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  1. #1
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    Default Neurectomy?

    Who has had it done for their horse?

    What did it entail?

    What was the end results?

    Thanks.



  2. #2
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    We had a jumper mare undergo a neurectomy last year after IRAP and almost a year of rest did not solve the lamness in that hoof. Following the surgury and more rest she was still lame, though maybe not in the exact same place. Vet said let her rest another year. We did. When she started coming back last month she was still not sound on that leg....we now have a potential brood mare..who BTW has trouble conceiving. She is pasture sound, nothing more. Neurectomy was a last resort and the vet does not know why she remains lame. It solves the problem in some horses and seemed worth the risk since a year of rest had not helped. We had the very BEST leg vets in the state. She was a valuable GP jumper so we had to try everything we could....just understand that it is a LAST resort, does not solve the problem in ALL horses, and affects any resale down the road. Good luck...hard decision.



  3. #3
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    Sorry about your mare Blue Star and not knowing why she is lame stinks even more. Do you feel neurectomy was the wrong choice since she did not come back sound?

    I have a navicular horse who is mild-moderate LF, moderate RF, just diagnosed two days ago. New shoes, round of Doxi. The game begins.

    He came up sore with the shoes, should have trotted off better. Impar ligament comes into play now...

    Talked about just getting inflammation down first and going from there.

    Talks on injecting the navicular bone.

    Talks about neurectomy.

    All this talk and all I want to do it make him comfortable. For Him.

    What I want to do it put his original standard shoes on. Doxi & or bute for a cycle and see how he comes up.

    Before the new shoes he was sound (to the eye) and then slightly off and so on. Never dead lame.

    I do not want to go for "test" runs with him. That becomes expensive and heartbreaking when you see no results. We have all been there. I want him comfortable.

    With injecting the N-bone isn't that a crap shoot as it is? And, correct me if I am not correct but every time you inject is doing more damage long term?

    Injections are frequent? Every 6 mos. to year? Or?

    Neurectomy why is that the last resort?

    I am aware of the horse not feeling and thinking about bruises/abcesses/anything foreign he may step on that he would not be able to feel that could lead into something bigger. Proper management could prevent that i.e. footing, turnout, riding etc.

    What are the biggest risks?

    Do most horses come up sound?

    So many decisions, what is the right thing to do here?



  4. #4
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    Default

    the one case i know of involved a QH gelding who was diagnosed with navicular (whatever that means) shortly after a purchase. owner tried various approaches (not all by any means) and then decided to go with neurectomy. sadly it did not resolve his lameness issues.

    sounds like you just got this diagnosis. before resorting to drastic measures, give him some time, read up on the subject, consider the hoof care he's receiving and what the farriers can offer a navicular horse. my own mare was at some point "diagnosed" with navicular (although Xrays didn't show the usual changes the vets look for). i changed her hoof care protocol and spent over a year just walking around on local trails. whether due to the rest, the new hoof care or the combination of both, she recovered and competed in distance riding for the next 4 years before a soft tissue injury forced retirement from competition.

    don't lose hope just yet.
    http://www.eponashoe.com/
    TQ(Trail Queen) \"Learn How to Ride or Move Over!!\" Clique



  5. #5
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    My 8 year old gelding had a neurectomy done on both front legs a little over two months ago. He came up lame over a year ago, and we tried everything we could think of to deal with it. The vets could find no navicular changes, just soreness. I had the navicular bursa injected twice, with very short term positive results (a couple of weeks is all), and gave him a year off with no improvement. I agonized over the decision, but couldn't stand seeing him limp around the pasture.

    He had the surgery, stayed at the clinic for a week, and before I loaded him to come home for a month of stall rest , they jogged him out sound. I just stood there and cried.

    He did great on stall rest, I've started him back to light work (walking and a little trotting) for 45 minutes a day, for the past three weeks, and he's happy as a clam. My farrier, my trainer, both vets all told me about horses they know who had good results. It was a really hard decision, but I love this horse and am willing to give him the chance to be pain free. The vets have to tell you what could go wrong, too, and that was pretty scary.

