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To Folks Who Are Very Familiar with Navicular Xrays

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  • To Folks Who Are Very Familiar with Navicular Xrays

    I am trying to come to grips with a completely devastating and unexpected xray/diagnosis of severe navicular. The horse (11 year old qh gelding) was sound and doing great. I only brought him to the big name lameness expert cuz I thought he had some chronic heel bruising.

    Two other general practitioner vets said the horse was absolutely sound and didn't need xrays or diagnostics. We had just done a lower level horse trial and he was his awesome self. The lameness vet himself was shocked to see the xray, since the horse was not presenting with any great amount of pain.

    I only got the horse a year ago, and had him pre-purchased by a good vet. The xray shows erosion of the navicular bone. My insurance paid for 50% of an mri. The mri report said that the bony remodaling was too severe for a neurectomy (not that I would have done that!) or bursa injection or really anything.

    The horse got osphos and eggbar shoes, but I'm still really freaked out. I've never had anything like this happen before or seen such a freaky xray. I'm looking for some wisdom about this kind of WTF lameness situation. Or, wisdom about how to move beyond the shock and devastation.
    Attached Files

  • #2
    How has your horse responded to the Osphos and shoeing regimen? My Anglo’s (he’s just 14) X-ray did not look like your horses’ films but he had a navicular change on his RF. We did the Osphos and changed his trim and he is sound and floating around again. It freaked me out as I’ve never dealt with navicular. I’m sorry I don’t have anything more to offer as far as my experience but I’m wishing the best of luck. It’s hard when they are so young and X-rays show some
    scary stuff.


    • #3
      "Navicular syndrome" is a difficult thing to relate to actual lameness or degree of lameness. And mostly, I think that lameness "because" of navicular is more often because of poor shoeing.

      IME, navicular x-rays can look horrific and have no impact on a horse, and conversely, I think that a horse can suffer from navicular pain without obvious changes.

      When I was a teenager I had a QH (halter bred) who carried me through the big grand prixes. That horse never took a lame step from when I got him as a 5 year old to when I sold him at 12. When we had him for sale the first set of buyers walked away after x-rays showed that his navicular x-rays looked like swiss cheese. Their vet said it was a miracle the horse was on 4 legs and felt that he was minutes away from catastrophic lameness. He told his clients to not walk, but run away from the horse.

      The next pre-purchase vet also did x-rays (and looked at the x-rays from the prior pre-purchase via a different vet clinic). He felt that there were significant navicular changes but given the sound horse and history of the horse, and without earlier x-rays to compare them to didn't feel that it meant anything in particular and gave the green light for his clients to buy.

      That horse went on through the big jumpers with multiple riders until he was stepped down to the little jumps at age 20. He ended up passing away in a field at 21, IIRC, because of a bad colic episode. Never took a lame step in all of those years.

      So I can't comment on the x-rays, because I am not well enough educated on reading x-rays to contribute anything other than the obvious. But I can say that horrific looking x-rays do not = a lame horse. Nor do they mean that crippling lameness is a foregone conclusion.

      Sounds like you've done the right thing. Best wishes to you and your horse, and I hope that you update us in a few months that he's doing well!
      Flying F Sport Horses
      Horses in the NW


      • Original Poster

        thanks PNWJumper and Lele!
        As to how's he doing with osphos and corrective shoeing, I have no fricking clue, since he was sound before all that. I haven't really been on him since i got the xray of despair in october. Just feels too depressing. Instead, i ventured into trick training with him, so we could still be partners and work together.

        The big name lameness vet said that one option would be, to just keep riding him and doing what I'm doing, but he can't say whether I'll get 2 more months or 2 more years out of the horse.....only that the bone will degenerate more and more over time. So, to be honest, I want to as little as possible with him and "save" him for a horse i'll at least be able to walk on the trails till he or me kicks the bucket. But then again I'm open to more wise perspectives.


        • #5
          I had a friend looking at a 10 yr old eventing horse last year. Seller disclosed that a couple buyers had passed based on navicular findings by a couple local vets, though horse had been competing and sound. Gave us the x-rays for our vet to review and he also said to pass on this horse. Months later, another prospective buyer took the now year old x-rays and some new ones and sent them to ortho specialists at Hagyard and Rood & Riddle for review. While they noted the navicular changes, they said it was nothing significant and gave a thumbs up for the horse to be used as a lower level event horse up to Prelim. Horse was purchased...

          Guess it never hurts to get more opinions by a specialist??
          Savor those rides where you feel like a million bucks, because there will be those where you feel like a cheap date...


          • #6
            Did the vet specifically say that riding him would give you only 2 months instead of 2 years?

