![]() This can improve the lameness, however, over a period of time the nerves can grow back. If all of the above treatment options fail a palmar digital neurectomy may be performed, which involves surgically removing the nerves that supply the back half of the foot. Equipak) can be used to fill the back half of the foot and provide support. Other products such as dental impression material and poly-urethane (e.g. This pressure can be relieved by applying a wedged pad, wedged shoe or rocker shoe. By removing the excess heel, the pressure on the deep digital flexor tendon, navicular bone and surrounding soft tissue structures will increase. In many cases, excess heel growth has occurred, which needs to be removed. Shortening the toe and easing breakover are important if the horse is to be left barefoot. Depending upon the diagnosis, different farrier treatments may be required. One of the most important treatment options is therapeutic farriery. If soft tissue structures are involved, a period of rehabilitation and a graded exercise program may be recommended to aid in the healing process. Bute Paste) or injections of steroids into the coffin joint or navicular bursa. Medical management may include the prescription of anti-inflammatories such as phenylbutazone (eg. Unfortunately, many horses do not have an MRI performed due to the cost and their accessibility. MRI is excellent for looking at the bone and soft tissue structures of the foot, which can help us accurately determine which structures may be affected.ĭepending on which structures are injured will largely determine the treatment. Ultrasound can be used to visualise the soft tissue structures of the foot however, this can be difficult and is limited by the hard hoof capsule. This doesn’t eliminate Navicular Syndrome, it could mean that the horse has pain associated with the soft tissue structures, which we can’t see on x-rays. In some cases, there may be no changes on x-rays. Lateral x-rays of the foot may reveal an upright hoof-pastern axis and excess heel. the inside and the outside of the bone are a similar density), new bone production and small cystic lesions (e.g. ![]() ![]() very white area of bone), reduced definition between the cortex and medullary cavity (e.g. X-rays of the foot can reveal abnormalities to the navicular bone which may include sclerosis (eg. It is not uncommon in horses with Navicular Syndrome, after the palmar digital nerve block has been performed on one leg, for the other leg to look lame. At this low level, the palmar digital nerves supply sensation and pain to the back half of the foot, including the navicular bone, coffin bone, coffin joint and the surrounding soft tissue structures. A nerve block applied around the palmar digital nerves at the level of the collateral cartilages typically resolves the lameness. ![]() flexes the fetlock, pastern and coffin joints all at the same time) may or may not make the lameness more obvious. The horse may or may not be painful to hoof testers applied across the heels or over the frog. Affected horses may land toe first when walking or trotting, unlike the unaffected horse that lands heel first or flat-footed. In many cases, one foot is more painful than the other, however, the horse typically has a shortened stride in both forelimbs. Horses with Navicular Syndrome can present with a range of clinical signs, from a chronic low-grade lameness to very sore one day and sound the next. One or more of these structures may be affected in the horse with Navicular Syndrome, which makes diagnosis and treatment difficult. These structures include the navicular bone, navicular bursa, the suspensory apparatus of the navicular bone, the deep digital flexor tendon, the coffin bone, the coffin joint, the frog, the bars, the digital cushion, collateral cartilages and the heels. Navicular Syndrome encompasses disease and injury to the structures in the back half of the foot. Many of the questions are difficult to answer, but hopefully, this article can shed some light on the elusive condition. But what really is it? How can we diagnose it? How can we treat it? What is the likelihood the horse will stay sound? These are all common questions asked by owners when discussing Navicular Syndrome. Many horse owners shudder when they hear the words Navicular Syndrome.
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