Navicular and X rays - opinions?

[Blue Eyed Xena]

My 5 yr old horse has been lame for about 4-5 weeks. Vet came out and used hoof testers, found nothing. Nerve block on right front (heel area) made horse go shound. We had xrays done and vet diagnosed navicular due to some "slight changes in bone". I had a farrier (barefoot specialist) come out and trim her up and we found a abcess in her right front "toe area" which "I" believe is probably the culprit. This horse was just starting to be ridden (and I mean just starting :rolleyes: )

I am just looking to get some opinions on the Xrays, the farrier I used looked them over and didn't see any of the tell tale signs of navicular. We both agreed that the xrays were not to good

as a side note, she had a real mild case of laminitis this past spring

thanks



Here is the link to the xrays
http://pg.photos.yahoo.com/ph/rlpage5/my_photos

[calshoer]

There is no way anyone here can give a second opinion on the diagnosis based on just Xrays.
First off, farriers are not vets. We cannot diagnose. Second, even if one of the vets here looked at the pictures, there is not enough detail in that format for them to see any detail. For diagnopstics the Xrays need to be examined close up and in operson. If you have doubts I suggest you or find another local veterinarian to give you a second opinion off your original films.
PS by definition, a barefoot specialist is NOT a farrier,unless they also shoe horses. Otherwise they are just a hoof trimmer.
Patty

[Blue Eyed Xena]

As I stated, I was looking for other opinions. None of the Xrays even have a clear shot of the navicular bone itself. I have read many posts on this site and it seemed to be a general consenus that all too often when a lameness occurs that its blamed on Navicular. The vet went over the xrays with me and there are not "spots" anywhere on them. Just a ever so slight variation on the bone edges. Yes, I could have them evaluated by another vet.

BTW, my barefoot specialist was a farrier before going to strickly barefoot. Therefore I believe either term fits the bill. (We are splitting hairs on defination) I am not here to debate anything

[Phil Armitage]

I think horse owners can use logic and determine what might be the culprit. Based on your description, it sure sounds like an abcess to me. I have seen just the opposite happen. Vet checks out a lame horse says it is an abcess soak the feet for a few days and everything should be good. Then the horse founders. Trouble with that situation the horse owner thinks they are treating an abcess and knows they need to give it time when time is the enemy. Stange it didnt show up with the hoof testers. Are you saying the horse is sound now? I would keep an eye on it, check for heat and pulse. Could be anything, you may be out of the woods or you may see another episode of lameness. Does his feet tend to split in the toe and seperate where gravel can get up there?

[Blue Eyed Xena]

Neither I nor the vet could find anything with hoof testers. Part of the problem is the horse is very tempremental with WHO handles her. She does well with me, though I can't say I actually tested that specific spot where the abcess was found. I think I was always farther in on the hoof testing it.
She wasn't real cooperative with the vet, but he did try a bunch of spots on her hoof and didn't see anything but its difficult to tell when the horse is yanking its foot :(
I had suspected a abcess or bruise right off the bat as the lameness seemed to show more drastic when she walked on the gravel driveway. The lameness just continued for weeks and didn't change, that why I finally called the vet.
I don't have a regular farrier, I normally trim myself (mainly due to the nature of this horse, most people won't deal with her and I can't say as I blame them). I also know most farriers don't want to "dig" for abcesses either and would rather have a vet do it. Needless to say I was extremely surprised with the diagnoses, then even more surprised when I had someone trim her feet and find a abcess in the foot she was lame on. There hasn't been any heat or swelling anywhere in the foot or leg. (not sure where to find the pulse, I have seen many articles that talk about it). She did have some white line seperation (I was bad and let her feet get a bit busted up) Her toe on that foot was extremely short due to breakage

I did some loose work with her today and she looked pretty good, a little off but better than she has been

[calshoer]

