Other Navicular 9 yr old paint mare

Discussion in 'Farrier Advice For Horses With Lameness Issues' started by Jennifer, Jul 10, 2013.

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    Jennifer New Member

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    Hi all -

    we have a 9 yr old paint mare recently dx with navicular. Bilateral, slightly worse in the left. She is not conformationally predisposed to this disorder and has always had a lovely heelf first landing... so who knows. Every professional she's seen has been surprised by her diagnosis. Changes to the navicular bone are present. We speculate the changes started about a year ago. I feel like an idiot because for a couple days last year she WAS head bobbing lame. By the time her vet appt rolled around, she was back to normal and no more was done.

    The left fore was the most painful and the one she was most reluctant to load.

    She presented with slightly less than a grade 1 lameness. She had a slightly shorter stride, no head bobbing. Main indications were slight edema through the suspensories and a slightly smaller left hoof. Approx 1/4" smaller.

    Initally treated with 3 degree wedges. The first set helped enough to take her off the previcoxx and she was sound for light riding. Immediately after her first reset, she went bilataerally lame again, this time worse than before we ever had her in to see the vet.

    Took her back to the vet. After a few rads decided hooves had a medial/lateral imbalance causing discomfort. Some speculation about changes to the extensor process of p3. Had a different farrier out to balance hooves, reset wedges and used equipak.

    It's clear from the both the rads and the visual appearance of her hooves that through 1.5 rounds of wedges, we've shrunk her own heel and digital cushion. Palmar angle of p3 is still positive but not what one would expect with a 3 degree wedge.

    We have one farrier who is absolutely traditional and sees no value beyond wedges and maybe pads. Access to another farrier who is adamant we can treat and maintain using barefoot methods. Vet is willing to try whatever we want as this mare's sole value is sentimental. If she is sound for light riding, all the better.

    I am absolutely open to criticsim, opinions and advice on this. I'd rather have hurt feelings than a mare in pain.

    This first picture is the lateral view of her left from April.
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    Here are rads of the left from July 5[IMG] July 5
    [IMG]

    Here are rads of the right from July 5
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    [IMG]


    Thanks for you time.
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    david a hall Moderator

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    Good clinical history thank you Jenifer. It looks like the mare was bare foot in April when it first went lame, or were the shoes taken off for the x-ray? It would be good to see some photos of the hoof to marry up with the x-rays. It looks like it may have had some development issues, the proximal phalanx (long pastern) looks cranked and that could to be the reason for the medial lateral imbalance in the capsule.
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    Jennifer New Member

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    She was barefoot in April, yes. She has only worn shoes once before that. Approx 2 years ago when we were riding more often in varied terrain. She had them on for one 8 week cycle and they were off again.
    As for cranked... quite possibly. When standing she is fairly correct but she does "paddle" at the trot. Vet's opinion, when her shod hoof was placed on the block for xray - her hoof walls were uneven. Farrier last night agreed when he got the shoes off that the there was hoof wall imbalance.

    I will upload pics of her hooves and legs sans shoes in April just before we got the wedges on and just after. I don't have any of the second set of wedges. Just spaced on taking any pics or vids of that for some reason. Didn't even take pics last night when the farrier was resetting and appplying the equipak either... fascinating process, too.
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    david a hall Moderator

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    Interesting, the paddling will have a whole array of problems attached to that type of movement. The loading of the limb will have a rotational effect through the coffin joint. Did you mean edema in the navicular suspensory apparatus?
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    Jennifer New Member

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    No, I'd have had a hard time palpating that in the paddock :eek: I mean her actual suspensory ligaments. Tiny bit of tenderness and swelling there, along with slightly smaller hoof and I hit the panic button. Vets were surprised we noticed... it's my JOB to notice that crap and honestly, I should have caught it much earlier.
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    david a hall Moderator

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    If the farrier has trimmed to the xrays be interesting to see if its sounder.
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    Jennifer New Member