    The procedure itself was pretty straightforward, four tiny incisions with stitches that had to be removed in two weeks. They had him on IV antibiotics at the clinic, and his legs stayed wrapped for a month. He never acted sore or bothered afterward, either, except he hated being on stall rest and let me know it.


    Good luck.



  6. #6
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    My mare had a neurectomy on her RF 9 years ago. It was recommended by her leg vet after three years of trying varying therapies without 100% success. Before giving the final recommendation, the vet gave her what he called a 'very light' block on the nerves to see what the result might be. Based on that, we had the procedure done. She did not come 100% sound immediately after the 30 days. I was warned that horses respond differently and can take varying lengths of time to gain the full effects. It took a few months, but she did come 100% sound and has remained sound, zero problems on that hoof.

    The one note in this case is that it was done as a last resort and the vet offered his recommendation after he was confident of zero bony changes in the navicular bone. Her diagnosis was a slightly bruised coffin bone and a "princess and the pea" temperament. Each case is different.

    I've known several horses that have had the procedure done and they've all benefited from it long term. I knew one that had to go back in for corrective surgery due to lesions, but she did fine after the second procedure.

    In my area, the vets have the final say in which horses are candidates and if the vet doesn't recommend it, the clinic won't perform it.

    The procedure was simple, done in a clinic under sterile conditions. My mare was tranq'd. . . and tranq'd . . and then a lip-chain was used; she was a nervous nellie and they need to be STILL for the procedure. Follow-up was 30 days of stall rest and icing the area twice a day.
    <><




  7. #7
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    Caudal foot pain (from the impar ligament, or suspensory ligament of the navicular bone, or just bruised sore heels, or navicular bursa, and MAYBE but doubtful the bone itself ) is ALMOST ALWAYS manageable and treatable with a shoeing approach that involves BALANCING and properly aligning the internal structures in the hoof and shoeing in a manner that reduces leverage ALL AROUND around the hoof.
    Many traditional shoeing approaches to "treating" navicular syndrome fails miserably to address those mechanics.
    It is likely that the shoeing (however skilled), did not properly address the imbalance/stress issues that caused the injury and pain on the first place.
    Personally, I would never recommend a neurectomy on a horse that did not have significant actual bone changes on the navicular bone itself , and even if it HAD bone changes, had every possible shoeing approach tried that addressed the imbalances that caused this in the first place.
    "Navicular" is usually pain from some connective tissue around the navicular area, rather than damage to the bone itself. Soft tissue can heal if it is given the proper chance. That means *removing the cause*, which is most often hoof imbalance and leverage around the foot.

    I have seen enough equine victims of neurectomies who regrew painful neuromas, or eventually lost a hoof due to severe infection, or disconnected their deep flexor tendons from the attachment at the bottom of the coffin bone. In other words, from what I have seen, don't do it .

    Do you have any recent X-Rays of the feet ? Perhaps after the last shoeing?
    Patty Stiller CNBBT,CNBF,CLS, CE
    Natural Balance Certified Lameness Specialist ,instructor.
    www.hoofcareonline.com



  8. #8
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    He wasn't mine when he had it, but I have a QH I picked up free last fall who had a neurectomy after all conservative measures failed.

    Clinic records sent with him. He recovered wonderfully and is absolutely sound and a great riding horse. They did say he does best in pads in front, so I've left those on. But if you didn't know, you'd never know from watching him or riding him.



  9. #9
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    I agree. All of the navicular cases we have had responded to proper trims and corrective shoes - in most cases a wedge pad, and rolled toe, but you have to find what is comfortable for that horse. Sometimes that means switching around to several farriers to find one that can make the horse comfortable.



  10. #10
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    I had a horse who did NOT respond to proper foot care. The better and more balanced his foot got the more horribly lame he was. I tried waiting it out (we are talking 8+ weeks, PLUS injections and Bute!), putting him on stall rest - his feet looked great! He was lame and miserable (and almost downright dangerous). Finally put him back in those horrible wedge shoes and while not 100% sound he could at least walk comfortably and was nearly sound at the trot. X-rays really weren't bad, but I wasn't going to do much else with him and sent him to live with a girl who loves him.