I am sorry if I misunderstood. It seemed that you wanted a second opinion on the Xrays, based on your original post......
I am just looking to get some opinions on the Xrays, the farrier I used looked them over and didn't see any of the tell tale signs of navicular. We both agreed that the xrays were not to good
Patty

[mwmyersdvm]

Simply put, a hoof abscess at the toe would not be desensitized with a heel block.
Your horse has heel pain and possibly chronic laminar issues which could be the cause of the toe abscess. Radiographs taken to specifically delineate hoof balance would be in order.
Your trimmer may be able to alleviate some of the problems initially, but they can "smoulder" for some time if they are not pursued and the result can be a disaster later down the road.
Before I would be too critical of the veterinarian's films do be advised that a lateral film can reveal some serious navicular bone changes. Your farrier may be looking for the classic navicular view which is often misleading and may have little bearing on the actual source of the lameness.

[Blue Eyed Xena]

just curious, did you check out the x-rays in my photo album?


>>>>Your horse has heel pain and possibly chronic laminar issues which could be the cause of the toe abscess. Radiographs taken to specifically delineate hoof balance would be in order.<<<<

Vet doesn't want to see her, he made his diagonosis and I did not do as he requested (shoes & stall rest). Quite frankly I refuse to put shoes on this horse and if I leave her in a stall all she will do is "raise cane" if confined with no turn out (she will rear and bang around constantly). I'll end up with another vet bill due to a foot getting caught in the water bucket or something. From everything I have read, there is no real merit to stall confinement if it is navicular. The medicine she was put on "Isoxsuprine" has limited success. He didn't put her on any anit-inflammitorys (like bute)

As far as her feet, farrier commented that her heels were kept too high, her toes were a little short and she has a abcess in her toe. Frog is nice and healthy

[Phil Armitage]

Simply put, a hoof abscess at the toe would not be desensitized with a heel block.
Your horse has heel pain and possibly chronic laminar issues which could be the cause of the toe abscess. Radiographs taken to specifically delineate hoof balance would be in order.
Your trimmer may be able to alleviate some of the problems initially, but they can "smoulder" for some time if they are not pursued and the result can be a disaster later down the road.
Before I would be too critical of the veterinarian's films do be advised that a lateral film can reveal some serious navicular bone changes. Your farrier may be looking for the classic navicular view which is often misleading and may have little bearing on the actual source of the lameness.

Very well put Dr. Myres, I wonder if this Vet said this? Is it possible heel pain in this particular horse was caused by shifting excessive weight back onto the heels from pain in the toe? Maybe shoes are in order for protection and support.

[caballus]

Blue Eyes .... could you post some photos of these hooves?

--Gwen

[Blue Eyed Xena]

I'll try to get some "fresh ones" tomorrow and post them

Here are a couple from May of this year, Please remember these were taken prior to any problems :)

[Blue Eyed Xena]

Hi Phil,

None of the stuff Dr Myers said was mentioned during the vet visit as the vet didn't find the abcess, the farrier found the abcess after the vet visit.

Believe me when I say I am not looking to fault the vet for anything, he just seemed a bit perplexed as to what was actually causing the lameness. Even with the review of the xrays which we went over in great detail, he seemed to give the "hint" of not really understanding why she was lame. Nothing seemed to be "bad enough"


Here is EXACTY what he wrote on slips

Some sclerocis q ventral border (both front hooves)
New bone formation on ventral border mainly on lateral aspect q ventral border. Some enthesophytasis on flexor cortex. Minor formina ventral border of each navicular bone.
other findings: sidebone both fronts-marked sidebone on medial side of RF.
Some DJD q front fetlock joints. Mild rotation of coffin bone both fronts due to bout of laminitis this spring

[caballus]

Well, May's photos really don't do any good for today's discussion. I hope they still don't look like that. Those were pretty rough. If there's anyway you can get current photos posted then maybe we could help a bit. All of what was described can be contributed to imbalances and unleveled hooves. Relief would be seen with correct trimming of the hooves prior to shoeing or barefoot, either one. Being a natural hoofcare provider I lean towards leaving horses barefoot. Either way, however, the trim, the FORM of the hooves is what is going to make a difference.

