Worried navicular??

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jessieblue

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Hello all, I am in a real dilemma! My horse was sick 4 months ago, started with fever, he was referred to RVC for treatment. He was very sick but they couldnt find out why. Anyway he was treated with pen and gent antibiotics and got better in a week. Last injection gave him an abcess which made him terribly sore on his hind end, he could barely walk and he was in pain and swollen for anpther 3 weeks or so. When he returned from RVC after 10 days and I was walking him out daily I noticed he was footy on sharp turns especially on concrete. I was not sure if this was to do with his sore hind end so didnt do much about it until his back end was better and then he suddenly went lame in trot on both front feet! Heat in feet digital pulses and soreness to hoof testers at seat of corn area. Diagnosis after suspecting abcess/bruising (he hadnt been anywhere to get abcess/bruising but whatever) was stress/concussive laminitis. Very mild because he was never hopping lame. A week of box rest and restricted diet and he seemed fine. Was shod with heartbar shoes and was sound for the next 8 weeks. He is now back in regular shoes and on friday I noticed him sore on turning again!! He had just been ridden and he was in no way lame in the menage, no way! But turning away on hard he was a little scratchy. Next day he was sound on straight line but even more sore on turning!! We are now poulticing again, heat in the foot a little sore on toe with testers, but its def not an abcess as this happened before! I had started jumping him a couple weeks ago and he has been absolutely fine. I have been very closely watching him!! So I now suspect navicular or some sort. He has good feet, maybe could do with a little more heel, but not bad and not at all contracted. His feet were x rayed for pedal bone rotation when he was suspected to have laminitis. X rays were normal. Not sure if they wuld have shown navicular bone coffin joint etc. My question is, would you advise me to ask for an MRI scan straight away?? I wont be insured as I have maxed out my insurance with oprevious claim. I dont want to pay my vet for several visits to nerve block and ultrasound only to need an mri after. There is no more money in the pot really, but I need to get to the bottom of this quickly so I can decide whether to turn him away for the rest of the year. My farrier came out and took his shoe off and put a pad on to protect his sole, when he put the shoe on with the pad my boy was hopping lame, so obviously this aggravated something!! Subsequently vet came out and took shoe off to poultice. All to no avail, horse is still the same! He does have quite flat soles, not sure if this means he is more prone to navicular or not. Otherwise his conformation is pretty good!
 
Although you say he has good feet, I think the problems you are having suggest otherwise, unfortunately. Pics would be really helpful, as its hard to guess what might be going on without seeing the hooves.

Flat soles and footiness on stones even in shoes suggest thin soles and/or laminitis/soleitis (inflammation of the solar corium). Lack of heel suggests he has under run heels. Footiness on turns could indicate either laminitis or navicular (or possibly other things too). It's hard to offer any more specific info though, without seeing the feet. I think your best bet would be to get a vet out for a lameness workup and go from there.
 
Hi and thanks for the replies. Yes I have already had the vet out. This was why I was interested in asking for MRI scan rather than wasting another 1000 on lameness workup and then having MRI. Vet wasnt too interested in MRI he seems to think its bruising, but I think not! He had cushings and EMS blood tests done and all normal which means its less likely to have lami, but who knows?? I say he has good feet as thats what I have been told by farrier and vet. They look ok, but will try and get pics for you to see.
 
Ah I see, sorry thought the vet was historical.

In that case, before spending £1k+ on an MRI I would try treating him as though it were laminitis now for a good week, and monitoring closely for improvement. That'll mean taking him off grass entirely, I'm afraid, and feeding ad lib hay that has been soaked for at least 12 hours. That and nothing but fibre feed in the bucket as a carrier for some minerals.

If there's a significant improvement on the above regime then it's highly likely that laminitis is your culprit. If not, then you've ruled it out and can safely pursue other possibilities.
 
Ok well that does make sense! As I said the vet and farrier both said not laminitis, but Im not convinced entirely myself. He is not walking like a laminitc at all, its only 1 foot at the moment, foot was cool today no elevated pulse. Again this is very similar to before really. My vet explained to me that most horses only get lami if there is an underlying cause. The cushings and EMS tests were normal. Does this not really mean very much?? There is a lot of information to do with laminitis and cushings at the moment, all very confusing. Also does anyone know if laminits would show on MRI scan?? Is there any way of telling if a horse has laminitis or not? Thanks for advice.
 
