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Navicular

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  • Navicular

    Last September I bought my first horse in a very long time. A 10yo Appendix. Was to be my dressage horse. Had him vet checked, specifically asked if I should have x-rays done. Vet said, "I wouldn't".

    He came up lame a month later, took him to another vet within the same office. He nerve blocked him and took x-rays, came back with a tendon injury diagnosis and recommended I put him on stall rest for 8-10 weeks.

    I did.

    He was still off, so I took him to another vet office on Monday. $1,000 and 90 minutes later I was told that my boy has Navicular, arthritis, bone spurs, and the beginnings of ringbone. He had so much inflammation in the hoof that fluid spurted out when they nerve blocked him. The vet said his Navicular was a 4 or 5 out of 10 with 10 being the worst.

    The doctor gave him HA and steroid injections in both front feet and told me to put him in aluminum wedge shoes. He'll need another set of injections in 3 to 6 months. The vet told me that if all goes well, he should be sound for a couple of light trail rides a week.

    Still waiting for a farrier to get back to me - most are either out on a trail ride or on vacation.

    He looked better yesterday when I visited him. His strides were much longer. When the treatments stop working and he gets to be in too much pain in the pasture, I'll have him put down.


    Anyway, he's on a good quality feed (low NSC, fixed formula, high fat, medium protein) and he's on 24/7 turnout. Could anyone recommend a good supplement that might help him?

    I know there's some debate over whether oral HA supplements work...

    I found Recovery EQ on SmartPak and it seemed to have favorable reviews. They also have a more expensive version with HA in it, which had good reviews, too.

    Any suggestions?

    Thank you.

    These were taken two weeks ago: http://picasaweb.google.com/nervousa...eat=directlink
    Last edited by nervousalter; Feb. 25, 2009, 10:00 AM. Reason: link

  • #2
    So sorry to hear about your boy. Like they say, hindsight is 20/20 (or something like that). It's too bad that things weren't found on the PPE, but I was in the same boat a few years back. No x-rays and a couple months later had a lame horse who had fractured his coffin bone (old fracture too, btw). But whatever... that's in the past.

    I've been using Recovery Eq on my old Gus, who has a CCL injury that's healing (bad stifle, really bad). It seems to help make him more comfortable, but is spendy because I did one month at the loading dose (so two scoops a day). What really worked best for him, a year back, was Legend injections. It's an IV injection and well, ran about $100 month to have my vet do them, but were SOOOOO worth the money. I think you can get the 'script cheaper... but I haven't got a clue as to how to do an IV injection. Sadly, I haven't had much success with the Legend in recent months. So we're sticking to doing the stifles as needed (hopefully not again until June or so).

    Otherwise, I have used Smartflex Senior and it seemed to help a bit, for a while. Pretty palatable. Used MVP's Matrix 4 years back and loved it, but I think there are better products on today's market.

    FWIW, I'd be sure he's on a good dose of MSM (like 10,000mgs at least). That helps IMMENSELY with inflammation (as me how I know). Otherwise, they say after an injury has set in, HA is your best friend (along with the aforementioned MSM). Everyone has different remedies as to what works and what doesn't. You make need to experiment.

    Best of luck to the both of you. Like I said, I'm in the same boat with one horse (though both are no longer "usable" for their original purpose) and I'm just enjoying each day I have, taking it one day at a time.
    Proud owner of Gus & Gringo.
    See G2's blog
    Photos

    Comment


    • #3
      Let me guess - right front?

      Comment


      • #4
        Originally posted by BornToRide View Post
        Let me guess - right front?
        Don't you have, like, a 50% chance on that guess?

        Are we doing this like a cold reading?

        "I am getting a vibe from your horse that he's got pain in his right front."

        And then if you guess right, you say "whee! I am psychic" and if you guess wrong, you say "well he's putting more weight on the LEFT because of the underlying problem on the RIGHT. Look harder at the right and you'll see I'm correct.... whee! I am psychic!"

        nervousalter, I would be fairly peeved at the vet who didn't think X-rays were prudent, but at the end of the day it's the client's decision whether to do films or not. Now you've just got to manage what you've got as best as you can. I would take the horse to a really good sports medicine vet and see if there are any therapies/management practices that make sense, aside from what you're already doing.

        In terms of supplements, I've tried Recovery Eq and didn't see any effect. I have had excellent results with BL Solution. I always think you get more bang for your buck with Adequan/Legend, as opposed to oral supplements, if you are willing to try Adequal/Legend.

