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Discussion on Left front foot/navicular view
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New Member:
roanqh
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Posted on Friday, Oct 14, 2011 - 9:00 pm:
This is my 4 year old AQHA gelding's left front foot. He comes out of the stall "stingy" and usually works out of it, but has recently had corrective shoeing to restore the angle of the foot. I will post a lateral view. I would like to get your opinion Dr O and recommendation for next steps. He has been on stall rest and limited round pen turnout for since May (due to another injury). I am concerned about his front feet. He breaks over quickly when he trots and appears to me that he is sore on both front feet, but worse on the left.
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New Member:
roanqh
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Posted on Friday, Oct 14, 2011 - 9:13 pm:
Here is the lateral view of the same foot. The vet and farrier worked together to assess this. They put a aluminum wedge shoe on this foot on 9/19. The horse still starts out a little quick/sore, but it appears as the blood flow increases, the soreness decreases. I want to make sure I am on the right track. Many thanks
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Moderator:
DrO
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Posted on Saturday, Oct 15, 2011 - 9:41 am:
Welcome Cherie,
I think we can help you but from the information you provide above I cannot tell if we are on the right path or not, more on that later.
To address your direct question. I am glad to review your veterinarian's objective findings on the above radiographs but due to the importance of the physical exam, the lower quality of internet images, and my own time constraints I cannot make diagnostic or therapeutic recommendations based on posted radiographs. That said there is significant pathology of the navicular bone (enlarged synovial fossa) and some indication that the foot is out of A-P balance (heels low). This last finding supports your vet/farrier's decision to use a wedge if the toe cannot be lowered enough by trimming alone.
As to being on the right track, I do not see in your post the necessary steps to diagnose what I think you are implying in your post: bilateral chronic heel pain formerly termed navicular disease or synDrOme. For more on this check out the article associated with this discussion area. However if nerve and regional blocks have not been conducted I would suggest backing up even further to the article on the diagnosis of lameness, HorseAdvice.com » Diseases of Horses » Lameness » Localizing Lameness in the Horse. Only when the location of the pain is proven and then a precise diagnosis made can you be 100% sure you are on the right track.
DrO
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New Member:
roanqh
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Posted on Saturday, Oct 15, 2011 - 8:43 pm:
Thank you. I will read the referenced articles. I think the nerve and regional blocks are the next step in locating the pain. I have an appt this week and will post the findings. Thanks so much.
clw
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Member:
paul303
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Posted on Sunday, Oct 16, 2011 - 12:27 am:
The blocks are extremely important in your program of diagnosis and treatment. I had an AQHA mare foaled in 1980 who was diagnosed in 1985 with navicular. She was a promising reiner until then. Thankfully, we had good veterinary and farrier counsel back then. Although she was out of training and reining for 2 years, she came back to a decent western pleasure and trail career. She's 31 now, and still quite comfortable, although we stopped riding her when she was about 28. Navicular, when addressed aggressively, can be managed. Wish you the best.
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New Member:
roanqh
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Posted on Tuesday, Oct 18, 2011 - 7:14 am:
The vet performed an exam yesterday to find my gelding 2 out of 5 lame on his right front. (it appears the farrier work and balancing is working on the left front) (He mentioned that it is interesting that my horse has had documented lameness this year on 3 out of four feet).He did regional blocks of the right front heel area and the horse trotted out sound! We reviewed all of the radiographs (taken on 9/19/11) of both front feet and the next step is Isoxsuprine for one month, farrier work today to reassess both front feet and additionally to add gel pads. He said an MRI would be the best course, however at $2500/plus it is cost -prohibitive at this time.
He feels certain that it is soft tissue related and the location of the inflammation is in heel region since it blocked successfully. Although we don't have a definitive diagnosis, we have a reasonable next step. Thanks your articles and references on this site are wonderful.clw
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Moderator:
DrO
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Posted on Thursday, Oct 20, 2011 - 6:46 am:
Thank you Cherie, though I have not had much luck with Isoxsuprine (see Navicular Article for more on this) it is often a next step after balancing a foot. Keep us informed.
DrO
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