--Gwen

[Blue Eyed Xena]

I know her feet looked pretty bad in May,

Here are the ones I took today. I tried to get some of her walking around also, the problem is she was circling me so they may not be very helpful. Anyways here what I got. The bottom of the hoof picture shows where the abcess was/is

[Blue Eyed Xena]

heres a couple of more

[caballus]

Just a quick sketch of marked photo and a few comments ... I rotated the photo for easier viewing but you can see the gross imbalance of the heels and the overall imbalance. Also the length of the toe outside the deliniating line I've marked ... that will cause the pressure which, in turn is most probably part of the origination of the abscess. I also see that it appears that the frog and the sole have been trimmed down. The bruising is evident immediately around the P3 which leads me to believe that the sole has been excessively pared down. The sole is the protection for the P3 and should not be pared except to aid in the eradication of the dead, chalky, flaky sole material that is already exfolitaing. Excessive paring of the sole thins it and severely weakens the support needed for P3. The crevice depth at the apex of the frog indicates the toe of the P3 is very close to ground surface whereas the at the heel region, the heel of the P3 is well tucked into the capsule. The heels need to be brought back to the widest part of the frog and taken down to at least 1/4" above the LIVE sole at the seat of corn. The frog should not be touched except to rid it as much as possible of any layers of black, dead material that will harbor thrush, etc. Other than than, it needs to be left alone for the proper shock absorption and cushion of the footfall.

Asides from the abscess, the imbalances will cause discomfort and lameness. This needs to be addressed to (on all 4) so the horse has decent, level, balanced foundational hooves on which to move.

--Gwen

[Ronald Aalders]

Some sclerocis q ventral border (both front hooves)
New bone formation on ventral border mainly on lateral aspect q ventral border. Some enthesophytasis on flexor cortex. Minor formina ventral border of each navicular bone.
other findings: sidebone both fronts-marked sidebone on medial side of RF.
Some DJD q front fetlock joints. Mild rotation of coffin bone both fronts due to bout of laminitis this spring


Lets get this straight, I'm a shoer not a vet. Listening to some on this board this would mean I should just shut up where an opinion on X rays is required. Well I just don't listen. And since I'm far away anyone wanting to kick my *** over this will have to travel! :D

What I see in the D/V views is sidebone, obvious. Further on the L/M view I see a navicular bone on the RF that has changed shape big time. I don't know about the rotation. None that I can see on these pics, but the vet will be right on this.

So if I had to take a guess what causes the caudal heel pain on this horse my first one would be "navicular disease". Would it not be more helpfull if the vet suggested to try easing breakover and raising heels here? If only to find out if that would help?



Ronald Aalders

[Blue Eyed Xena]

I tried a few more photos today with my little helper, hopefully these are a little better. I believe on the bottom of the foot picture the angle of the camera thru off the actual view of the foot. Its really not that far off (at least to me)

Hope these help!

[Blue Eyed Xena]

Ok, here is a couple more. I hope I am not photoing everyone to death! :D

I really do appreciate the input!!!!!

[Gary Hill]

Try walking and taking pictures on FLAT ground or concrete instead of rocks! We can't tell anything about the movement on the conditions you are using! I feel any thing that helps this horse to breakover quicker will help this animal. JMHO, Gary

[Blue Eyed Xena]

I don't have any smooth ground other than grass or gravel driveway. :(
She shows no lameness when walking on grass. At the trot she is lame on grass but my camera stinks really bad and motion shots are near impossible.

[Blue Eyed Xena]

Lets get this straight, I'm a shoer not a vet. Listening to some on this board this would mean I should just shut up where an opinion on X rays is required. Well I just don't listen. And since I'm far away anyone wanting to kick my *** over this will have to travel! :D

What I see in the D/V views is sidebone, obvious. Further on the L/M view I see a navicular bone on the RF that has changed shape big time. I don't know about the rotation. None that I can see on these pics, but the vet will be right on this.

