Neurectomy

[technopony]

I am writing a paper on nerving in horses (specifically show horses) and can't seem to find many papers or articles that are against the procedure. I need both sides for my paper. Does anyone have any suggestions, stories or places to look? Thanks.

[BornToRide]

That's the problem - there's rarely enough follow up that shows the track record of a certain treatment or procedure. Your best bet may be interviewing veterinarians and owners of affected horses.

Perhaps start with Dr. Teskey. Maybe he has some additional ideas: http://easycareinc.typepad.com/ask_the_vet_tomas_teskey/

[chai]

Hi technopony,
I was just discussing this subject yesterday. I have taken in many old, unwanted horses, and I have had a few come in with Navicular syndrome. I had a big Saddlebred/QH cross, and old foxhunter who had been ridden into the ground by his middle aged, social climbing owner who never really knew what an amazing soul his horse had. I had always told his owner that if he ever wanted to sell Henry, I would buy him. Five years later I got a call from Henry's owner out of the blue, and I bought Henry from him on the spot, sight unseen because all I wanted to do was give this amazing horse a great retirement.

When Henry arrived at my home and got off the trailer, he was dead lame with severe Navicular. X rays showed distinct honeycombing of the navicular bone and that hard evidence helped me make a difficult decision after two years of trying everything my vet and farrier to help him find comfort. In the end, I had him humanely euthanized in our back field. He was the most amazingly dignified, intelligant, 'human' horse I have ever known, and it broke my heart that I could not help him find comfort in his final years.

A few years later, we had another horse come in as a rescue, an 18 year old QH who had been everything from a track lead pony to a trail horse, also with Navicular problems. I started the same round of medicinal/shoeing treatment and when it became obvious that these modalities weren't working, I considered a low neurectomy for him for four reasons:
1. He would be with us for the rest of his life.
2. I would make sure he would always have the correct shoeing.
3. I would never ask him to do things that he should not do with such a degenerative disease.
4. What was the only other option? Chronic pain or euthanasia, and I had already gone down that road with Henry.

The surgery cost $1200 at a well respected equine clinic and he made a full recover, even at the age of 18 (maybe older). We figured we would buy him a few years of comfort, hanging out at the farm and living the good life until he passed.

He is now somewhere around 32 -35 years old, still hanging in there and loving life. We don't ride him, but he has never had a sore day or a problem with his front feet. This is not a surgery I would recommend to patch up a horse for further jumping, competition or to cover up a serious problem for resale. imho, those reasons would constitute fraud or cruelty. In our case, we knew the old boy would be with us to the end, well cared for and comfortable for the rest of his life.
Hope that helps. If you would like more information on the clinic, recovery, etc., please pm me and i'll be happy to share.

[eqrider1234]

I had a girl at my barn, who for this very reason I could not stand. She had a vet from our area come out who I also despise. She had her horse nerved, for navicular? Im pretty sure or maybe it was something to do with the horses cannon bone, a bone chip? I cant remember, anyways this was a horse that she had ridden into the ground, a nice childrens hunter that really needed to be retired as she was 16 or 17 and unsound. The girl had her nerved with the shock therapy so she couldnt feel the pain and she continued to show her in the 3 ft and eventually gave her away when she no longer could use her. She also had terrible horse ownership skills, im talking wouldnt come see her horse for a month and the would come out everyday for a week and ride her for an hour plus the whole time jumping and then she would disappear again for 2 months

sorry my rant is over :mad:

[chai]

eqrider, I agree with your disgust about the girl who nerved her horse so she could continue to do the 3'. That kind of 'patch up the horse to win at all cost' attitude is exactly what I was talking about in my post. A bad use of the neurectomy.

[appychik]

We're considering a neurectomy for Gringo. He's young, only 6, but has an old coffin bone fracture that won't heal. He came to me with the fracture (never found on the PPE because I didn't do x-rays... learned my lesson). Anyways, he was successfully blocked... so a neurectomy is the next step. Just trying to decide if I want to go the route or not. This horse has never been successfully started and will now be with me for life as a pasture ornament. We'll see how the summer goes... if I can get him back sound(er) again, then we may bypass the surgery for now.

[Rubs Not Pats]

Appy chick.
Mine made it back to the 4' regulars with a type 1 coffin fracture. She avulsion fractured the collateral two years later and I was left with few alternatives. She is 8. I opted for the unilateral palmar neurectomy. I do hope to get her back in the 3' but if she doesn't ever come back thats fine. She has had other problems since and unrelated to the neurectomy about 2 months ago and is still on stall rest. Once I turn the horse out she is done forever, so my choice is work or retire. The poor alternative of letting a young horse live out the next potentially 20 years in pain is a poor way to reward a girl, who has given me everything since the night I pulled her out of her mother. For more information on her story see the ongoing medial collateral thread that goes on forever before anyone judges me.