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    She moved much better after the reset and balance last night. However, since we also used the equipak (to eliminate peripheral loading) it's hard to tell which was the successful component or if it was a combination.
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    david a hall Moderator

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    The heel trim would have my money.
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    Jennifer New Member

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    What are you thoughts on using the equipak?
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    Gary Hill Active Member

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    Pretty healthy sidebone grownin on the L... are you building in relief to the lateral side there..? I am confused as to how these shots were taken? The xrays look to be taken from behind? but are marked L?? Am I looking at it wrong? The open heels of the shoes are the tipoff? they look like they are closer to the camera??Maybe my eyes are really getting bad?:(
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    Jennifer New Member

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    The L is simpy "left" on those photos. R is right. Some were shot laterally, others are dp/ap views.

    as for the sidebone, neither one of the farriers or the vet that thought was a) a part of her current discomfort and b) anything to consider when shoeing/trimming. What are your thoughts on this? This is exactly why I posted - for more and different input.
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    Justin Decker Active Member

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    How did they diagnose navicular changes without a shot of the navicular bone. I find it interesting that the joint spacing is compressed on the low side.
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    Gary Hill Active Member

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    Well, thought so ...just got thrown by them open heels...my bad...anyway, yes IMO that long one could cause some discomfort in the future. I would just start now if I haven't..sidebone or half round would work I bet? I am not much on the pour in pads only because shelf life sucks with that stuff...I would use IF needed a frog support pad either flat or wedged? It depends what you have in hand.? R seems to have aslight broken back at the distal of P1? That would call for a wedge for sure to me?
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    david a hall Moderator

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    I almost never use it. I almost never use wedges any more. I just focus on heel level, getting the toe back and sufficient heel cover with the shoe. awful lot of problems are kept at bay that way.

    The bare foot April shot looks a bit thin in the sole.
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    david a hall Moderator

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    Justin the joint spacing is miss leading. They are a clue as to the rotation of the limb as it aproaches the loaded phase of the stance and as it unloads. A ginglimus joint is a joint that allows movement in one direction but also some medial lateral movement, but at mid stance that joint space will be even, if there is articular cartilage wear then the joint spaceing is significant. What you see here is what allows you to move the leg side to side when you have it up.
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    david a hall Moderator

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    The image is gathered from behind on a plate, as opposed to your camera phone where the image is gathered from the lens in front of the object.
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    Jennifer New Member

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    We held a seance and the mare's ancestors spelled "navic" on the dirt of the barn floor.

    Kidding. Ha? I didn't post the rads that displayed the navicular bone in all its glory. Was trying to keep avoid posting 12,000 pictures AND the quality of the rads emailed to me were not that great. On their display, with the ability to rotate and change contrast, awesome. On my computer, not so much. Suffice to say, I'm comfortable with the diagnosis.
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    Jennifer New Member

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    I see that..... what's your opinion of heel and digital cushion changes from April to July? I think I'm justified in saying the wedges are the answer here but definitely open to opinions. Current farrier wants to wean off wedges and take a barefoot approach. My issue is - she was barefoot when this STARTED so how can that be the answer?
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    Gary Hill Active Member

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    Thanks for explainin that for me..I knew that but just couldn't remember that ???:)Duh!
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    Tom Bloomer Well-Known Member

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    So your horse is caught in the "navicular suspensory circle of pain."

    Wedge to relieve DFT pressure on navicular bone transfers that load to the suspensory and extensor.

    Horse is sound for a while, then the suspensories start to hurt.

    Take off the wedges and the suspensories feel better until the navicular bone begins to have problems again.

    Back and forth back and forth. Been there, done that got the goddam T shirt.

    The problem is that you are changing the angle of the lever and NOT reducing the force on the lever.

    Make the lever shorter. Put the angle at NORMAL Short lever reduces strain on BOTH the navicular AND the suspensory.

    Red lines = existing lever. Green lines = new lever. Chop toe off at angle = cyan.

    rightlat_zpse54eef19.jpg

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