What is the normal prognosis for Nevicular Disease?

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What is the normal prognosis for Nevicular Disease?

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    10-29-2009, 06:18 PM
What is the normal prognosis for Nevicular Disease?

One of my Vets informed me today that he is going to test my mare for nevicular disease. Every thing I have been reading online so far is saying that you can really only make them comfortable for awhile. What is the normal prognosis and quality of life for a horse with this issue?
Also, he informed me that he has been seing ALOT of 8 to 15 year old QH with this issue in the last few years and that it could be related to blood line. Has anyone else heard this?

Thanks in advance for all replies.......
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    10-29-2009, 10:32 PM
It depends on how up-to-date your vet and farrier are.
If they attempt treatment with an outdated shoeing package, like you suspected, the best that could be hoped for is to keep the horse comfortable for a few years.
If they prioritize a heel-first landing, the pain of Navicular Disease can often be eliminated and Navicular Syndrome can be reversed.
Sound ludacris? Read Dr. Bowker and Dr. Rooney's finding's...
Dr James R Rooneys Corner of the Web
Navicular Syndrome
is characterized by pain in the back of the foot and an incorrect toe-first landing.
Navicular Syndrome turns into Navicular Disease when years of those toe-first landings result in friction damage. This damage cannot be reversed, but pain at the site can be eliminated by avoiding any further friction from toe-first landings.
To prevent Navicular Disease and reverse Navicular Syndrome the priority must be achieving a heel-first landing by balancing the foot. Pads (either with shoes or inside boots or casts) may be needed temporarily. They will ensure the back of the foot is a comfortable place to land until it has been stimulated by enough heel-first landings to be properly developed and lose over-sensitivity. Thrush in the back of the foot due to excess height often accompanies navicular problems and must be eliminated as well if the horse is expected to land on his heel.
Many vets and farriers are lead to believe that navicular problems are hereditary, but research shows this is false. This belief is understandable, as blood-related horses are often cared for similarly (same farrier/vet/owners same method/frequency of care, same living conditions, etc) and show the same problems as a result.
Good luck... don't let a diagnosis get you too worried.
    10-29-2009, 11:07 PM
Hi! I came across your post and it reminded me of my 'old' horse. His name was Cotton and I posted a lot on here about him. He was diagnosted with navicualr is april or may. I was devestated by the diagnosis. I had always thought it was arthritis. Since he was already barefoot I went ahead with the barefoot trimming for navicular. Then I got news that made my hopes dimminish. He had they 'type' of navicular that affect the navicular bone, and boney growth that was jagged had grown on the navicular bone and everytime he took a step, the jaggedness of the bony growth would tear into the deep flexor tendon. There was no hope. Not even shoes would help. I had him put to sleep July 1, 2009. Hardest day of my life, but I know and so did he that it was for the best. But there are VERY good meathods out for navicular. You just need to work with your vet and I TOTALLY recomend the barefoot way! Barefoot all they way! The vet said that keeping him barefoot added years to his life :) Keep us updated with your mare! Best of luck and I will keep you in my prayers for a good prognosis!
    10-29-2009, 11:12 PM
Agree with Rosetreader. Normal prognosis? Depends who you ask. It is *traditionally* looked upon as an inexplainable & incurable condition that can only be managed palliatively until it progresses to such a state that the horse cannot be made comfortable, or the hooves completely break down.

I also agree that it is *likely* not genetic, except in that some hoof conformation types, such as typical QH or arab hooves are more likely to develop these probs *when not managed well*. I think of no. 1 importance is management & ensuring horses get a LOT(compared to normal) of exercise on firm ground from a very young age. Trimming is also very important, and farriers also often tend to trim certain breeds or types in a certain manner - eg. QH's often left with high heels, which makes them more prone to 'navicular' issues.

Basing my attitude on recent research, and experience in successfully rehabilitating some of these horses(along with other 'incurable' conditions such as founder with sole penetration), it seems that the prob is, most domestic horses have underdeveloped digital cushions & lateral cartilages. They don't get enough exercise & good hoofcare from birth, so the soft, fatty digital cushion that is quite adequate to support the weight of a foal, never develops into something that can support a grown horse. This causes them not to be strong enough for heel first impact. Bad trimming, diet & thrush can exacerbate the issue, until the horse is very sensitive in his (underused) heels. I think 'navicular syndrome'(ie unexplained heel pain) is much more common than people suspect, and is probably the more usual cause of horses being 'ouchy' on gravel & rocks, rather than thin or weak soles, which are what is usually blamed.

Unfortunately the traditional palliative measures of bar shoes, pads, wedges etc. further remove the heels from use & therefore cause them to become weaker, along with forcing the horse more on his toes, which create other probs including damage to the ddft & bones of the hoof & leg(not just nav bone). It seems to be the regular state of affairs that horses managed palliatively in this manner can generally be kept relatively comfortable(but generally unable to 'work') even when quite advanced, until due to the continued toe first impacts, the horse founders badly(I've seen horses with *convex* soles!), and that is generally the end of the road.

As you may be coming to see, the horse desperately needs to use his heels to be/become sound & develop strong feet, and the above does virtually the exact opposite. But just shearing high heels down to 'correct' parametres isn't likely to be appropriate treatment, especially in the beginning, because it will just make the horse more uncomfortable, less likely to get the much needed exercise, and he will still likely 'tippy toe' due to pain regardless how his feet are trimmed. So my approach is *generally* to lower heels only gradually, and protect sensitive heels with boots &/or pads, but ensure his heels aren't too out of the picture to get stimulation from ground pressure. Eg. If they're still high, use frog support pads for extra pressure.