[BornToRide]

I started the same round of medicinal/shoeing treatment and when it became obvious that these modalities weren't working, I considered a low neurectomy for him for four reasons:
2. I would make sure he would always have the correct shoeing.The problem is that the underlying root cause is in far too many cases not correctly identified and eliminated.

Most, if not all, navicular horses have the follwoing in common:

Heels and toes that are too long
Toe loading that results from long toes and heels or other heel pain
and heel contraction that results from toe loading and/or incorrect trimming and shoeingMost horse improve immediately once the hoof is trimmed balanced to internal hoof structures and allowed to correctly heel load.

To me navicular is not much different from carpal tunnel syndrome in humans. The problem arises when the hoof is being used with altered and unnatural biomechanics, or in other words ergonomically incorrect.

It stresses the soft tissue and tendon around the NB which then become inflamed. Later the chronic inflammation also damages the navicular bone.

There's no reason why the horse should not be able to heal once the hoof form is corrected and proper heel loading re-established

[Watermark Farm]

I had a bi-lateral neurectomy done on my horse 18 months ago by a surgeon at a major lameness clinic. I had several long conversations with both the lameness specialist vet and the actual surgeon prior to our doin the neurectomy and we went over different reasons why neurectomy would not be a good idea, complications, failures, what makes a poor candidate, etc.

I suggest you get on the phone and call a couple of clinics or university hospitals and explain your situation and ask to speak with a surgeon who has lots of neurectomy experience OR talk to a vet who's a lameness specialist. They are usually very helpful and happy to answer your questions!

What a great topic for your project! I hope you will share here!

MTA: A great clinic that does a lot of neurectomies on performance horses is Pioneer Equine Hospital in Oakdale, CA. That's the clinic that saw my young horse for the 2 years prior to neurectomy, and also where I had the neurectomy done. They have done many neurectomies and are well known for their lameness program. I'm sure they would be helpful if you call them. Dr. Jerry Black was the vet I worked with.

[purplnurpl]

I'd like to hear more about people's personal experiences.

I know someone who had 2/3rds of her horse's front foot nerved and then ran around Radnor ** on him with no issues.

He had broken his navicular and sesmoid. I think that is just fascinating that he could show at all afterwards.

[chai]

BornTo Ride,
That is an interesting perspective, but unfortunately horses are not cookie cutter items where there is a one-size-fits-all cure like you describe. I wish that was so, but you do not know my horse, have not seen his x rays or his treatment plan and your internet diagnosis does not consider the fact that we worked with some of the best farriers/veterinarians at a leading clinic in our region for a long time trying to find comfort for this old horse with the treatment options available in the mid 1990s.

We went the route of various trims and angles, giving each effort plenty of time to see if it would be the one that helped him. It was only when we agreed as a team that we had exhausted all options available to him in the late 1990s that I made that decision for him.

I think if you asked my old horse if he would choose euthanasia back in the 1990s or a life filled with pain over a low neurectomy and a pain free life being loved and pampered on our farm, he'd tell you we made the right decision for him.

[BornToRide]

BornTo Ride,
That is an interesting perspective, but unfortunately horses are not cookie cutter items where there is a one-size-fits-all cure like you describe. I wish that was so, but you do not know my horse, have not seen his x rays or his treatment plan and your internet diagnosis does not consider the fact that we worked with some of the best farriers/veterinarians at a leading clinic in our region for a long time trying to find comfort for this old horse with the treatment options available in the mid 1990s. I did not diagnose. If I did, I would have said: Your horse has XYZ".Besides, I cannot diagnose - only doctors can.

We went the route of various trims and angles, giving each effort plenty of time to see if it would be the one that helped him. It was only when we agreed as a team that we had exhausted all options available to him in the late 1990s that I made that decision for him.There may be cases that are so far advanced, that it may be too late. However, I also know how little understanding even the veterinary community has of what a healthy hoof actually looks like. They are so used at looking at pathological hooves that they often fail to do the necessary changes for a hoof to become more normal.