Well, several days on and my horse has both front shoes back on with pads. This time not painful after the shoe being put back on. After shoeing he was trotted up and looked to be sound, but still a little sore on the turn to the left, which was the affected hoof. Looked to be comfortable otherwise. The hoof still felt quite hot. This was on wednesday and I left him a couple more days for things to settle as the hoof was still warm and he was still off on the turn. Today, hoof feels much cooler, it now matches the other three, but he is still sore on that turn. Fine turning the other way, but just turning tight to the left is very slightly sore. I have attached pics of his feet for your advice. You will notice on the unshod left foot he has a chunk of hoof missing. This was actually what looked like a puncture that was high up on the hoof when I first got him last year. It has grown down and now is crumbling away as it has nothing to protect it. I just wondered if this could cause pain if there is exposed sensitive laminae or soreness when loading that side of the hoof like if we has a split in our nail and you pressed on it?? I dont know just hoping for a miracle!

Hmm, it seems I cant attache pics of feet as I dont know how!! Will try to add them any advice on how to welcome!!
 
I'm really sorry, but those are very unhealthy, unbalanced hooves and are definitely demonstrating the under-run heels/weak caudal hoof that is associated with a greater risk of Navicular.

The chunk of hoof missing is not a problem.

Look at Rockley farm as there is a lot of interesting information RE rehabilitating navicular horses on their blog.
http://rockleyfarm.blogspot.co.uk/
 
I'm sorry to say OP that those are not healthy hooves :(. Have the vet and farrier discussed with you a way forward for growing some healthy feet?

ETS: cross posted with Faracat :D
 
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I'm not an expert but have learned a lot since my girl was diagnosed with navicular. Your horse's feet don't look balanced to me and heels are under run so even if not navicular that could be reason or discomfort?

My girl was eventually diagnosed after thermal imaging showed problem in heel area. X rays aren't always helpful unless you've had them previously enabling you to see any changes from one set to another.

Navicular is manageable, my girl is well, ridden 4 times a week on average. I don't compete her but that's my personal choice :)
 
Thanks for your comments. Its interesting. Vet and farrier keep saying his feet are ok. I asked speciafically again my vet the other day when I took these photos. His words after looking really closely were, they are pretty good. Ok he could do with a bit more heel but so could every horse!! Farrier has been similar. He knows I am concerned and both know I have been banging on about "navicular" since the beginning. But neither have given me any feedback that the shape of his feet could be at the bottom of it. When you say navicular, do you mean the boney change type of navicular pain versus the ligamentous issues?? So I can assume it is indeed a navicular problem I am dealing with! He wasnt lame when he was at RVC. He was treated there for fever of unknown origin and then he developed penicillin injection reaction and was sent home with a care plan. They didnt notice any lameness, it was when he first came back I noticed him being uncomfortable just sometimes when walking across slopes on the hard. Can I assume the heat in the hoof and sensitivity to hoof testers would all be consistent with navicular syndrome too?

Oh yes he was also x rayed in march to check orientation of the pedal bone. The vet checked his foot balance which he said was pretty good. He said to ask farrier not to take anything off the heel and to let that grow a bit but otherwise was ok?? Go figure. Could this be due to bad farriery? I mean should I be looking for a new farrier if these problems havent been picked up and addressed? Its a shame had the same farrier for a long time.
 
OP, if you look at the top part of the hoof, just under the coronet band, can you see that the first centimetre or so is growing at a much steeper angle than the rest? This steeper angle is called the 'healing angle'. It is the angle at which the hoof wants to grow. As you can see on your horse's hooves, this angle is vastly different from the angle of the majority of the hoof.

You would also find that if you were able to grow a hoof following the healing angle, that the heels would just pop into the right place. It's troubling that the vet says 'what horse doesn't need more heel', as that suggests that all of the horses he treats are suffering from this problem!

I've never seen a hoof grow in at the healing angle with a shoe still on. That's not to say it can't happen, but I don't think it's an easy thing to accomplish. I imagine if you took the shoes off, however, the new hoof growth would grow down at that nice steep angle.
 