So if I had to take a guess what causes the caudal heel pain on this horse my first one would be "navicular disease". Would it not be more helpfull if the vet suggested to try easing breakover and raising heels here? If only to find out if that would help?

Ronald Aalders

Hi Ron,

You don't have to worry about me traveling with a lame horse & 3 kids :eek:

anyways, Xena had fairly high heels up until 6 months or so, her toe is really short (mainly due to being broken up from our unusually dry summer). Her right foot has always had a ever so slight "turn" to it.

I had a horse many years ago that had navicular and I had shoes on her. I remember the farrier had used heeled shoes, shortened her toe and rockered the toe of the shoe to help the break over.

Shoes at this point are really not much of a option as we are going into winter and on top of that I don't want anyone getting hurt trying to put shoes on the horse! She is a nightmare for just trimmings (unless its me doing the trimming) :mad:

I suppose patience is the key for getting this horse sound, I am sure her feet hurt some from getting trimmed by the barefoot specialist, though it doesn't seem to have made any difference in the amount of lameness she is showing. Its neither worse nor better since she was trimmed this way.

I just get the feeling that there is something there that we are missing, maybe its just me going a bit wacky over it :o

thanks

[Phil Armitage]

Was she better with long heels and more hoof in the toe? Maybe she needed to wedged back up after trimming her heels down. She appears to be landing toe first in the still pictures. I think she is sore in the heels and also sore in the toe. The episode of laminitis may have cause her soles to flatten maybe the coffin bone has decented a little and is now recieveing cuncussion to sensitive tissue and the bone. I would let her grow and keep them on the long side if she is not good to shoe.

[Roy Amaral CJF]

I can't make out much from your pictures of x-rays other than the sidebone. Your horse is clearly foundered and dosen't have much depth of foot. Maby all she needs is some iron between her feet and those rocks.

[calshoer]

Well for goshs sake you may have given the answer in your own questions. Lets see...(Roy hit this nail on the head already)......
She is sore on the rocks, and not in the grass. Think about that. She appears to be a classic example of just plain footsore and mildly foundered, needing either proper shoes, or a completely different environment
This looks like a case of too-small feet (and probably soft feet,) on a way too FAT horse who probably has low grade chronic laminitis. (mildly foundered).The pattern the of the rings on the feet is a tell tale giveaway, along with the fact she is better in the soft grass.And the grass is probably the culprit, if she is out all day eating it.
AND, hoof testers are not a reliable guide to this type of laminitis. A horse who has subtle, very low grade laminitis due to metabolic problems (FAT causes a lot of other subtle metabolic issues) may not hoof test sore in the usually places. (Toe) In fact a lot of them hoof test more sore in the heels rather in the toe, for various reasons. And the do not take on the usual laminitis stance with their feet parked out forward. They stand with their front legs straight , or even sometimes under themselves.
Chronic laminitis explains the toe abscess too. For starters you need to get her properly shod including getting some protective /supportive pads on her. And get her on the Southbeach diet ASAP. Seriously. She looks like she could lose a couple hundred pounds. I'd be crabby too if I were her.
Patty

[Phil Armitage]

I can't make out much from your pictures of x-rays other than the sidebone. Your horse is clearly foundered and dosen't have much depth of foot. Maby all she needs is some iron between her feet and those rocks.

Hey Roy, I agree but as he said this horse is a problem to shoe. That is why I recommend let those feet grow. Hopefully with more foot this horse will be more comfortable. I also think the horse looks over weight.

[Rick Burten]

Initially we were told that among other things, this horse has some DJD in the fetlocks, sidebone , rotation of p3 and other pathologies. That alone would explain the current problems/lameness. Then we look at the latest pictures and see , as others have pointed out, a horse with "fat pony syndrome", who may well be pre-Cushings, IR, or the like. Has any blood work been done to eliminate these pathologies as players in the equation?