        Good luck!
        ~Veronica
        "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
        http://photobucket.com/albums/y192/vxf111/

        Comment


        • #5
          Originally posted by vxf111 View Post
          Don't you have, like, a 50% chance on that guess?

          Are we doing this like a cold reading?
          Yeah, that would solve a lot of problems for me..... I go by hoof shape. I looked at his photos

          Comment


          • #6
            Originally posted by BornToRide View Post
            No silly, I go by hoof shape. I looked at his photos
            How your guess about which foot has navicular useful information when nervousalter has already been to the vet and has films?

            How can you even really see this horse's feet in those kind of dark, somewhat blurry, far away pictures anyway?
            ~Veronica
            "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
            http://photobucket.com/albums/y192/vxf111/

            Comment


            • #7
              From experience I know that it usually is the more upright, non-dominant front hoof that is affected, which, if not trimmed correctly, generally leads to toe loading and heel contraction. In this case is it appears to be the right front.

              For further info on the subject see here:
              All horses with heel or navicular troubles can be seen to have deformed hooves to some degree…these deformities arise through improper hoof care and lack of exercise
              http://www.easycareinc.com/Education...n_trouble.aspx

              Comment


              • #8
                And this helps the OP and her horse HOW?
                Click here before you buy.

                Comment


                • #9
                  Uhm, that trim changes could possibly make this horse a lot sounder?!

                  Comment


                  • #10
                    You can tell that a horse needs a different trim, and has navicular affecting him more on one foot rather than the other, based on 4-5 artsy far away photographs of a horse, taken at dusk, that you saw on the internet? You should take this show on the road! Who needs vets, radiographs, medicine etc. when a few quick glances at a blurry photo online can get 'er done?!

                    Don't you think, if there's an issue with trimming, that BOTH front feet-- no, that ALL four feet ought to be assessed and trimmer properly? So how is it at all helpful to say "lemme guess, right front?" in this situation?
                    ~Veronica
                    "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                    http://photobucket.com/albums/y192/vxf111/

                    Comment


                    • #11
                      I'm sort of surprised the photos were even necessary.

                      To the OP, he looks like a sweetheart. I've personally got something only very slightly more than zero faith in supplements, nutraceuticals, etc. for chronic mechanical problems.

                      By all means I'd enlist the help of an expert farrier, and I even think that trying barefoot sounds very reasonable, if there is no other compelling reason to shoe him, especially if he's going to be given some time to adapt and reshape his feet.

                      In the end, if he just can't be made comfortable, a neurectomy can be a humane solution.
                      Click here before you buy.

                      Comment

                      • Original Poster

                        #12
                        Thank you, Appychik & vxf111.

                        I'm so sorry about your guy, Appychik.

                        vxf111, I started to kick myself about not having gotten x-rays, but then realized that the PPE vet works under the vet I took him to in October and he missed it then, so I can't be sure he'd have caught it before I bought him. I'm trying to stay positive - it could be worse. He's alive and comfortable right now and I love him to death.

                        His injections ran $360 on Monday. The vet gave him 2mL of HYVISC (11mg/mL Hyaluronate Sodium) in each foot, plus the steroids. He does seem high - my friend had her gelding's knee injected with steroids and he charged her $100 for the injection. Looks like Legend would be cheaper, but I can't give the injections myself and I don't know if he'd write me a Rx for the Legend to bring in to him.

                        This new vet is a sporthorse lameness expert.

                        I'll try as many supplements as possible to find one that helps make him comfortable.

                        BorntoRide, unfortunately, he has it in both feet. He was showing more pain in the right front, possibly due to him being more upright on that foot (he was being trimmed to try to correct it - when I bought him, his hooves were extremely short, so it's taken time), but the x-rays were equally bad in both. They were really hard to look at. I'll flat out admit it: I started crying and had to leave the room for a moment, before the doctor continued with the readings.


                        DeltaWave, the photos weren't for diagnostic purposes, just to show my sweety. He's an exceptionally kind animal. I rode him 4 times before he started showing lameness and the photos of him from two weeks ago, marked my sixth ride (a walk around the pasture to check on his 'tendon injury' recovery). He didn't bob, but he was stumbling.

                        He's been so clumsy with his feet, that a neurectomy scares the hell out of me.

