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To date, I have not ever had a true navicular client. I
think that is for a lot of reasons – one being that people who already have
their horses barefoot are often attracted to my services. I just have not seen
true navicular yet in horses who have been primarily barefoot most their
lives – and I do not think that is coincidental. Horses kept barefoot cannot
have their feet kept overly unnaturally – they usually will break off. Whereas
in a shoe, it is much easier to maintain a less than natural form. I think the
other reason is people willing to spend all the money on the diagnosis of
navicular (not cheap) are often more swayed by treating the condition with
expensive, fancy shoes.
Anyhow, I am putting this section in here (first and
foremost, you will notice), to hopefully put some new clients at ease – I am
kind of tired of typing long emails and/or having long discussions on the
phone. I have yet to see a TRUE, diagnosed navicular case. I get folks calling
me all the time with supposed navicular horses – but to date, not a single one
has even been through the battery of tests to accurately diagnose the disease.
My understanding is, to truly diagnose navicular you
need to: #1 diagnose “heel pain” and, #2 have bony changes present on the
x-rays. Any vet should tell you, the x-rays in and of themselves are entirely
unreliable diagnosis-wise. I have the views written down somewhere – but it is
like a minimum of 5 or 6 views of each foreleg – not cheap. Some horses have
bony changes and no apparent heel pain or loss of soundness – some horses have
heel pain and obvious loss of soundness and clean x-rays. The x-ray views in
and of themselves are totally useless. If you were to go out there and just
x-ray horses with no complaints, half of them would x-ray clean, and half of
them would not… the x-rays are totally inconclusive in and of themselves.
Heel pain is typically diagnosed by watching the horse move
and watching for an acute toe first landing – the horse avoids weighting its
heels because it’s painful. Sometimes symptoms like starting out sore and
getting sounder as the horse is worked – or a horse who stands pointing his toe
out – are used to help diagnose the problem. After seeming pain is verified,
the vet then more accurately verifies pain in specifically the heel region with
nerve blocking.
If the horse moves better when his heel is blocked of
feeling, it is considered to be bona fide heel pain – potentially navicular or
navicular syndrome. X-rays are then taken. If there are bony changes AND heel
pain, it is often considered navicular. If there are no bony changes, navicular
syndrome.
None of this is bona fide conclusive. This is not a cut
and dried disease. There is not a bona fide link between the heel pain and bony
changes on x-ray and every vet knows that – or at least should. In reality,
many horses presented with supposed navicular symptoms do not even substantially
improve with nerve blocking. I have no idea if that is due to poor
interpretation of the symptoms or yet just another confusing link in the
disease. But the disease is hard enough to definitively diagnose when textbook
symptoms are exhibited…
All I know is the term navicular sure seems to get
slung around a lot…. It is bad enough to hear it with minimal veterinary work
up, but really bad with NO conclusive veterinary work up…
All that said, I get clients here and there all the time
who have a horse whom their vet or farrier termed to have navicular. When I ask
further, I often find out NONE of these tests have been done.
I think unfortunately this term – navicular – can get
thrown out there to cover “seemingly inexplicable hoof pain” (I personally use
the term laminitis for thatJ
and it is generally more accurate….)
Most of the clients I have gone to see with supposed
navicular are not even landing toe first or showing any other signs of
definitive navicular/heel pain and did not have a thorough soundness exam done
on them, much less did the owners confer with a highly trained soundness vet or
have any x-rays done. So I hope I am putting some of you guys at ease.
I am not a vet and would not pretend to be able to diagnose
navicular. But hopefully I can be of help in helping you decide whether or not
further testing is warranted.
Even if you do have navicular, it is not a red alert
situation like colic or acute founder where an immediate veterinary treatment is
going to highly affect the outcome.
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