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The Management Of Navicular Disease Syndrome

By Daphne Bowen


The navicular bone is found in the ankle region between two other bones; the cuneiform and talus. In horses, this bone together with the surrounding supportive structures may degenerate leading to progressive lameness. The front feet are more frequently affected than the hind feet. Understanding the anatomy of the forelimb is important if you are to manage navicular disease successfully.

The cause of this condition is not clear but there are a number of theories that exist. One of this theories purports that the disease is the result of repetitive movements of the bone and the surrounding structures. This is what is used to explain the high prevalence of the condition among horses that take part in competitive races. Diet and genetic disorders are the other major contributing factors.

The resultant inflammation reduces blood flow to the ankle. The other effect is an increase in pressure in the heel. Pain sets in and horses start exhibiting lameness. The lameness is intermittent at first but becomes more constant with time. Horses start having a tip-toeing gait as they attempt to shift the pressure onto the anterior aspect. Stumbling will be seen every now and then.

There are a number of conformational defects that serve as a risk factor for the disease. Most of the known defects increase the risk of concussion and by extension, bone damage. Narrow feet, small feet and long toes are all examples of conformations that increase pressure on the tarsal bones. This effect is multiplied several times during movement due to the large amount of shock produced.

Working on hard and irregular ground is another predisposing factor. Such unfavorable terrain has been found to place great stress on the main tendons. The same may be seen in horses that spend most of their stand in the standing position. A lot of weight is transmitted through the feet hence the increased risk. The load is particularly high in horses that have a high weight to foot ratio.

Poor shoe selection is another common cause of lameness. This problem is more common in domesticated then wild horses. It is for this reason that some experts have recommended barefoot trimming as opposed to the use of shoes. In the absence of shoes, they argue, feet can contract and expand freely allowing for blood to circulate freely.

Due to the many causes that exist, there is no one known treatment. If the cause is due to degenerative changes, reversing the condition is possible. In this case, the treatment given will mainly be supportive and aimed at relieving symptoms. Proper trimming ensures that the foot is in neurological and biomechanical balance. Once the diseases has already established itself the intensity of work should be reduced.

Drugs also have a role to play. Drugs known as vasodilators help to maintain the patency of blood vessels and maintain blood flow to the affected regions. Other groups of drugs that have been shown to have beneficial effects include gallium nitrate, bisphosphonates, corticosteroids and NSAIDS. Surgery is performed when all the other conservative measures have proved futile.




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