    I did not go so far as to do the neurectomy, but this horse was a good canidate for one. Did not respond to injections of coffin joint nor navicular bursa... and when blocked it was just the outside portion of his foot that needed to be blocked to come sound.



  11. #11
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    I had a horse who did NOT respond to proper foot care. The better and more balanced his foot got the more horribly lame he was.
    I will be blunt. If the shoeing made him worse, it was incorrect shoeing for that particular horse.
    "Balanced" has many definitions and involves a lot of aspects of the foot and shoeing .
    Some farriers and veterinrians ideas of "balanced" is not even close to the horse's idea of "balanced" or properly trimmed.
    Getting these horses sound involves a lot more than lining stuff up on an Xray.
    Patty Stiller CNBBT,CNBF,CLS, CE
    Natural Balance Certified Lameness Specialist ,instructor.
    www.hoofcareonline.com



  12. #12
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    You are right. With a horse with navicular syndrome I think it takes more than just the farrier/feet to get the horse sound. Its a constant carefule management that requires vet, farrier, caretaker (b/o or whoever) to be all on board to keep the horse sound.

    The particular horse tried flat shoes, NB shoes, flat eggbars with leather pad and a wedge eggbar. Went best in with the eggbars, wedge only had a very slight effect. His heel went from contracted to open and beautiful and healthy looking - which is when he was the most lame.

    The seller not only lied, but drugged the horse (or had him blocked) when I tried him out and had him flexed (which is entirely another story!). I ate not only the sales prices but nearly 8 1/2 months of board and lots of vet and farrier bills! Seller was a trainer of my good friend, who we both thought we could trust - obviously not... Lesson learned!



  13. #13
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    Quote Originally Posted by Patty Stiller View Post
    I will be blunt. If the shoeing made him worse, it was incorrect shoeing for that particular horse.
    "Balanced" has many definitions and involves a lot of aspects of the foot and shoeing .
    Some farriers and veterinrians ideas of "balanced" is not even close to the horse's idea of "balanced" or properly trimmed.
    Getting these horses sound involves a lot more than lining stuff up on an Xray.
    I agree with you Patty. That's why I call this situation a "game". Finding out what works for my horse is the hardest part. If only he could say take a little more off the left, that feels good!

    I do have recent Xrays, as in 4 days ago Off these Xrays Navicular is what showed. Mild-moderate on both. I hear about alot of people barefooting their ND horses however, my horse is not a candidate of being barefoot. I rode before the vet came and he was pretty darn sound, then lame after his new shoes. Got me thinking of going back to his standard shoe w/ doxi to start. I have never seen a change with horses on doxi though (other people's horses that is) opinions on that?

    I did get on him last night for a long walk, I trotted around just to see how he was. Looked pretty good on the straight, slight head in the corners. I guess better, at least he was not dead lame.

    Forgive me for being uneducated but Patty or anyone please ...

    What do you know about the impar ligament? I was told that when my horse came up lame after the new shoes that he should have trotted off ok. Maybe be tender in the impar ligament. I know it runs down next to the navicular bone and the digital is covering that. What happens when the impar comes into play? Is that serious? Could it just be inflammed from the ND? No tares were talked about.

    I would like for neurectomy to be the last case resort. I decided I really do not want to inject the N bone - ever.

    With proper shoeing will he be pain free or still a day by day?
    I just want him comfy instead of going shoeing to shoeing, Xray to xray, vet to vet and so on. I don't want to jump the gun but I don't want him sitting around in pain while I decide.

    Calena- When your considering neurectomy Does the vet block the area prior to get a generalization of how the horse would come out afterwards? Or was that just something your vet did?



  14. #14
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    I do not have a ton of knowledge or experience with navicular, but I'll tell you about the cases I "do" know about. There's one horse I used to board with who had neurectomies on both fronts and they ended up putting him down. He continued to get more and more lame and he wasn't even safe for trail riding because he stumbled so badly.

    I trim a handful of horses diagnosed with navicular disease, or navicular syndrome. A handful sure isn't any type of "vast knowledge" but I'll just relay to you my experiences and observations as it is.

    Like Patty said - the prettiest foot in the world isn't necessarily functional TO THAT HORSE. In all the cases that I trim, what is consistent is the need to get the toe back and reduce the leverage. The shorter the toe is, the better the horses go.

    One mare was going to be put down because she was living in a stall on bute and was unable to move at all. She was so lame and every type of shoeing, including bars and wedges, that the farrier tried had made her worse. As a last ditch, try or die effort, she wanted to pull the shoes and go with "barefoot trimming." She started out with another trimmer who got the horse started, and I took over and have been trimming her over 2 years. I think we're coming up on 3 years.

    The mare does GREAT now - she trail rides all over the place barefoot, and even runs barrels for fun. But there are a couple of things - she cannot wear hoof boots because it increases the breakover enough to make her sore. And she cannot get too fat. If she gains that extra 50 lbs. she goes lame. With the other horses I do, diet and weight are also a HUGE piece of the puzzle. The weight needs to be maintained so you can just barely see a rib in the sunlight. When they get fat, they get lame. Every horse, every single time. That's been my experience anyway. They do well with the short, rolled toe, and keeping the heels back as far as possible. Essentially, keeping the foot well under the leg.

    Also, these horses do NOT do well with stalling or turnout in small areas. They need plenty of room to move and stretch. Even the ones that have radiographic proof of changes to the bone. If they go in a stall for more than a few hours, they come out stiff and short striding. But after a few minutes of movement, they are fine. They also don't do well in deep sand or sucking mud. That seems to stress the soft tissue and make them sore. They need relatively firm, supportive footing.

    Undoubtedly there are those that will never be sound barefoot, but in the ones I'm working on, that has not been the case. Some of them would be declared "they need shoes to be sound" if the owners were not carefully managing the turnout environment and schedule, and the weight. My experiences may change as years go on and I see more and more of these horses but for now, that's all I can relay.



  15. #15
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    Auv-Two. My horse would not be a barefoot candidate because on his RF years ago he blew an abcess high out the front of his foot. He has damage to the hoof wall and without a shoe on the foot breaks. No matter what supplement I give or stuff I put on it, it still crumbles, forever weekness.

    Which - rises a concern because the RF needs to be kept a bit long in the toe. So, if I cannot toe trim him short enough for comfort of the ND because of the pre-exsisting damage what can I do?

    Thankfully my footing is not too deep. We have always been leary of too deep foot for the horses well being in general. He is turned out and walk alot. My set up for him is pefect for his problem.

    The horse you mentioned that had a neuectomy, did the nerves grow back together in time causing horse to come up lame again or was the horse lame from start to finish?

    My fear is if I do a neuectomy with my horse being heavy to begin with (even with his new shoes he stubbed his toes at random) will I end up with a clutz that is dangerous to ride? He is a chunky breed Xdrafty ... they are hard to make rib show but I understand you have to maintane ND horses fully.

    I feel confused and sad. Thank you all for your knowledge.



  16. #16
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    Quote Originally Posted by Auventera Two View Post
    Undoubtedly there are those that will never be sound barefoot, but in the ones I'm working on, that has not been the case. Some of them would be declared "they need shoes to be sound" if the owners were not carefully managing the turnout environment and schedule, and the weight.
    I agree with all, except that I have seen it both ways. Horses with navicular that need shoes to be sound, and horses that need to be barefoot to be sound. Bone also tends to change and remodel a bit, so what doesn't work now, may work fine in a year or two.

    Weight is always a key issue with any lameness. I10% agree with keep them at the perfect weight - seeing just a hint of rib in the sunlight, and large field turnout. That means you either have to have a lot of horses on the pasture, so it does not get lush, or scrubby pasture that grows a bit of grass, but not the fertilized, seeded, type.

    Ok, I am going to say it, but if the horse tends to be an easy keeper, after removing the grain, limit the hay enough to control the weight. Sometimes that means a half a flake per day.

    Navicular is by far a management problem. Find the right system, and the horse will get many more years. We had one here that Foxhunted for another 10 years after diagnosis.

    Quote Originally Posted by Ozone View Post
    Auv-Two. My horse would not be a barefoot candidate because on his RF years ago he blew an abcess high out the front of his foot. He has damage to the hoof wall and without a shoe on the foot breaks. No matter what supplement I give or stuff I put on it, it still crumbles, forever weekness.

    Which - rises a concern because the RF needs to be kept a bit long in the toe.
    I am a bit confused. I have had many, many horses blow an abscess in the front of the foot, and once it grows out, the foot is 100%. Damaged hoof wall usually comes from deep cracks that have been allowed to crack up from the bottom, until they cause scarring at the coronet band. Abscesses that pop out the coronet band don't make the scaring that the upward cracks will. In either case, they need the toe kept shorter, not longer, to keep the stress/pressure off that area of the hoof wall. Deep, sifting cracks often need a plate to stabilize them.
    Last edited by Fairview Horse Center; Mar. 23, 2010 at 12:13 PM.



  17. #17
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    Quote Originally Posted by Ozone View Post
    Auv-Two. My horse would not be a barefoot candidate because on his RF years ago he blew an abcess high out the front of his foot. He has damage to the hoof wall and without a shoe on the foot breaks. No matter what supplement I give or stuff I put on it, it still crumbles, forever weekness.
    I've not heard of a permanent wall disfirgurement due to an abscess, but that's not saying it doesn't happen. I've just never seen it or heard of it. Generally they grow down, and the new hoof growing is healthy. There must be permanent scarring to the coronary band if your horse's hoof never grows in normal.

    Just for kicks, you might try a Clean Trax soak, and having the area opened up a bit to get some sunlight and air. Sometimes these "permanent" cracks are due to bacteria residing in the protected/dark environment.

    Which - rises a concern because the RF needs to be kept a bit long in the toe. So, if I cannot toe trim him short enough for comfort of the ND because of the pre-exsisting damage what can I do?
    I agree with Fairview that a shorter toe with less leverage and pressure would help keep it from cracking and splitting. The more length = the more leverage. The more leverage = the more damage.

    Thankfully my footing is not too deep. We have always been leary of too deep foot for the horses well being in general. He is turned out and walk alot. My set up for him is pefect for his problem.
    I agree with you. I've seen too many soft tissue injuries from deep mud and sand.

    The horse you mentioned that had a neuectomy, did the nerves grow back together in time causing horse to come up lame again or was the horse lame from start to finish?
    Unfortunately I don't really know a lot of detail. I just remember that he had navicular, then had a neurectomy and he continued getting worse until he was euthanized. The owner took him a trail ride one time and he ended up falling down with her and she broke her leg, or hip or something. After that, he was euthanized.

    The danger with neurectomies is that they cannot feel the back portion of the foot, which can affect the way the foot lands. Also, if they land on something like a rock or something sharp, they don't feel it, and end up doing more damage. I think that horses with neurectomies have to be kept in shoes and pads to protect the frog and caudal portion of the foot.

    My fear is if I do a neuectomy with my horse being heavy to begin with (even with his new shoes he stubbed his toes at random) will I end up with a clutz that is dangerous to ride? He is a chunky breed Xdrafty ... they are hard to make rib show but I understand you have to maintane ND horses fully.
    I would not even remotely CONSIDER neurectomy at this point. There are lots of different avenues to explore before jumping into a neurectomy. Severing the nerve is usually done as a last ditch resort because the horse is going to be put down if they can't become more comfortable.

    Navicular disease and syndrome seems similar to plantar fascitis in people, to me. It can be excrutiatingly painful but with the right management, can be significantly improved or even totally resolved.

    I feel confused and sad. Thank you all for your knowledge.
    That is completely understandable, but just keep reading, asking questions, and talking to as many vets and other professionals as you can to become better informed. People get confused and scared when they don't have the answers. Nobody ever has all the answers, but being well informed helps to remove a lot of the worry and confusion.

    Hang in there, you're going to get through this!



  18. #18
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    Quote Originally Posted by Ozone View Post
    He is a chunky breed Xdrafty ... they are hard to make rib show
    You may find out that if you get the weight off of him, the problem disappears.



  19. #19
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    I have some more questions and answers they are in other color.

    Quote Originally Posted by Auventera Two View Post
    I've not heard of a permanent wall disfirgurement due to an abscess, but that's not saying it doesn't happen. I've just never seen it or heard of it. Generally they grow down, and the new hoof growing is healthy. There must be permanent scarring to the coronary band if your horse's hoof never grows in normal.


    Just for kicks, you might try a Clean Trax soak, and having the area opened up a bit to get some sunlight and air. Sometimes these "permanent" cracks are due to bacteria residing in the protected/dark environment.

    When I purchased him some years ago he was shod in pads and had this abcess at the top of his foot, took 8 months to grow out. As his toe grows I have to get his feet done on a strict regular 7 week schedule or the foot "T.Pees" at the toe. It never goes too far up the foot.

    He also had white line disease which has since subsided. I don't know it all but this foot must have something other then wall damage you think? It is his RF this foot was called as moderate ND (mild-mod on the left) as well. I took the pads off right away when I got him, regular shoes, but that toes has always been an issue so we kept him long. If he was trimmed short his toe would crumble. If I post pics of his feet can you tell me what you think? Right now they look good. Also: He has sheared heals so that is a player too, no?



    I agree with Fairview that a shorter toe with less leverage and pressure would help keep it from cracking and splitting. The more length = the more leverage. The more leverage = the more damage.

    I agree but I am so confused


    The danger with neurectomies is that they cannot feel the back portion of the foot, which can affect the way the foot lands. Also, if they land on something like a rock or something sharp, they don't feel it, and end up doing more damage. I think that horses with neurectomies have to be kept in shoes and pads to protect the frog and caudal portion of the foot.

    THIS is what I am terrified about.


    I would not even remotely CONSIDER neurectomy at this point. There are lots of different avenues to explore before jumping into a neurectomy. Severing the nerve is usually done as a last ditch resort because the horse is going to be put down if they can't become more comfortable.

    That is completely understandable, but just keep reading, asking questions, and talking to as many vets and other professionals as you can to become better informed. People get confused and scared when they don't have the answers. Nobody ever has all the answers, but being well informed helps to remove a lot of the worry and confusion.

    After reading some of the posts - not the ones where it did not work or the success of some others but more on the ends of the horse. What he will feel, what he is not going to feel - the risks. There seems to be a heck of a lot more risks then I imagined. I do not want to be afraid if Froto is outside in a rocky paddock at some point or I cannot go out on trail because he may hurt me by not feeling his feet. I am SO very glad that I seek COTHs opinion on this. I stil feel like I have a ton of reading and research to do but this time it will be on how to keep him comotable WITHOUT a neurectomy. Should the day come to neuectomy or put down I will go neuectomy for his comfort but I will not ride him at that point either

    Thank you all for your knowledge. I have some reading to do on the foot itself!

    Hang in there, you're going to get through this!



  20. #20
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    A couple of points-

    I have never seen a horse who had real, actual, honest to goodess navicular syndrome/issues, who did not ALSO have hind end problems, of some degree.

    So, when you get them to get on their back end, and they come off of their front end some, you get at least some degree of relief. But how to do this? GREAT shoeing, or trimming, is only a piece of the puzzle.

    I had a great education given to me by a horse who I owned years ago. He had substantial navicular issues in his rf, and remarkably, stifle and hock issues in his rh. I had retired him, and he was just not comfortable-- even on pasture. As a competitive dressage horse, I had him in egg bars, injected him, used a bunch of neutraceuticals, etc, and I took him swimming three days a week, to increase fitness, without stressing everything through concussion.

    In any event, I went with a chemical neurotomy. They last 30-45 days, depending on the drug, and your horse. I would never- that is as in never, ever-- recommend to anyone (even as a layperson) that they do a surgical one, without trying this. The horse in question improved dramatically. His heels opened up, because he was actually walking on them. With less contracture, blood flow increased, and he was more comfortable. His hind end, which had been stressed by trying to stay off of the fron end, improved. He was one happy guy! It became difficult to decide if the thing had worn off, actually.

    Wish you the best with your horse, OP!
    When someone shows you who they are, BELIEVE them- Maya Angelou
    www.americansaddlebredsporthorse.net
    http://www.asbsporthorse.blogspot.com/



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    By Technicolor in forum Horse Care
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    Last Post: Nov. 21, 2008, 11:35 PM

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