse was diagnosed with Navicular but he wasn't bad enough (the changes in the bone were insignificant) and therefore not an ideal candidate for the treatment. He then went on to do his suspensorys through compensating for the discomfort in his front feet and the navicular is now irrelevant!

 

[ihatework]

Its not approved for use in the UK so your vet will need to obtain it directly from the company who owns it (Ceva) who are based in France I think.
It's very expensive so make sure you discuss costs with your vet and insurance company.
I have heard some good reports about it but it doesn't always work, however if it were my horse I would be going this route.

 

[josephinebutter2]

Yea- feeling your pain LadyLinney!

Mine has done his DDFT and SFT also - where they fork, on both insides - 4 months box rest minimum - he's only 6 poor bugger!

He has early signs of Navicluar and was only picked up coz he went lame with his Tendons!

My vet thinks the earlier treated the better so fingers crossed!

 

[hussar]

My horse was used as part of a clinical trial of Tildren two years ago after Navilox had been tried and failed. The Tildren also failed. At that time they claimed a 60% success rate - that might have changed now.

 

[josephinebutter2]

Oh dear hussar - not good. What was the outcome for your horse? Did you manage to keep riding with bute?

Have been doing my internet research and have found out some stuff.

At what level did your horse have navicular and what type? - aparently it only has a good success rate where the level is mild to moderate and the bone is degenerating from the inside out, although they are trying injections of a Tildren hybrid direcly into the foot for Navicular where the bone is degenerating from the outside in.

They have also changed how it is administered - used to be a small amount over 5-10 days - now it's just a one-off injection of a high dose.

Will keep you updated!

 

[BBs]

Havent used it yet - I have a horse with Ringbone and its hoped the Tildren will be help him.

Its now at the vets waiting for us to try, however, hes sound and we have been treating it conservatively all summer - at times I didnt know what to do, but atm it seems to have *touches wood* not got any worse, and my horse is sound.

However, should he go lame again *the vets are shocked that hes actually sound and managing to event at all* I will put him straight on the Tildren in hope he will come back and continue to event/SJ.

It took around 6 wks for Tildren to arrive, and my vet had to send off reports to teh French authorities - they had to decide whether he was a good enough case to receive the treatment.

 

[josephinebutter2]

Thanks BBs.

Not sure if it is licenced here now for navicular, or if my vets have been bulk buying(!) but I got dionosis on Sat am and he's going in this Wednesday to be treated!

Hope your one stays fit and sound as long as poss and it will be successful if needed.

 

[aran]

Just read a paper on it from the Equine Vet Journal 2003 Jun;35(4):407-13. Tiludronate as a new therapeutic agent in the treatment of navicular disease: a double-blind placebo-controlled clinical trial. By Denoix JM, Thibaud D, Riccio B.

They show good results with the high dose (total dose 1 mg/kg bw over 10 days) of Tiludronate (Tildren is the trade mark) but 17% failure with lower levels.
They recommend, for optimal results, that treatment occurs alongside remedial shoeing.
The most significant benefice of the treatment occurred 2-6 months after treatment. Tildren is a bisphosphonate which inhibit bone resorption and alleviate pain.

 

[hussar]

[ QUOTE ]
Oh dear hussar - not good. What was the outcome for your horse? Did you manage to keep riding with bute?

Have been doing my internet research and have found out some stuff.

At what level did your horse have navicular and what type? - aparently it only has a good success rate where the level is mild to moderate and the bone is degenerating from the inside out, although they are trying injections of a Tildren hybrid direcly into the foot for Navicular where the bone is degenerating from the outside in.

They have also changed how it is administered - used to be a small amount over 5-10 days - now it's just a one-off injection of a high dose.

Will keep you updated!

[/ QUOTE ]

Hi Jo

The old boy is still rideable and so far remedial shoeing and a daily dose of No-Bute have kept him going but not competable. By the time navicular disease was diagnosed they reckon he'd had it for about a year, so it was fairly advanced in both front feet. Happily, Xrays a year later showed no change, so degeneration, if happening, is at least slow.

It was the single high dose he got, with the option of a second but on vet recommendation I decided not to go for the second dose as the first had made no difference whatsoever.

Hope you have more success with yours if you go down that route.

 

[lornaA]

My horse, megan, was diagnosed with navicular in march then in june was injured in the field and damaged her hock. Her hock was diagnosed with early arthrosis of the tarso metatarsal joint which i beleive is an early bone spavin. She was reccommended for treatment with tildren as my vet said it had some promising results on bone spavin and that there had been some good results on navicular too. Megan had her tildren on 2nd of august, it took a good month to organise as vet as to apply for import licence then import it. The tildren is given through a drip mixed with saline and dripped in over approximately an hour. If the horse is tolerating it they can drip it in a bit faster if not then slower. The horse is then monitored for a short while again depending on the horses reaction. This is because it can have side effects such as colicy symptoms and very rare but seriously can affect the heart causing heart failure. Megan was fine tho and allowed home more or less straight away.

She was at vet last friday for check up and although still lame she's not as bad as she was. Vet says because she's still lame doesn't mean the tildren hasn't worked but that it can take time and to think on it as more of a long term thing that it should help protect against further damage. As megan is still lame he has given her a steroid injection into her hock to settle the inflamation.