            Gallium nitrate saved my little QH rescue. I saved him at 6 and he was 3 legged and he's now 21 and still pasture sound. His x-rays showed nothing at all really, just a little cyst but I always figured he had swelling up the bursa that made him so sore.

            Another TB that I knew had terrible x-rays all around, even hind, and I mean terrible, vets couldn't believe he was sound but he competed for 10 years in the 3'6" jumpers and ended up passing away from something unrelated to the navicular.


            • Original Poster

              One of the questions I struggle with, is that the mri was co-read by a leading radiologist vet at Colorado State, with whom the big name vet consults. So does that already count as a second opinion? Do I really need to get another opinion from another big name lameness vet? I'm pretty sick of general practitioners, who told me nothing was wrong in the first place. thanks.


              • #8
                I would be inclined to listen to your general practitioner vets over the specialists. I mean, it's great that they took x-rays and did an MRI and have this data....but to what end? Your horse is sound!

                Curious about why you had him looked at for heel bruising in the first place since you say he's been sound. Was he unsound and you noticed heel bruising? Or does he have white feet and you noticed some discoloration and "went fishing" for the cause?

                My vet often says that the vet world would be a very different place if we could x-ray/MRI every sound horse that's showing in the world. Because there are all sorts of things that *should* be career enders that horses cope with just fine.

                I would continue riding and enjoying your horse until you have a reason to stop (i.e. he becomes lame). Otherwise you're just obsessing over nothing. Perhaps those ugly coffin bones have looked like that since birth and it's not a problem for him and never will be. On the flip side he could go lame tomorrow and never come out of it (but on THAT note, he could misstep in the paddock and break a leg and have to be put down anyway).

                Short story is that you have a sound horse and you've proactively managed his potential issues the best you can.

                Also, I've found over the years that horses who are kept conditioned are far less likely to go lame/be lame/suffer from long term management issues (e.g. arthritis, etc.). It's not like there's a bank you're drawing from and if you use them you'll "use it up faster." That's just not how bodies work. Not using him now WILL NOT preserve him for more riding later. Not with a degenerative issue.

                As for the vet report.....I think those are worth the paper they're written on. In today's litigious society, vets are hard pressed to EVER be positive about a scenario lest they get sued down the line for misleading a client. I sold a horse a few years ago who I had owned from 11 months of age to 9. The buyer did a big package of x-rays and the (very good) local vet I used for that (not my vet to prevent conflict of interest) said overall his x-rays were stellar for a horse who had been under his work load and for his age. He said he wouldn't hesitate to recommend the horse whole-heartedly to any of his clients based on what he saw (IIRC, he had a touch of arthritis in his RF pastern and a bone chip in his hind fetlock that looked like it had been there forever, they also called out minor navicular changes). The consulting vet at the buyer's vet clinic absolutely tore apart the x-rays (though pointed out nothing beyond what the vet here did) and wrote a vet report that said most memorably (along with a lot of other stuff): "it's not a matter if IF this horse will go lame, but WHEN. He could stay sound for 2 years or he could be crippled tomorrow. Your personal level of risk tolerance will dictate if you're able to accept the grave risk presented by these x-rays." The way it was worded implied that at most the horse had 2 years in him, which was absolutely absurd! I was very grateful that the buyer was willing to read the vet report intelligently and understand the risk the vet was trying to avoid. And to be fair to the vet, I wouldn't want to be in the position of interpreting another vet's x-rays and making claims that could possibly be seen as false either!

                But short story, person bought the horse. Horse has been sound (as he always has been) in the ensuing years, and I anticipate no issues moving forward.

                Anyhow, my point is that YOU HAVE A SOUND HORSE. Now go enjoy that sound horse until you have a reason to worry!
                Flying F Sport Horses
                Horses in the NW


                • #9
                  So, I can’t comment on your particular horse’s X-rays. I have two stories that perhaps may help you.

                  a) I owned a 4 year old homebred that came up a tad short. Took him to a clinic and had a whole set of baseline X-rays done. Thought it was good to have baselines on hand. The-worst-navicular-X-rays three sport horse vets had ever seen on a 4 year old! Even I could tell they were bad. We did an MRI and there was no soft tissue involvement. Just ugly bones. We did some Tildren and a calcium phoshorous supplement. Never xrayed him again, really didn’t change his shoeing and I went by the premise that horses can not read X-rays. Never had a soundness problem with those front feet. I did retire him early at 11, but it had nothing to do with his soundness. (Muscular.)

                  b) I bought a beautiful 8 year old mare. Xrayed great, (like super!) but had continuinous soundness problems up front. Tried various shoeing methods and always went back to being unsound. Did an MRI. Ugly, ugly MRI and was advised to never ride her again; it was dangerous to ride her because of soft tissue involvement.

                  So- X-rays mean nothing. It’s more soft tissue you have to worry about. And really, since you know what is going on- you can be proactive about slowing any progression.

                  Good luck!


                  • #10
                    Originally posted by ytr45 View Post
                    thanks PNWJumper and Lele!
                    As to how's he doing with osphos and corrective shoeing, I have no fricking clue, since he was sound before all that. I haven't really been on him since i got the xray of despair in october. Just feels too depressing. Instead, i ventured into trick training with him, so we could still be partners and work together.

                    The big name lameness vet said that one option would be, to just keep riding him and doing what I'm doing, but he can't say whether I'll get 2 more months or 2 more years out of the horse.....only that the bone will degenerate more and more over time. So, to be honest, I want to as little as possible with him and "save" him for a horse i'll at least be able to walk on the trails till he or me kicks the bucket. But then again I'm open to more wise perspectives.
                    Just keep riding OP. Treat him the same as before. As long as he is happy to be working, ride him like normal. He will let you know if his navicular gets bad enough to need to step down in work load. I have a horse who was diagnosed navicular at 8 with X-rays who has been jumping since that diagnosis, and competing regularly. He is 17 now and the navicular is the least of our issues!
                    The problem with horses is if you look hard enough you will find something wrong, in every horse, even perfectly sound ones.
                    If don't see the improvement you want with the eggbars try taking him barefoot or with rubber/plastic shoes, or using glue ons. In my experience sometimes the nails can irritate everything.


                    • #11
                      With my background of owning multiple horses with Navicular, I feel that I should be able to read x-rays, but I can't. I also do not have any heartwarming stories to make you feel better.

                      But I do have someone who I can recommend if you want another opinion. He is the vet who manages Goober's shoeing. He has worked exclusively with his handpicked farrier for 20 years and between Dr. Mansmann's vet's eyes and Kurt's farrier's eyes, you will get a really good "2-fer".

                      I do not know where you are located, but Dr Mansmann is in Chapel Hill, NC.
                      "He lives in a cocoon of solipsism"

                      Charles Krauthammer speaking about Trump


                      • #12
                        I have a mare that was diagnosed at age 5 with "the worst case of navicular I've ever seen in a horse this age". I had taken her in because she was tender barefoot. Wanted to see if it was just thin sole or if there was something else going on. So long story short, I put her on Equibone and had the vet give her a dose of Osphos. I then, at my vets recommendation, had regular front shoes put on her. That was 3 years ago and she has not taken a lame step since. Not one.... And we ride pretty heavily, regularly jumping 3'+ once a week and showing at Novice level eventing. Just to be sure I was not causing more damage by riding her I had another set of x-rays taken at 6 months post initial x-rays and then another set one year after that. No further degeneration has shown.

                        Tldr; go ride your pony and enjoy him. I'd recommend Equibone and keeping on top of his shoeing, but otherwise keeping him in shape is probably the best thing you can do for him.
                        Last edited by flaxenfilly23; Nov. 20, 2017, 06:25 PM. Reason: clarification


                        • #13
                          the horse can't read the x-rays.....I would let him tell you when he is sore
                          "You can't really debate with someone who has a prescient invisible friend"


                          • Original Poster

                            thanks everyone for you input. I guess what freaked me out and completely demoralized me was seeing the xray, and, the vet explaining that the erosion of the navicular bone will only get worse with time.

                            He said I can keep doing what I'm doing with the horse, and then eventually go to equioxx when the horse needs it. But he said its impossible to predict whether i'll get 2 more months out of the horse or two years. (He was just being very frank with me).

                            But I can't imagine spending money and time and effort on lessons - knowing- there is a ticking clock (or time bomb). I'd rather just enjoy walks on the trail for the rest of his/my life. But I haven't even done that, since I've just been so upset by the situation. Hence, my post.


                            • #15
                              Again, that 2 years is a completely made up number, even for a vet. I once had a buyer pass up a quarter horse I had for sale due to navicular changes on his x-rays. The next buyer came along and I fully disclosed the findings. His response was "there are only two types of quarter horses, those who have navicular, and those who will develop it and 90% of them are sound until their dying day". That horse is still out there 10 years later as sound as can be. Of course that generalization is far from true however I think people would be very surprised by how many sound, highly competitive horses are out there with things that look really severe or "career ending" on a set of radiographs. If I ever become a multi millionaire I'd love to fund a study on the UL horses and see just how many of them are running around with things that would make 9 out of 10 buyer run from them.


                              • #16
                                OP, you've gotten good advice. You don't ride X-rays. You ride the horse in front of you. He's sound, it has never bothered him, so keep riding.