                        Comment


                        • #13
                          I understand what you are going through. I have a 22 year old, 18 when he was given to me, that came to me with ringbone and supposedly riding sound. He went lame about 6 months after I got him. Well three vets, lots of $$$ and many months later Ohio State University Vets found that he did not have ringbone. he had a tendon injury, many years ago, that caused rotation of the navicular bone, scar tissue and pain. Poor horse was being used as a lesson horse before i got him with this injury

                          Best thing we ever did for him was the aluminum wedge shoes. About three weeks after putting them on he was pasture sound and down to one gram of bute every other day, he was on 2 grams a day when I got him. He now only gets bute when needed and goes on short trail rides a few times a year. I also started him on daily oral MSM. I noticed a huge difference. If your vet recommends injections they will help. They did not help my guy in the beginning but in conjunction with the shoes they work great.

                          Make sure you have a good farrier. The aluminum shoes wear down fast. I have to replace mine every other time, every 12 weeks. Make sure you stick to a 5-6 week shoeing schedule. Keep your boy out of the mud and watch when the ground gets hard. I notice my guy gets very sore on hard ground. But turnout is very important he gets stiff standing around.

                          Give him time. It took 6 months for my guy to be back to where he was. He is now happier and in less pain then I have ever seen him.

                          Comment


                          • #14
                            BornToRide in gray

                            From experience I know that it usually is the more upright, non-dominant front hoof that is affected, which, if not trimmed correctly, generally leads to toe loading and heel contraction.

                            Silly me, I've always made it a point to have the attending veterinarian inform me of his diagnosis and his prescription for treatment. Did you decide to skip this step because of your "experience"?

                            In this case is it appears to be the right front.

                            Do the diagnosis of pathologies affecting the hoof fall within your purview as a trimmer? (As someone has already pointed out, if it turns out to be the left, you can always say, transference from right to left was the culprit.) Whatever your layperson's opinion, the diagnosis of pathological conditions remains the vet's call, not yours.

                            For further info on the subject see here:
                            http://www.easycareinc.com/Education...n_trouble.aspx

                            LMAO! Tesky as a viable resource? You're kidding, right? What will you tout next? Strasser's 30º hairline? Bowker's heel whacking? The Feral Follies?

                            Think! If the many pathologies associated with the distal sesamoid and distal interphalangeal joint were readily apparent on visual inspection, there would be no need for diagnostic tools like hoof testers, nerve blocks, radiographs, MRIs, and similar stuff - a vet could simply look at a hoof and say, "Yup, looks like navicular to me."
                            Tom Stovall, CJF
                            No me preguntes cualquier preguntas, yo te diré no mentiras.

                            Comment


                            • #15
                              OP - so sorry to hear of your troubles - it seems like we just have to learn things the hard way sometimes. I can certainly identify with what you're going through.

                              Has anyone suggested shockwave? I had good results with it on my ringbone horse. Other than that, my suggestions would be to find an excellent farrier and perhaps consider neurectomy as a last resort.

                              You can experiment with joint supplements but I wouldn't hang all of my hopes on them. I've also seen horses go sound after a year of turnout, but I realize that isn't an option for everybody.

                              Best of luck!

                              Comment


                              • #16
                                OP- best of luck to you. I don't think my situation is exactly like yours, but wanted to let you know there's some hope.

                                My horse was originally diagnosed as a navicular case- bar shoes with wedges recommended. After a little more investigation, though there were "navicular changes" we found the actual inflammation/pain was in the coffin bone. Not that that's relevent to you, at all. The part that is relevant is that after getting initial injections done, and following the protocol set by the vet (a top sporthorse lameness vet, btw, who is wonderful and I adore him in every way), I changed farriers.

                                The original farrier went ahead and did the bar shoes, and the pad (the vet did not advise wedges, but a pour in pad instead). Things were a little better but not perfect, and though the grade of lameness was much reduced it was still there and making me frustrated.

                                The new farrier immediately brought my horse's heels down. He obviously did more than that, but that was the main, first, most important thing. We kept up with the bar shoes and pour ins for a while, but for the last cycle new SuperDuper farrier said if it were his horse, he'd go back to regular shoes and no pads. So I did.

                                The difference since I've had the new farrier has been night and day. We have some back end hitchiness now, probably due to lack of work, but the front end lameness is imperceptible. Can't see it, can't feel it, there is no more head bobbing or lugging. He is throwing his feet out there with confidence and is HAPPY to work

                                Moral of the story- find the very best farrier you can. I don't know what area you live in, if you're in my neck of the woods I would wholeheartedly recommend mine. In all seriousness, my horse walked off a million times better after the first shoeing. It almost made me cry.