I would recommend checking your insurance will pay the cost of treatment as it is expensive but i'd say worth a go. I would say tho that i thought tildren was only licenced for use on hocks and not licensed for navicular even abroad, its maybe changed tho as things do.

 

[Hollymav]

Jo, I would be very interested to hear how your horse gets on. My horse has been lame and after going through a whole series of nerve blocks, x-rays, an MRI scan, various medications and injections he is now possibly going to be having Tildren. Vet is coming out tomorrow to see him again and then i'll find out the costs etc!! He's no longer covered by his insurance and we are pursuing a loss of use claim so the costs for any treatment are now down to me!!
Hope it all goes well for your horse.

 

[josephinebutter2]

Thanks for all your help guys - much appreciated.

Insurance co. have said if the vet has recommended it, they will pay - didn't ask for costs tho.

I dropped him off at the vets this morning to have remedial shoeing, Tildren IV drip and shockwave therapy for his ligaments - got it wrong earlier - he's actually damaged both medial collateral ligaments on the insides of both front feet - not the tendons. So am anxiously awaiting a call!

Sorry to hear about all your injuries etc! Will keep you updated on my boy!

 

[lornaA]

please let me know how your horse gets on with its treatment

 

[josephinebutter2]

All went well at the vets yesterday.

He came back all happy having had a bit of mental stimulation for a day. He gets bored so easily at the best of times, let alone staring at the same 4 walls all day every day. Didn't need to be sedated for any of it - even the drip - what a good boy!

No side effects from the Tildren so far (aparently they can get colicy for the next 2-4 hrs) and had his shockwave therapy and HUGE round shoes on that stick out the back so far he has to wear over-reach boots even in the stable so he doesn't pull them off!

Have been advised that 10 mins hand grazing twice a day will be beneficial to increase circulation, which I'm sure he will be pleased about. But have been told he must remin quiet and only walk - unfortunately no-one seems to have told him this! Am now looking into calming supplements.

Am told it will be 2-6 months before we will be able to see if the Tildren is working. And 4 months before his ligaments are all better if all goes to plan.

Any tips for keeping him calm and amused during box rest will be much appreciated!

Jo x

 

[aran]

when aran was on box rest (2 months only coming out to be mucked out - he didnt seem to mind and didnt get depressed) he got lots of little small-hole hay nets around his stable, snack-a-ball with spillers high fibre cubes, happy hoof with some carrots (and a vit min as no real sunlight in the stable etc) as many times a day as possible, swede on a string, apples in water bucket (caused much mess!), lots of grooming, cuddling and I used to put on and take off his stable bandages regularly. when i started leading in hand i put him in a bridle on a lunge line in case, and he was on naf calmer.

good luck with the tildren

 

[Santa_Claus]

My lad was treated with Tildren for both Navicular and Bone Spavins (my poor baby!) about 7 or 8 weeks ago now. They say if there is improvement by week 6 it is positive but if nothing by then it is most likely to be non effective.

Well Before the treatment he had actually developed a strange gait as he found it so hard to turn in circles, and when coming down hills had to do so almost sidewards. He had been off work for a few months at this point (not been in regular work for nearly 2 years !!!!!!)

Well now he is although not 100% sound is 90% of the way there. He still is rotating the footfall of his off fore (the worse affected) but this is improving all the time, and he is being ridden again (only walk and a bit of trot so far). My physio saw him about a month before he was treated and then about 5 weeks after and she said the improvement is very significant, and i have to agree.

He also has remedial shoeing which consists of hind shoes on his front feet and raised heel pads.

Prognosis wise for him we are not sure yet, I am just taking it as it comes, aim is to get him back competeing dressage (were schooling Advanced Medium before things went wrong!) and if everything went perfectly low level affiliated on a surface only but I'm not going to push that side of it although he would love it if i did!

One interesting thing is that Dan didn't have any box rest he went straight out. He was at a point where it was too uncomfortable to prat about in the field anyway so vet advised to allow him to go out so that he could keep moving and therefore improve the blood flow! Granted the first few days was in the small starvation paddock by the yard entrance so that he could have a close eye kept on him but that wasn't actually specified was just us using common sense

 

[josephinebutter2]

Thanks!

My boy's only on box rest coz of the ligaments - if it was just the navicular, he could go out.

We got the navicular really early, so he would not have been lame with that anyway - so only way to judge if it has worked is to do more x-rays in 2-4 months (when his ligaments have healed) to see if nav. bones have deteriorated further, stayed the same or got better!

Vet says if they stay the same or get better, he should not have any problems. Will even be able to hunt/event! I will still make sure I don't do too much on hard ground tho just in case - tho I never did anyway. Hardly did anything this summer due to dry conditions.

Thanks for the tips on box rest. He has been surprisingly good so far. Have 2 small holed haynets either side of the stable, have lickit and snack-a-ball with his top spec in and has a scoop of chaff with carrots twice a day.

Only problem is when he did come out for his grass walk he was very over excited. All last winter, he stayed in at night and when I turned him out every morning, he would leap in the air when we were on the way to the field! Cant have him doing that now tho. Vet has recommended a calming/stress relieving supplement, so I may try that if he is naughty tonight.

Jo x