Posted by M. W. Myers, D.V.M. on April 06, 2003 at 17:36:11:
In Reply to: Re: RVI & Navicular treatment posted by Adrian on April 06, 2003 at 15:35:55:
: Not predictable in what way-- in that it's a coin-toss if it works, or does it cause bizarre side effects? What type of prices are we talking about? I'm going to talk to my vet about it Monday and wanted to have as much info about RVI as possible : )
: Oddly enough, my mare's problem is in her "good foot" -- it has a far better hoof build than the left, which is long-toe-low-heel. But she is pretty up-right in both pasterns. And I know a bit about her past shoeing history-- it was unpredicatble at best before I got her-- when I first started woking with her she was 10 weeks in her shoes!
: I don't know the phalangeal alignment, breakover or caudal limb support. I will ask my farrier tonite since she blew a shoe today in the field-- strangely enuf trotting sound as a dollar in her easy-boot : o
: Her toes are rolled for an easier breakover. Would love to find an option that is non-invasive-- saving neurectomy as a last effort as she only blocked 90% sound.
: Was also interested in shockwave therapy but the closest place to do it is a 4 hour haul one-way.
: : I use RVI in my practice and it does assist in some cases. It is not in general use because it is not predictable in its effect and can be a bit pricey.
: : Since you did not mention the phalangeal alignment, breakover or caudal limb support, I am assuming a shoe was applied to see if it would work its magic without addressing these vital issues and you have discovered that it doesn't. Until these issues are addressed, no medication will help for any length of time if at all. The mechanics of shoeing for navicualr problems is the most important aspect of the control.
: : M. W. Myers, D.V.M.
Just rolling the toes for easier breakover is the barest minimum that can be accomplished mechanically for NS. It is actually only successful in horses that are temporarily heel sore from poor shoeing and do not actually have NS. On the other end is the Grand Circuit Therapeutic shoe or the Redden Rockered Rail shoe. The bony column must be aligned or slightly broken forward and this can only be accomplished with radiographic guidance. Breakover must at least be behind the tip of the coffin bone and may need to go as far back as the coffin joint. The rear limbs will require assistance as physical therapy and training is needed to encourage the horse to use his rear for support and unload the fore limbs.
RVI has no side effects. The initial dose is six 2cc subcutaneous injections given daily followed by six more given once weekly. If no improvement is noted after this regimen none will occur. The six dose vial cost ranges from $150 to $200 making the initial trial $300 to $400. If the mechanics are not fully addressed, the process will fail.
M. W. Myers, D.V.M.