                                I'm not an expert by any means, I have only dealt with my first horse's navicular diagnosis and treatment. Looking at the x-ray, that looks like a top down view of the foot? In which case you can't see the navicular bone, because it is located at the back of the coffin bone. Normally when doing X-rays and considering navicular, you examine the side view of the foot.

                                X-rays aren't super telling though, there's A LOT of structures involved in the heel of the foot that are associated with a navicular diagnosis. My horse had OK X-rays, but his MRI was a nightmare... Do you have prior X-rays to compare to? Like from your pre-purchase?

                                Another question is, if you only bought him a year ago, is it possible he was nerved before you bought him and whoever sold him to you didn't disclose? (Just throwing this out there, as it's possible.)


                                • #17
                                  I am definately not an expert at reading x-rays, but I agree with the others --> Your horse is sound. Ride him!!!

                                  Have you ever done x-rays before on him? How do you know these "changes" haven't been there forever and maybe have not changed at all?

                                  I have a gelding who we found some fluid in a tendon on his right front foot when he was a 4 year old. I took him for a "preventative" lameness exam, since my other gelding was going anyway, and I was not suspecting any problems. He flexed VERY off on that foot much to my surprise, and we found the fluid pocket via ultrasound. Fast forward 2 years later, again, not suspecting any problems, but he still flexes off on that foot as a 6 year old. X-rays and ultrasound were both clean this time. While it bothers me that he doesn't flex good on that foot, I have to remember that he is otherwise sound and has no problems. Rode him hard all summer, had a recheck with the vet -- still flexed a little off but not any worse. So I've come to the conclusion that he's probably always going to flex a little off on that foot -- it's just how it is.

                                  Sometimes you have to ride the horse, and not the tests.

                                  So to flip the situation ... if your horse was lame, but the diagnostic testing (x-ray, MRI, etc) all came back normal, you still wouldn't ride the horse because he was lame, right? Even though the diagnostics tell you he's fine.

                                  So I would enjoy your horse. If he's sound and happy, ride him!
                                  It is not enough to know how to ride; one must know how to fall.


                                  • #18
                                    Ride the horse, not the x-rays. Your horse is currently sound. There are plenty of horses out there with horrific x-rays that no one knows about because they've never looked. No one knows because they are sound and doing their jobs.

                                    Do Osphos regularly, and keep him trimmed/shod properly.

                                    No one can tell you know long your horse will be sound for. No one can tell you how long any horse will be sound for. Cleanest pre-purchase exam I ever did... horse was nearly perfect. Tore a check ligament in turnout 3 weeks later and never came back. You have a new risk factor on the list, and that isn't fun, but it wouldn't change the way I treat the horse now.

                                    I'm not sure there is any truth behind the idea that not riding him now will keep him sound for more years.


                                    • #19
                                      As everyone else has said, ride and enjoy the horse! He doesn't know what his X-rays look like so if he's comfortable, go with it.

                                      Point of clarification though, you mention not being a candidate for neurectomy, is that because the bone is so jagged that it has a high risk of tearing the DDF tendon? If that is the case, that certainly does change the game a bit as the more work you do, the higher risk that it will rupture and that is career ending for sure. If that's the case, I probably would only do light work with him, just to keep him in shape and happy to be getting some attention.


                                      • #20
                                        Originally posted by ytr45 View Post
                                        But I can't imagine spending money and time and effort on lessons - knowing- there is a ticking clock (or time bomb). I'd rather just enjoy walks on the trail for the rest of his/my life. But I haven't even done that, since I've just been so upset by the situation. Hence, my post.
                                        To be blunt, you are not thinking about this the right way. The things you learn in lessons are going to be applicable to the rest of your riding life--whether you ride this horse for 10 more years, 2 more days, or never again. You enjoy riding this horse, I assume--and as people have said, he is sound. Why not enjoy what you have always done with him, and learn as much as you can?

                                        If you truly want to just doodle around for the rest of this horse's life, that is your choice. But it doesn't make sense at all. Most horses benefit from regular low-level work and that is more than just moseying down the trail at the walk. You aren't going to do the horse any favours if you let him loose a ton of fitness--that is just going to cause him different issues.

                                        A horse isn't a cake. You can't "save" them for later. They are either going to be sound or they aren't, and all you can do is enjoy the precious time we all have with them. I regret not doing more things with my mare when she was younger and more physically able. She is still happy and healthy and sound, but she is 17 and needs to step down from what we were doing (giving me clear signs like trouble making it down the lines, etc). She is so special and the best horse I could ask for and I didn't meet all the goals I had for the two of us because my own fears held us back until it was too late.

                                        Don't do the same thing.