Even Pete Ramey says these days that navicular is no longer an issue for him:
have personally seen many horses with confirmed navicular changes that have endured years of pain while the owners footed the bill for orthopedic shoeing, only to watch them become completely sound within days of a correct trim and a chance to go barefoot. Sometimes it is a longer process of course, but I have yet to experience failure on one single navicular case. (Yes, I know my time will come, but I wrote the same thing in my book five years ago. I’m still waiting.) http://www.hoofrehab.com/end_of_white_line_disease.htm#Navicular

[Marshfield]

I did both barefoot and all forms of supportive shoeing before conceding defeat and having a unilateral neurectomy performed on my horse four years ago. It was neurectomy or death at that point. He's not being ridden at the moment for reasons in my personal life, but still can be. He was schooling third level as recently as late last year. My only regret is not doing it sooner. The decision was made following consultation with multiple other veterinarians I trust.

[paintjumper]

I had a mare that required the procedure, the vet removed an inch of nerve, he handed it to me, and she grew back in less than a year! Very expensive considering it did not last longer. I won't do it again.

[technopony]

Thank you all for your replies (and sorry to those with bad experiences). Someone told me that if the procedure is done too many times, the horse's hoof wall can actually fall off... has anyone ever heard of this happening? Thanks.

[OkLurchers]

Not to hijack the reason for the post, but has anyone had experience with nerving a horse b/c of severe ringbone? My lovely retired 17yr old TB jumper (just a pasture ornament for last few yrs.) has bad upper & lower ringbone in both fronts...has been maintaining for past 3 yrs. on small amounts of bute & meclophenamate. A couple of months ago farrier & I noticed he's not wanting to put full weight on worst front. Last week farrier noted his other foot is spreading. He has a great life with 'the girls,' he eats well, etc., but I'm not willing for him to be in bad pain & he's obviously deteriorating again. Would neurectomy be a viable option for him? I can control as much as is possible in his life--no riding, lots of turnout in good conditions, excellent care--he lives at my home, so I can (and do) watch him like a hawk. What do you think? Should I talk to my vets? Also, what is the recovery period for such an operation like?

[Bluey]

Several years ago we euthanized our old ranch horse with ringbone on one foot, due to a pasture accident.

The vets consulted about that and decided he would not get enough relief, so we didn't try it.
Being just in one foot, that would have made sense.

I had a horse that stepped on a nail a few months ago and it went clear into the coffin bone and did extensive damage.
He was at the vet for five weeks, until they decided they could not keep him pain free enough, but they did consider at one time using that technique as a last resort, to see if he would use that leg at all.
They decided against it as he would not use it even when blocked.

I have known of some older horses that were nerved and kids used them in playdays.
Don't know what to think of that.
The horses seemed to participate willingly and were not limping, so...:confused:

[MistyBlue]

The problem is that the underlying root cause is in far too many cases not correctly identified and eliminated.


I did not diagnose. If I did, I would have said: Your horse has XYZ".Besides, I cannot diagnose - only doctors can.

There's no reason why the horse should not be able to heal once the hoof form is corrected and proper heel loading re-established

This in direct reply to Chai after you quoted her.

Seriously, leave Chai alone. Pete Ramey is obviously not the end all/be all and is laughable to many other experienced professionals. He also exaggerates to a ridiculous degree in order to sell his dogma.

The OP asked for personal experiences with nerving...not a run-down on what you or Pete Ramey think of Chai's horse or trimming. She asked about nerving.

[Blue Star]

Our 1.40 jumper injured something in her foot (never quite sure exactly what structure). After stem cell treatment and 10 months of rest she looked ready to bring back....but in work she was still lame. The final resort was the nerving....we had it performed at the best clinic around, seemed like it went well..another 6 months rest, came back slowly...under work she was still lame, apparently higher than the nerving. We are going to give her another season off (she is only 8) and then see if she gets back to any level of riding soundness, or retire her. Enough is enogh for trhe poor girl. She IS pasture or breeding sound however. There are just so many structures in the foot and each horse is so different in how they take care of themselves and respond to medical treatments, it was worth trying for us but not a resounduing success.:confused:

[Rick Burten]

However, I also know how little understanding even the veterinary community has of what a healthy hoof actually looks like.
The truth is that you know nothing of the sort, rather you are again bloviating and placing your ignorance on display for all the world to see.
They are so used at looking at pathological hooves that they often fail to do the necessary changes for a hoof to become more normal.
With your vast experience, please share with us how many veterinarians you are talking about and how many of that number you have personally seen acting in the manner you describe.
Even Pete Ramey says these days that navicular is no longer an issue for him
So what? Do you really think that very many people, veterinarians included, care what Mr. Ramey[apparently, the current BUAtista guru d'jour] has to say?

