Presentation on theme: "Navicular Syndrome and Heel pain in the performance horse"— Presentation transcript:
1 Navicular Syndrome and Heel pain in the performance horse Phillip D Jones, DVM, MSDiplomate American College of Veterinary Surgeons
2 Outline Causes for caudal heel pain Diagnostics and therapies Shoeing recommendations
3 Caudal heel pain Navicular syndrome Degenerative process that changes the bone-initiation and progression of the disease is a result of excessive and prolonged forces of compression on the boneImportant factors- signalment, conformation, and use
4 Navicular syndrome Mild to moderate intermittent lameness Insidious onsetPerceived as shoulder lamenessPoor confirmationBilateral lamenessLameness switches to contralateral limb after unilateral PD block
5 Navicular syndromeImportant PE findings -contracted heels -atrophied frog -small foot compared with body size
9 Navicular syndromeChanges within the navicular bone edema vascular stasis enlargement of the nutrient foraminae cyst-like medullary areas subchondral bone changes changes in the flexor surface fragmentation of the distal border
17 Dyson- Radiographic Interpretation of the Navicular Bone. EVE 2008
18 Shoeing Correct or preserve dorsopalmar and lateromedial foot balance Hoof pastern angle should be straightFoot trimmed to maintain heel mass and shorten toe to facilitate breakoverElevation of heel may relieve pressure from DDFT on palmar aspect of navicular boneEgg bar shoe: greater surface area disperses forces Of 55 horses with navicular disease 53% had permanent pain relief of lameness after egg bar shoes in month follow up.
24 Caudal Heel Pain Desmititis of the collateral ligaments. Tendonitis of the DDFT at 3 possible locations: -insertion -palmar to the navicular bone -proximal to the navicular boneDesmitis of the impar ligament.Desmitis of the distal annular ligament.Synovitis in the distal interphaleangeal joint.Synovitis in the navicular bursa.Cystic lesion in the second phalanx
31 Bipartite Navicular Bone Develops as 2 separate centers of ossification that never uniteUnilateral or bilateralBroad well defined lucent line between the 2 piecesHorse may be clinically normal, or have episodic lameness in full athletic functionNo history of acute lameness as in fracture
32 BipartiteDyson- Radiographic Interpretation of the Navicular Bone. EVE 2008
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