                                Your guy sounds much more serious than mine, lameness wise- so I'm not sure why I'm going into this detail except the initial suggestion from one of the first vets to look was to try wedges, etc. But his actual problem was too-high heels to begin with.

                                Anyhoo if you're in my area and need a farrier recommendation, feel free to PM.
                                "smile a lot can let us ride happy,it is good thing"

                                My CANTER blog.

                                Comment


                                • #17
                                  Sorry to hear about all of your issues- he looks to be a very sweet boy.

                                  I went through the same thing a few months ago- bought a horse, no ppe x-rays. She came up lame over the summer, she would be fine one day and dead lame the next. My vet did a flexion, she came back positive on both her hoof and fetlock. He blocked her, still positive on both. X-rays revealed that she has deterioration in her fetlock joint and 'navicular changes'. She is 6.

                                  We put front shoes on her (she had always been barefoot) with wedge pads. I also changed her supplement from Platinum Performance to the new Platinum Performance CJ because it has glucosamine, HA, cetyl-M, MSM, and more. Knock on wood she has been sound with this set up. I am working very closely with my farrier and having her reshod every 6 weeks.

                                  Best of luck in finding the right setup for your guy.

                                  Comment


                                  • #18
                                    BorntoRide, unfortunately, he has it in both feet. He was showing more pain in the right front, possibly due to him being more upright on that foot (he was being trimmed to try to correct it - when I bought him, his hooves were extremely short, so it's taken time), but the x-rays were equally bad in both. They were really hard to look at. I'll flat out admit it: I started crying and had to leave the room for a moment, before the doctor continued with the readings.
                                    Good, I am glad it is being addressed already. Make sure that there's nothing else hiding in those hooves that could be a contributing factor, like frog infections.

                                    If this was my horse, would also not shoe this horse with metal shoes because of the possible increase of concussion from the metal, nor any wedging. Instead I would make sure that this horse is trimmed correctly and balanced to internal hoof structures and to encourage heel loading at all times. Use hoof boots if necessary for riding.

                                    Best wishes!

                                    Comment


                                    • #19
                                      So sorry to hear about your horse. I have a gelding with navicular and I've found a few things that have helped. His current shoeing regumine consists of steel bar shoes (my farrier fabricates the shoes so that the bar is placed farther forward rather than on the heel) with a 3 degree wedge pad. He gets shod every 6-8 weeks depending on how his feet look. The wedge pad really helps. I tried to take them off completely after dropping it to a 2 degree then a 1 degree over time, but he did best on a 3 degree. He is a big guy (17.2H warmblood) and would wear through the aluminum way too fast, in fact my farrier won't even put aluminum bar shoes on any of his horses because they just don't last and are not economical. I can usually get a reset out of the fronts too which is great. He is also getting Isoxsuprine (30 tablets 2x/day). Some vets and horse people don't think it has any benefit, but it seems to help keep him going. I also give him Adequan every 4 weeks religiously- you can tell when he hasn't had it. Initially, I gave him 1 dose every 2 weeks for the first two months to build it up in his system and then I did the 1 injection every 4 weeks for maintenance. I've found that he also moves a lot better when the ground is softer- he stiffens up quite a bit when the ground is hard (more so than the average horse). I've also found that keeping him moving is beneficial. Doesn't have to be real "work" but any movement, even a walking trail helps him. He really likes to work though and doesn't seem to be in any pain- it may be different in your case. We discovered his really early on and have been taking appropriate steps to keep him going. On his bad days, I'll give him 1g bute with each feeding. I still show him and ride him on a regular basis, so it is possible to keep them going.
                                      I hope you're able to keep him comfortable. Definitely get yourself a good farrier- they are invaluable, especially when dealing with something like navicular. Good luck!
                                      Riding: The art of keeping a horse between you and the ground. - Author Unknown

                                      Comment


                                      • #20
                                        I would like to add that it is quite possible to heal navicular with correct trimming and creating heel loading. Ringbone is a different story, but even that can and has improved by making sure the hooves are trimmed balanced to internal hoof structures. Navicular is no longer an issue for Pete Ramey: http://www.hoofrehab.com/end_of_whit....htm#Navicular

                                        Most likely management practices as outlined above will eventually lead to further breakdown of what is already going on, as it so happened with a horse belonging to a friend's client. Also diagnosed with navicular, was eventually put in natural balance shoes and recently re-evaluated. Horse is now more sore than ever.

                                        Comment

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