[caballus]

Not going to enter into a personal bashing here but did want to offer *my* thoughts on this ...

A neurectomy should be a LAST RESORT treatment. When people say "we've tried everything" have they tried a CORRECT barefoot protocal? By 'correct' I mean one where the individual hoof is balanced and leveled correctly.

If that has not been tried then not "everything" has been tried before resorting to a Neurectomy.

[kbbarn]

I have a 14 yr OTTB that has Navicular ( bone spurs on navicular bone, lateral, both fronts).

To those going on about proper and balanced barefoot trim, YES - we did this. He is barefoot, perfectly balanced. It took 2 years to get perfect hooves and he has been balanced for the last year. I have 3 vets, One who is the person who did get me started on Barefoot 4 years ago. She is a complete barefoot advocate, shoes are evil and every horse should be barefoot( I wonder if BTR would listen to her being that she is a veterinarian AND a barefoot advocate). I do not agree with this extreme belief in that barefoot is the cure-all since I believe that some horses, particular OTTBs, may need shoes. Each horse is unique and has specific needs but shoes did not help my 14 yr OTTB either so barefoot is easier for me since I can monitor his hooves better. Barefoot Vet saw the OTTB the other day and was thrilled with his hooves but does admit that even his beautiful hooves will not help his navicular. Thus I do believe that most horse owner probably try many things prior to going the Neurecotmy route.

Neurectomy is my only option at this point but to be honest, I will not do it. One of my 3 vets also thinks that he has arthritis in the hips due to racing thus unless I can de-nerve the whole horse, he the pain will be more noticeable in the rear end. Plus he is a TB - 6-8 weeks of stall rest after Neurectomy + wrap changes every day - not on this TB. He starts head bobbing after 15 minutes if he thinks he cannot go out into his run. The longest he has ever left a leg wrap on was 5 minutes. Thus not a good candidate.

I will blame the people who started him at 2 years old racing. I will just give him bute on his extra days and monitor daily as I do now. When the pain becomes constant then it is time for him to cross the bridge, Barefoot and all!

[Bluey]

---"I will blame the people who started him at 2 years old racing. I will just give him bute on his extra days and monitor daily as I do now. When the pain becomes constant then it is time for him to cross the bridge, Barefoot and all!"---


We started horses at four in Europe and had our share of horses with navicular.
What should we blame that on, other than maybe being horses and, like people, some have a certain amount of wear and tear on their bodies, others don't, no matter what we do or don't?:confused:

How about the many, many, many TB's started at two racing that are sound into their later years?
Some of those I competed in jumping, in their late teens.:)

In quarter horses, there are some lines believed to be more prone to navicular trouble by around ten, so partly a tendency to have that problem could be inherited also.

[kbbarn]

---"I will blame the people who started him at 2 years old racing. I will just give him bute on his extra days and monitor daily as I do now. When the pain becomes constant then it is time for him to cross the bridge, Barefoot and all!"---

We started horses at four in Europe and had our share of horses with navicular.
What should we blame that on, other than maybe being horses and, like people, some have a certain amount of wear and tear on their bodies, others don't, no matter what we do or don't?:confused:

How about the many, many, many TB's started at two racing that are sound into their later years?

In quarter horses, there are some lines believed to be more prone to navicular trouble by around ten, so partly a tendency to have that problem could be inherited also.

I would agree with this although I think 2 years old is way too young to start racing. My OTTB is 17 hh and has a long body. Vet #1 was quick to point that out as his biggest problem. So yes, could be he is prone to navicular and arthitis but I do not think starting him at 2 years did him any favors.

[caballus]

---"I will blame the people who started him at 2 years old racing. I will just give him bute on his extra days and monitor daily as I do now. When the pain becomes constant then it is time for him to cross the bridge, Barefoot and all!"---


Blame does nothing positive. It only takes focus away from what *is* and what needs to be done now. Nothing but a waste of time.

Do whatever you need to do *now* for your horse.

[Bluey]

I would agree with this although I think 2 years old is way too young to start racing. My OTTB is 17 hh and has a long body. Vet #1 was quick to point that out as his biggest problem. So yes, could be he is prone to navicular and arthitis but I do not think starting him at 2 years did him any favors.

Seems that so many are bashing racing from all angles today, that I took that part of the post as one more such, sorry if it was not so.

I hope your horse will have some painfree time yet so you both can enjoy each other company.

According to our vets, if we had gone on with nerving my injured horse, so he would use that leg, serious stall rest didn't seem to be something I expected in his recovery period?:confused:
He was to continue to be stalled in one of their large pens.:yes: