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Navicular support strategies--update following Farrier's Jam post 15

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  • Navicular support strategies--update following Farrier's Jam post 15

    Is there anything new in strategies to support "navicular issues"? One of my oldsters has an intermittent lameness that follows a "navicular issue" pattern, and radiographs that show some leisons on the navicular bone, little change over a 4 year period, but the navicular skyline views have changed, both were a bit "fuzzy" 4 years ago, now the left looks like it's been chewed by rodents, right is not much different. Lameness occurs on left, though sometimes is more apparent on a right circle on the lunge. Sole is a bit thin at 1 cm. Takes a bit short stride on right sometimes, indicative of wanting to speed breakover on the left (?).

    He's been in egg bars for the past four years with a two to three month break over the winter. We reset at 4 weeks during the rapid growth during the summer as the bar shoes with clips pull forward as the toe grows. Pads & pour-in or squirt-in sometimes help, sometimes not so much, I suspect due to the thin soles--have to be very careful to avoid sole pressure. He's also on firocoxib, which seems to help a lot, with a one-month break over the winter.

    He is in work but I temper it by what he can handle, we have no particular goals other than improving some body/muscular issues and working demons out of his brain--he's just a "project". Sometimes I have to really grit my teeth through the "old man trot" during warmup (some of which I believe to be psychological, he has a "colorful" history), after warmup he is sound and tolerates light work well.

    I don't have the budget to do an MRI on this older fellow, and I think the diagnosis is pretty straightforward from the xrays (though I'll listen to other opinions).

    I'm just wondering if there are any other maintnence strategies that people have tried, particularly in terms of shoeing. I'm perfectly happy and confident in my farrier, but we're a bit off the beaten path and there might be new things that haven't found their way to us yet.
    Last edited by monstrpony; Apr. 2, 2013, 10:43 AM.
    "One person's cowboy is another person's blooming idiot" -- katarine

    Spay and neuter. Please.

  • #2
    What you have described is the typical progression of navicular bone disease. There are many protocols, gadgets, and gizmos thrown at the problem - each having some success in the market. Since I don't have your horse in my hands I cannot offer any specific suggestion.

    I would be happy to share some very specific things that I have learned from Dave Duckett, FWCF about shoeing horses with navicular bone problems directly with your farrier on the phone. But that kind of information does not lend itself well to a discussion on an internet forum where the participants are not also the practitioners.

    Comment

    • Original Poster

      #3
      Tom--Fair enough, and thanks. I'll pass your contact info on to my farrier.

      I'm not looking for a specific prescription here, just wondering what other ideas are out there. In fact, we're taking the horse to a farrier's group meeting in a couple of weeks, and I'm wondering about things I might hear about there.
      "One person's cowboy is another person's blooming idiot" -- katarine

      Spay and neuter. Please.

      Comment


      • #4
        My guy had a left front navicular fracture. We tried many things over the years.

        Barefoot trimming did nothing for him, obviusly.

        Eggbar shoes helped for a bit, but we didnt have enough breakover.

        My farrier made a shoe by putting the shoe on backwards and welding a front plate for the toe. This worked well for a while, but the front plate would wear out before the 8 wks was up for the next reset.

        We then upped it to this homemade shoe and an impact gel pad under this shoe. This worked for about 5 yrs or so.

        Moved up to a leather pad and an equilibrium shoe that had great breakover. My guy stayed in this setup until i lost him last year. Sometimes the basics done the best work the best.
        Esmarelda, "Ezzie" 1999 Swedish Warmblood

        "The world is best viewed through the ears of a horse."

        Comment


        • #5
          My navicular horse will be having his first appointment with a new farrier in a couple of weeks so I can't tell you yet how well it works for him, but what the new farrier says she will do is use PLR shoes with rails for the wedges, a frog support pad and impression material under the pads. She will be watching him walk/trot to see how this impacts him, but I'm pretty excited to hear there is another option as my guy still isn't totally sound in his eggbars with wedges.
          "And I saw heaven opened, and behold a white horse..." ~Revelation 19:11

          Comment


          • #6
            Originally posted by Cruisesmom View Post
            This worked well for a while, but the front plate would wear out before the 8 wks was up for the next reset.
            8 weeks is quite a stretch if you want to keep the toes/heels back where they belong, especially on a horse with navicular.
            "If you think nobody cares about you, try missing a couple payments..."

            Comment


            • #7
              Keebler had navicular bursa rupture and surgery and, 3 years later, is still sound with Natural Balance aluminum wedge shoes and pour-in pads. That's what his surgeons recommended, and (touch wood) he's been remarkably sound on what was almost certainly a career-ending (and possibly life-threatening) injury. Surgery is what "fixed" him, but sticking with what his surgeons advised WRT shoeing is getting some credit in my book.
              Click here before you buy.

              Comment


              • #8
                If you haven't tried Epona shoes, I'd at least try them for a cycle or two and see if they help him. Because they are polymer and have a built in gel pad, you can set the breakover way back under the toe and support the heels without causing sole pressure issues. Having spoken to other farriers who have used them for years, two problems they seem particularly helpful with are ringbone and navicular/heel pain. If you can get a decent fit, nails are all you need to appy them but I do recommend packing the hoof underneath to keep out debris and to add more support.

                I probably wouldn't use any sort of pad under it but if you do need to build up the heels you can use the epoxy to do that. It adds an element of expense and a bit more work to the package but it might be worth it for your horse.

                You can hopefully find someone close to you who is trained to use them on the Eponashoe.com site. If not, and your farrier wants to give them a shot, I know the Epona team is very helpful for phone consultations also.

                Comment


                • #9
                  The full roller motion shoe aka: banana shoe/wedged heel banana shoe. 'Hidden bar' bar shoe.

                  Comment


                  • #10
                    Originally posted by SuckerForHorses View Post
                    8 weeks is quite a stretch if you want to keep the toes/heels back where they belong, especially on a horse with navicular.

                    this worked for him, we tried many many things. just my personal experience. no need for snarkiness.
                    Esmarelda, "Ezzie" 1999 Swedish Warmblood

                    "The world is best viewed through the ears of a horse."

                    Comment

                    • Original Poster

                      #11
                      Originally posted by Cruisesmom View Post
                      My farrier made a shoe by putting the shoe on backwards and welding a front plate for the toe. This worked well for a while, but the front plate would wear out before the 8 wks was up for the next reset.
                      Originally posted by SuckerForHorses View Post
                      8 weeks is quite a stretch if you want to keep the toes/heels back where they belong, especially on a horse with navicular.
                      Originally posted by Cruisesmom View Post
                      this worked for him, we tried many many things. just my personal experience.
                      Not sure exactly how this was actually done but it sounds like it could work. With the shoe on backwards, there is nothing (well, less) to pull the shoe forward as the toe grows, and I'm guessing the nails would be a bit further back than normal. With the shoe and the plate (I'm guessing this is across what would be the heels of the shoe) defining where the breakover occurs, the toe of the hoof could grow without the breakover moving forward so much. And what would normally be the toe of the shoe would provide support for the back of the foot, not unlike an egg bar. So it could conceivable work for longer than the usual reset. Interesting.

                      Interesting to read these ideas, thanks!
                      "One person's cowboy is another person's blooming idiot" -- katarine

                      Spay and neuter. Please.

                      Comment

                      • Original Poster

                        #12
                        Originally posted by Rick Burten View Post
                        'Hidden bar' bar shoe.
                        Can you link to a picture, or give a description? This one googles to all of the variations on 'Hidden Horeshoe Bar' as a saloon name, not so much to anything you'd put on a horse's foot.
                        "One person's cowboy is another person's blooming idiot" -- katarine

                        Spay and neuter. Please.

                        Comment


                        • #13
                          Originally posted by monstrpony View Post
                          Can you link to a picture, or give a description?
                          This is one version of a full roller motion shoe. It can also be fabricated out of steel. It can also be done as a bar shoe and additional wedges can be added as necessary. It is also known as a 'self-adjusting palmer angle shoe'.
                          http://www.grandcircuitinc.com/produ...it-open-roller

                          A hidden bar shoe is a shoe that has a bar inset and welded across it from branch to branch such that when the shoe is applied, the bar will be directly below the navicular bone. Most generally, an open heeled shoe is used and often, wedge pads are part of the package.

                          There is also the PLR shoe. It comes in either a flat or wedged version. Here's the flat version http://www.shopedss.com/products/Alu...%29-Shoes.html It too can have frog support pads/wedges etc added to the package and the amount of frog support can be made adjustable.

                          Then, there is the full EDSS system http://www.shopedss.com/products/EDSS-Shoes.html Which may or may not be what the horse needs.

                          With any of these orthosis, IT DEPENDS is always in play and often it takes several attempts to get the horse 'dialed in'. And, how the horse is trimmed is just as important as the orthoses s/he wears.

                          On last though to keep in mind. Navicular Disease is progressive and painful and there is no "cure". When all else fails, there is the option to have the surgeon perform a neurectomy(PDN) which brings with it its own set of consequences. And remember, if you choose this option, all you are doing is removing the pain pathway to the brain. The condition will continue unabated and will worsen over time.

                          Comment

                          • Original Poster

                            #14
                            Thanks for all of the info above. Makes me even more curious about what the shoer's group might suggest. There are a number of options and I understand that the people who have the horse in front of them will be in the best place to consider the options for the individual.

                            Originally posted by Rick Burten View Post
                            On last though to keep in mind. Navicular Disease is progressive and painful and there is no "cure". When all else fails, there is the option to have the surgeon perform a neurectomy(PDN) which brings with it its own set of consequences. And remember, if you choose this option, all you are doing is removing the pain pathway to the brain. The condition will continue unabated and will worsen over time.
                            This has been suggested as one option, and I've given it much thought. I imagine that if one isn't careful, at some point the whole thing just implodes and the horse no longer has options (I'd imagine the DDFT finally ruptures, or the bone just crumbles). On the other hand, it does sound like a way to give the horse a bit more pain-free time before the inevitable with any irreversible degenerative condition. I'd prefer that option stay lurking out there as long as possible.

                            It seems, thought, that the best way to slow the progression is to give the limb the best possible support, and to maintain it rigorously. I'm glad we'll have the chance for lots of input in determining what that might be.
                            "One person's cowboy is another person's blooming idiot" -- katarine

                            Spay and neuter. Please.

                            Comment

                            • Original Poster

                              #15
                              Update following Farrier's Jam Session--

                              I thoroughly enjoyed participating in this session, wish I could go every month! There were about 20 farriers present, and a half-dozen vets, a couple of vet techs, three horses and three owners and a few hangers-on. Everyone introduced themselves and we told a bit about the history of our horses. We all went out to the round pen to watch the horses move at liberty and jogged them as needed to see the issues.

                              My guy was a little up with being in a new place and all of these people watching him; he really didn't look very lame in the front, though he was a bit tippy-toe-ey, but he was moving nicely forward and an issue became apparent in his right hind. Something I'd felt under saddle, but honestly, this horse has a bunch of issues between his brain, his ageing body, and his feet and sometimes it's easy to tell he's not right, but almost impossible to tell where the issue is. But this time it was clear even to my poor eye, so he picked a good place to show it.

                              He's been barefoot since the end of December, and while not in much work, his feet are a tad on the short side. In my opinion, he needed the time out of shoes because his back quarters had blown out from the egg bars compressing the heel. While there wasn't much to trim, the balance was reasonable in front, though I admit he was a bit overgrown and out of balance in the hinds (intentional; I wanted the group to be able to see what his feet did, left to their own devices, and I'm glad I did).

                              The hosting vet did flex both hocks and all agreed there was something in the right hind.

                              After watching all three horses move, all three were radiographed, lateral and from the front--the two views most important for shoeing purposes; navicular views were already done on my horse, and the one other who was suspected of navicular issues also had the navicular views done. These were compared with previous xrays (in my case), and the floor was opened for discussion of all three cases in turn. There was almost more interest in my guy's back end issue, and good discussion about the pros and cons of shoeing for support versus leaving unshod to allow more movement/less torque of the hocks (consensus was that this was a non-issue, that the support was more important). The hosting vet was kind enough to take a view of the right hock; there was pretty advanced fusing, as an obvious explanation for him being off, but the jam session is focused on foot issues, so we didn't delve into whether or not this was the only source of the issue, just what could be done from a farrier's perspective to support it. There was a discussion of whether injecting was appropriate or even possible with the joint spaces, but ultimately focused on support as a first step, in keeping with the foot-oriented theme of the jam session.

                              The discussion of the front was kind of straightforward; most felt that a plain (non-bar) shoe with a well-rounded toe and beveled sides (both of the terms "rocker" and "roller" occurred in the discussion of the horses, and I get the two mixed up, so I just give the discription. ETA--remembered the links that Rick posted; more like the PLR shoe, but done from a plain shoe, not the NB style, not like the roller shoe example) was suitable. This will allow the horse to determine the best degree of lateral breakover for himself, provide generous breakover and adequate support. I was very happy to forego the egg bars. On the back, the shoe was modified so that the outside branch provides more support (I didn't get to watch the preparation, there were so many guys participating it was hard to keep track of who was doing what while holding the horse)--I believe the outside branch was widened slightly, and fit a bit wide, for more support, and the inside branch beveled on both sides of the crease, sort of like an Eventer, to provide a bit more grab. I was surprised when I got to look at the shoe on the horse that these modifications aren't more obvious, but this is how it looks.

                              We traveled about 100 miles to the session, and my farrier is about 45 minutes further away (a distance better described in time rather than miles, if you get my drift). So, he brought some of his hand tools but not his whole rig, so he was working with a lot of borrowed equipment--I felt really badly for him, it's hard to do one's best painting with someone else's brushes. But it was nice to watch all of the mutual support and cooperation, and I am particularly grateful to the one who allowed his truck and assorted equipment to be borrowed by a virtual stranger.

                              Time will tell how it all works out for the horse; one, or even a group, can only make an educated suggestion of possible solutions, try them, and see if the horse agrees with the choice.
                              Last edited by monstrpony; Apr. 2, 2013, 11:56 AM.
                              "One person's cowboy is another person's blooming idiot" -- katarine

                              Spay and neuter. Please.

                              Comment


                              • #16
                                Originally posted by Cruisesmom View Post
                                this worked for him, we tried many many things. just my personal experience. no need for snarkiness.
                                I wasn't being snarky. 8 weeks is a ways, when "suggested" is 6 to 8 and on a horse with navicular, you especially don't want underrun heels.
                                "If you think nobody cares about you, try missing a couple payments..."

                                Comment


                                • #17
                                  oooo, I'd love to take mine to a "Farriers Jam Session". Not sure we could get all those farriers and a few vets together without bloodshed, though...
                                  You have to have experiences to gain experience.

                                  1998 Morgan mare Mythic Feronia "More Valley Girl Than Girl Scout!"

                                  Comment

                                  • Original Poster

                                    #18
                                    Originally posted by quietann View Post
                                    oooo, I'd love to take mine to a "Farriers Jam Session". Not sure we could get all those farriers and a few vets together without bloodshed, though...
                                    LOL. I know what you mean. The farrier who, along with the hosting vet, organizes this thing came down with the flu yesterday and was not present. He's a fabulous farrier, very hard worker, keeps up with his continuing ed, has a really robust practice, but is the most quiet, kind, humble, unassuming, no-ego guy you can imagine. It's hard to get him to say two words, and even harder to get him to say anything unkind about anyone. But he's very well respected, and it was interesting to see the dynamic in his absence compared to the other time I was able to watch one of these meetings. A lot more little displays of sparks, and I'm not talking about the grinders.
                                    "One person's cowboy is another person's blooming idiot" -- katarine

                                    Spay and neuter. Please.

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