Then , looking at the DV(front) views of the hooves, we see the coronary band is jammed in several places indicating hoof imbalance, what appears to be a large horizontal vent in the right front that has grown partway down the hoof capsule which may be the result of the abscess the farrier found, and toes that appear too long. Other views of the feet only confirm that this is a horse who needs the feet correctly trimmed and balanced, and as others have suggested, may need shoes(and some form of support for the structures in the rear of the hoof) in order to acheive a comfort level that will enable it to begin to heal and stabilize.

As to the horse being difficult to trim and or shoe, you might try standing the horse on some thick foam or styrofoam and/or administering some chemical restraint so that the job can be done properly and safely for both the horse and the service provider.

In fact, it may be a good idea to just apply some styrofoam right now and see whether or not that begins to help the horse.

And Ron, I don't think anyone said farriers should not look at radiographs, just that its not part of the basic job description :o

[Blue Eyed Xena]

Hi Rick

can you explain the styrofoam and how its done, I saw it mentioned in a few other posts that I was reading, just not sure what its all about.

Xena is fat and has been dieting with little success, I put the weight tape on her today and it reads 1200#, she stands a true 15H (without shoes :D )

I know I have to get her weight down some, she is just a food hound, she doesn't hardly lift her head from the grass when she is in the pasture. Just eats & eats & eats. Vet did not order any blood tests

I have her in "scrub" pasture with some first cutting grass hay, turn out in the grass pastures is only about 8 hours total a week, about 2 cups of plain pellets a day (to get the medicine down her).


Laurie

[Phil Armitage]

Hi Rick

can you explain the styrofoam and how its done, I saw it mentioned in a few other posts that I was reading, just not sure what its all about.

Xena is fat and has been dieting with little success, I put the weight tape on her today and it reads 1200#, she stands a true 15H (without shoes :D )

I know I have to get her weight down some, she is just a food hound, she doesn't hardly lift her head from the grass when she is in the pasture. Just eats & eats & eats. Vet did not order any blood tests

I have her in "scrub" pasture with some first cutting grass hay, turn out in the grass pastures is only about 8 hours total a week, about 2 cups of plain pellets a day (to get the medicine down her).


Laurie

Laurie this link will help. http://www.equipodiatry.com/hoofsupt.htm

[Rick Burten]

[QUOTE=Blue Eyed Xena]>Hi Rick

>can you explain the styrofoam and how its done, I saw it mentioned in a few other posts that I was reading, just not sure what its all about.

Phil has given you one website where the protocol is explained, another is at www.hopeforsoundness.com in the tech support section.

>Xena is fat and has been dieting with little success, I put the weight tape on her today and it reads 1200#, she stands a true 15H (without shoes : )

You need to have some blood work been done to rule out EMS(Equine Metabolic Syndrome) .

>I know I have to get her weight down some, she is just a food hound, she doesn't hardly lift her head from the grass when she is in the pasture. Just eats & eats & eats.

You may need to get a grazing muzzle for her to wear, and you should also join the Yahoo Equine Cushings Group(http://groups.yahoo.com/group/EquineCushings). Even if your horse is not IR or Cushings, there are valuable tips on diet and nutrition . Check out the 'Files' section.

> I have her in "scrub" pasture with some first cutting grass hay, turn out in the grass pastures is only about 8 hours total a week, about 2 cups of plain pellets a day (to get the medicine down her).

Again, it sounds like her diet/nutritional intake needs adjustment, and her feet definately need better attention.

[Redd Mcintyre]

hey Rick,
Could you explain for an apprentice what you mean The corinary bands are jammed in several places? I see the horiz. vent but not following the "Jammed"
Are you see ing that in the exarys or the picture of the two front feet.
Thanks, Redd