My girl had been for two lameness assessments and was sound at both so I decided on thermal imaging. Having shown the vet the images they used heels as starting point.

I used Clare from the Inner Picture www.theinnerpicture.com have a look at her website. Interesting even if not in our area. I was sceptical so didn't tell her anything about my girl and opted for a full body image so as not to give any clues. LOL You don't need a referral & it was cheaper than another vet call out.

After seeing images I did explain that she didn't feel quite right but vet was struggling because she wasn't lame.

Your vet has aknowledged heels are under run so why haven't they worked with farrier to improve?
 
I'm so sorry Jessie, you have been seriously let down by your Vet and farrier.

The good news is that if you can fix the hooves (as TS said, unshod/barefoot will get them right far quicker than in shoes, but you need to get the diet right too - low sugar, high fibre is a good starting point) and with healthy hooves many, many 'navicular' horses return to full work.

You need a farrier (or trimmer) that will help and support you.
 
Wow!! Im stunned. I know what you are saying is right because its how I have been feeling inside! I knew the problem was heel pain and my vet and farrier both have kind of blown me off every time I mentioned it!! I specifically asked them several times each and each time, they keep insisting its a bruise or abcess or something like that. I know its not, have been sure about it, but dont obviously know enough about hoof conformation to be sure. But I specifically asked vet the other day, he looked closely and still said, feet are good just could do with a bit more heel!! Now this is a great vet. He has shining credentials having worked at newmarket for many years. He has been brilliant always there for me and so keen to try and get my horses right. I dont know what to say. Also the farrier I have known for years is a good friend and has done lots to try and help out, but I noticed when he first showed signs of lameness that he was wearing what looked like a smaller shoe than he had previously done. It didnt reach back behind the heel at all and was sort of pushing in on the frog. At first I thought this was the problem maybe. Then he was shod with heartbars and he seemed comfortable with the extra support.

I am really greatful for all your advice because now |I feel extremely alone with this. I have no professional I can turn to for advice. My vet is planning nerve blocks now and x rays and that will cost me probably 700 - 800 then no doubt MRI. Do I go doen this road or do I just go it alone?? His shoes have been on and off so should I just take them off for now and see what happens. I cant send him to rockley because I will lose my stable at my yard and I cant afford to pay livery at both places. I really dont want to have to box rest him, is this necessary?? Could I implicate a programme for him at my yard? How long will he need off work?? This is quite scary, should I go back to my vet?? I really dont know what other vet I would trust as have had some bad expreinces in the past!
 
Sorry, so many questions. Can anyone give me a diet that I can implicate right away? My yard will feed whatever he requires they are so supportive. Is a feed such as happy hoof a good idea. Any detail for a diet to start him on would be great. That I can do safely. Do you think this means he has navicular for sure?? I have definitely been very quick to pick up the soreness, I dont think it has been going on for too long. I know little but have eagle eyes!! He came from a very good professional eventer and I have had him a year. No one ever mentioned his conformation and my vet vetted him originally so maybe he missed the underrun heels then too!

Oh and by the way, I did ask my vet about the different portion of hoof at the top, I wondered if it was banding from the suspected laminits which he had 2 months ago as the timing could have been right for that. He didnt think it was anything unusual.

Thanks in advance.
 
Jessie, I really feel for you. I have been exactly where you are except my mare was nearly PTS with tendon problems. Three Vets told me that her hooves were not a problem (like you I wasn't happy) so I arranged for a fourth Vet to see her. That vet said that the hoof inbalance was the cause of the mare's problems. So I got a new farrier who supported a BF rehab and with Vet number 4 we got the mare sound and back in ridden work.

The new Farrier and Vet came to see her together. They talked about balancing her hooves and it was decided to take off as much toe as possible and shoe her with heel support (shoe sticking out at the back). The next time the farrier came, the shoes came off and she was happy without them straight away. She lived out 24/7 and I walked her in-hand to start with. I always worked her on surfaces that she was happy on. She had a few abscesses while the stretched white line grew out. She was not walked while she was unsound. I also changed her diet to encourage good horn quality and a tighter white line.
 