In addition to Rose's links, hoofrehab.com has some great info & I highly recommend Pete's book(altho he wrote it some time ago & has better, more precise info on some things now), and if you have the money, his DVD set. You will find plenty of other links on his site and plenty of other sources of good info online. There're also the studies done by Dr Chris Pollitt(sp?) of the University of Queensland, but I can't find the articles or my links to studies since my computer crashed a couple of months back.
    10-30-2009, 12:00 AM
[quote=loosie;443680] Trimming is also very important, and farriers also often tend to trim certain breeds or types in a certain manner - eg. QH's often left with high heels, which makes them more prone to 'navicular' issues.


That's not correct. You need to raise the heel in Navicular horses to a proper angle, but not excessively.

When the heels are dropped, it puts to much strain on the tendon that moves across the Navicular bone and bursa... many horses have "farrier onset" Navicular due to their heels being chopped off and/or underslung.

The angle of the hoof will be different per horse, but need to have a substantial heel for support. To much heel will cause problems as well. A good farrier can judge, gauge and set your horses hooves to the correct angle for comfort. Most do well around 55.

Hire a MF/CJF
    10-30-2009, 12:13 AM
Our old boarders horse was diagnosed with Navicular in her late teens. She lived to be 32. She was shod with an egg butt shoe and pads that raised her heels. As long as she was shod she rarely was lame. She could not go barefoot at all.

I hope you have success with your horse and the treatment or special shoeing works for you as well.
    10-30-2009, 12:27 AM
That's not correct. You need to raise the heel in Navicular horses to a proper angle, but not excessively.

When the heels are dropped, it puts to much strain on the tendon that moves across the Navicular bone and bursa... many horses have "farrier onset" Navicular due to their heels being chopped off and/or underslung.
I disagree thoroughly. However, this illustrates the huge contrast in the theories, and that learning about the principles that govern correct hoof function & soundness & studying recent research is imperative, because without good information, it's all just a matter of opinion.

Heels being 'chopped of and/or underslung' is a bit of a contradiction of terms, as if the heels were kept short enough, they wouldn't become overgrown enough to be underslung.

While as I said, with a lame, weak heeled horse, I don't think it's appropriate to take the heels down too far &/or too fast. Hooves, along with the horse they're attached to are all individual & should be treated as such too, IMO. It also depends on the surfaces the horse lives & works as to what his optimum hoof conformation should be. But **generally speaking**, optimum angle is having the bottom of P3 at or close to ground parallel(depth of colateral grooves will give you an idea on that) and optimum heel height is having the heels & frogs on or near ground level when the horse is standing on a hard, level surface.

Regarding tendon strain, heel first impact and low heels actually helps the tendons work properly without undue strain, whereas high heels & toe first impact causes a lot of excess stress on not only the DDFT(up the back of the hoof/pastern) but also on the DET(up the front). I agree that many horses may have 'farrier onset navicular', but not for the reasons you've said. I would like to see any studies that support your theory?
    10-30-2009, 12:36 AM
Originally Posted by qtrhrsecrazy    
That's not correct. You need to raise the heel in Navicular horses to a proper angle, but not excessively.
I agree, but I want to clarify as well.

I see 2 types of Navicular horses. Those with,
A) long low underslung heels
B) long upright heels.

Obviously, a horse with underslung heels needs them brought BACK under the bony column, NOT lowered. And sometimes they may require a wedge (whether in shoes or boots) to help align the bony column and maintain comfort in the back of their foot. I feel that this pad should be temporary until the heel can grow back in at a healthy angle and the back of the foot can be brought back to health.

I completely agree that a heel that is too low can harm a navicular horse, and the majority of horses with navicular have low/long heels that are run under.

However, the horse's with excessive heel height do need lowered so that the structure's in the back of the foot can work properly as per research by Dr. Bowker and Dr. Rooney.

Most do well around 55.

I also see that most sound horses are in the 55 range...

But the most common mistake I see being made is a foot with toe flaring being made to 'stand up' to look closer to the 55 ideal without regard to the position of P3 inside the hoof capsule...

Most navicular horses have toe flaring and may appear like they are at a lower angle, when the flare merely needs grown out.
    10-30-2009, 12:54 AM
I completely agree with you
    10-30-2009, 12:55 AM
Thanks to everyone for the information. Kays farrier is on a regular 6 week schedule for trims since I bought her in March. Also, she is rotated between three grass pastures and is only on hard surface when riding or for walks. We have no gravel areas. As the nevicular issue is all new to me I will be spend alot of time watching her foot placement when walking in the next few days. I contacted her farrier tonight and have scheduled him to come out. He just trimmed her a week and a half ago.
This has become a very frustrating issue with Kays left leg. First the Farrier shoed her in July, thinking the issue was cracking, flaking in hooves. Then the vet thought it was the knee and did three steroid injections, which did not help because the issue isn't the knee. Then we were told the issue was in the shoulder/ withers possible pinched nerve. Today I contacted the most recommended vet in Indiana and explained Kays issues to him. He immediately said it's her hoof, possible nevicular.
All around I've gone from being told she had mild arthritis when I bought her and her limping only occasionally to her constantly limping, some days she doesn't even want to move. Vet's wanting to charge anywhere from $50-$500 to do the same procedures for a diagnosis. (I have contacted 4 different vets) All I want is my mare to not be in pain!!!!
Thanks again to everyone for your information.

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