It's beggars belief that in the country with the highest standard of farriery in the world, you find yourself in this position :(. It's sadly all to common, however. Vets lack training on hoof pathologies and rely on farriers, who are often none the wiser themselves.

If you chose a barefoot rehab there are plenty of people on here who will walk you through it. No two horses are the same, of course, but there are common pitfalls which can be avoided.

Boxrest is usually not necessary, but in very difficult cases it can be helpful if the horse is very sore.

Step one would be to find a suitably qualified person to help you - people on here could give you a recommendation if you say what area you're in.

Before taking shoes off, it's a good idea to look over the horse's diet and make any necessary changes.

Boots and pads are very helpful for the transition period, and will enable you to walk the horse out and keep up that all important stimulation which will help the horse grow some healthy hooves.

How long it will take depends entirely on the horse, however, and it's very important to stick to the horse's comfort levels. Some horses never notice the shoes are gone, but others are more difficult.

ETA: No, it's not necessarily navicular - it could be laminitis, or any number of things related to weak unhealthy hooves.

A good starter diet would be fast fibre, micronised linseed and pro balance +. The latter two are both available online.
 
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It's difficult challenging a professional and they may have thought leave well alone before the lameness even though heels look under run.

Lameness assessment is process of elimination although the feet being balanced is a good starting point. Have they nerve blocked yet to see if bilateral lameness?

I'm sure someone on here could help with barefoot rehab at home if that's what you wanted to do.
 
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Oberon is the HHO feed expert. :) Cptrays has done rehabs and they both helped me a lot.

I feed dengie hi fi molasses free (although some horses don't get on with alfalfa) and speedibeet.
 
jessieblue said:
Oh and by the way, I did ask my vet about the different portion of hoof at the top, I wondered if it was banding from the suspected laminits which he had 2 months ago as the timing could have been right for that. He didnt think it was anything unusual.
Click to expand...

Ironically, the band at the top is the healthiest part of the hooves - it's where the laminae which attach the hoof wall to the pedal bone are strong and tight. This is why the angle is steep. Where the hoof becomes more sloping further down, the laminae are weak and stretched.
 
Ok, so he is on dengie hi fi original and hi fibre cubes now. So can he stay on hi fi original and add say speedi beet and micronised linseed, lose the cubes?? He only has a small feed as out during the day and unlimited good quality haylage??

He hasnt been nerve blocked as yet. He isnt that sore, its just a little sore on turning sharply to the left!( You may wonder why I keep turning him sharply to the left???) He is sound or as near as I can see in straight line walk and trot. Havent lunged him, but have video of him in a lesson last friday and he was sound as a pound on circles in all gaits then. Looked fab actually!! Jumped him on thursday on x country course, no sign of lameness. So this is low grade and vague at the moment, but I tend to jump on things early (long story, lots of bad luck!!) So presumably I keep him moving, lightly. In hand walking maybe. At our yard we have gravl all weather turnout paddocks, would this be a good place to walk him/turnout for an hour a day or so to stimulate his feet?? I have heard pea shingle can help stimulate the frog and heel to grow faster??

I dont think I can attach video can I?? Would be interested in your opinions.
 
If you could turn him out for a bit each day on pea gravel that would help, I'm sure - in conjunction to walking out on the roads in boots.

I would switch to hi fi molasses free if you want to stick with that. Be aware though that it contains alfalfa, which some horses can go footy on.

I'd strongly recommend a good balancer like pro balance +, though.

Well done you for picking up on it :).
 
He has always been on alfalpha. Originally at last yard was on alpha a and balancer. I did change him to alpha a and balancer just before he went "footy" last time!! Funnily enough someone else advised me to take him off that, which I did, so not sure if that had anything to do with soreness then or not. He was on box rest at the time, but I wanted to give him a boost because of having been so unwell! Anyway he is on hi fi original now and has been all the rest of the time I have had him, so switch to molasses free and speedi beet then. Fingers crossed!
http://youtu.be/9r_0mcgqOCI

I dont know if this will work or not but value any opinions on movement
 
I'd agree the hooves are not healthy and difficulty turning can be an early warning sign for sub clinical laminitis.
 
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