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| HorseAdvice.com » Diseases of Horses » Lameness » Diseases of the Hoof » Navicular Bone Fracture » |
| Discussion on Bipartite and Tripartite Navicular Bones or fracture? | |
| Author | Message |
| New Member: 3wishes |
Posted on Saturday, Mar 18, 2006 - 12:09 pm: Dear Dr. OI have a 13 year old QH gelding who started showing intermittent lameness in the front ... with the right being more significant. This has been going on and off for about 8 months duration. The local vet came out but forget his xray machine. Jack (the horse) seemed sore in the right front hoof but did not show pain in either foot with the testors, had no signs of laminits (stance, pulse, not obese, no getting into the feeDrOom etc). He recommended shoes which the farrier applied and the horse seemed significantly better. BUT (and there's always a but...)when attempting the shoe the right front, Jack acted terribly, which led me to wonder if it was pain (concussion from the hammer) related and not behavioral. He nearly flipped up and over in the crossties. Because of this I had the vet and farrier out for the next round of shoeing to sedate Jack and avoid anyone (farrier or horse) being injured. Farrier removed his shoes and Jack seemed completely sound. The vet brought his xray machine...but forgot the film! arghh... Vet thought horse could forego shoeing and stay barefoot,...again no pain with hoof testors. Farrier trimmed him and 2 days later Jack was off again, especially in the right front. Vet recommended trying glue on shoes (thought horse may have thin sole). Jack has done okay for the time since then (last 6 months), but does show pain when turning in small circles in the right front. So I trailered him an hour away to a specialty clinic for xrays. Coffin bone looks beautiful, great sole depth but the vet said his navicular bone was fractured. Just to cover all bases she xrayed the left navicular also and the films revealed a tripartite left navicular bone. So, although it seems like he may have been born with tripartite left and bipartite right navicular bones....she said that the right could indeed actually be a fracture and advised that the only way to rule it out would to have a bone scan done. Sorry for the long rambling history.... so my question is this.... where the heck do I go from here...or would you go? It is not so much the expense of the scan ($1000) or the 3 hour trip to get to the facility to have it done....rather... will it change how we treat this horse in anyway? If it is a fracture she recommended 90 days complete rest and eggbar shoes. Is there any hope for soundness in a horse with bipartite/tripartite navicular bones and or fracture? Thankyou in advance.... Sincerely, April |
| Moderator: DrO |
Posted on Sunday, Mar 19, 2006 - 8:13 am: The smooth interaction of the navicular bone with the flexor tendon and the palmer aspect of the coffin joint region usually means such congenital defects of the navicular bone result in various chronic lameness issues including degenerative joint disease of the distal interphalangeal joint and other navicular related diseases.The question is, "what is on your radiographs?" Usually when fracture is uncertain more radiographs from different angles is indicated not a scan. The scan would actually have much less information about a specific diagnosis. I recommend you have the current radiographs forwarded to a veterinary radiologist / equine orthopedic surgeon for a second opinion. DrO |
| New Member: 3wishes |
Posted on Monday, Mar 20, 2006 - 8:54 am: Dear Dr. O,Thankyou for your input. I called and cancelled the bone scan. I also asked for copies of the digital radiographs and they are putting a disk in the mail. I will post them on here and I am going to get a second opinion from a veterinary radiologist. Thank you again. Sincerely April |
| New Member: 3wishes |
Posted on Wednesday, Mar 22, 2006 - 4:50 pm: Dear Dr. O-Here is a link to his xrays (if it works). Would appreciate any impressions you have. Thankyou. https://photobucket.com/albums/y149/3wishesdun/ |
| Member: Dres |
Posted on Wednesday, Mar 22, 2006 - 5:55 pm: Ok , educate me please on what i am looking for.. i had posted under x rays my boys hoofs, but the attending vet pointed out what i was looking at.. Could you Dr.O explain what Bipartite and Tripartite Navicular Bones are ..On the first day God created horses, on the second day he painted them with spots.. |
| Moderator: DrO |
Posted on Thursday, Mar 23, 2006 - 10:46 am: Hello All,For several reasons I have quit critiquing images not on the site April. If you will post the images here that you want reviewed I will be glad to comment. Be sure to mark clearly which leg each image belongs to. If you need help on how to do this see, » News & Help » Uploading Images and Files Into a Posting. DrO |
| New Member: 3wishes |
Posted on Thursday, Mar 23, 2006 - 11:57 am:          
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| New Member: 3wishes |
Posted on Thursday, Mar 23, 2006 - 12:15 pm:    
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| Member: 3wishes |
Posted on Thursday, Mar 23, 2006 - 12:17 pm: I apologize if I duplicated any....my eyes were starting to cross....Thankyou Dr. O- for any input you can provide me... |
| Moderator: DrO |
Posted on Friday, Mar 24, 2006 - 10:10 am: Wow April,Really the first question that comes to me is how did this horse remain sound this long! My apologies to your vet I can see the diagnostic dilemma she faces but I think the next diagnostic step really depends on what are current goals for you and this horse, considering the poor prognosis of remaining sound under saddle? Ann the terms mean simply divided into two and three parts respectively. This is a uncommon congenital condition. DrO |
| Member: 3wishes |
Posted on Friday, Mar 24, 2006 - 1:56 pm: Dr O,*Sigh* You are not the first person to look at his xrays and shake your head in wonder. The strange thing is that with the glue on shoes he appears relatively sound. Maybe its the soft Florida terrain.... only on the cement center aisle of the barn can you notice he is off when performing a circle from a stand still. He reacts almost violently when the farrier attempts to pound his clips flat. Will not tolerate having shoes set by nailing. When turned out he will run with the other horses. Honestly my goals with this horse *were* just pleasure/trail riding- but this was before I had him xrayed. Now I suppose my goals are to keep him as free from pain as possible. If this means he can no longer be ridden- I will accept that. He is (to me) not an old horse, such a shame to lose him as a riding horse. How would you treat this horse? What recommendations would you make to a client in the same situation? If he were yours...would you put him down? Thank you very much for taking the time to look over all those films, and for your advice. Sincerely April PS- Jack as a baby and now.   
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| Member: Hwood |
Posted on Friday, Mar 24, 2006 - 4:30 pm: What a beautiful, flashy horse, April. Did you raise him yourself? Is there any history of the navicular problem in either of his parents or in any of his siblings, do you know? I'm sorry you are having to watch him in pain. Are there any surgeries for such things? Like cementing the bone pieces together with "Super Glue" or something? |
| Member: 3wishes |
Posted on Friday, Mar 24, 2006 - 5:38 pm: Thankyou Holly for your kind words. Jack is the foal of my sister's first horse. Missy was a beautiful QH without any soundness issues. My sister was going through a divorce in '96 and I took Jack in for a few months (he was 3 going on 4) til she was able to get settled... sadly she was killed by a drunk driver 3 months later. I have no idea who his sire is... We lived at opposite ends of the state and I was not around when she bred her mare or foaled Jack. As far as I know... he is not registered. Her mare was. I do not think there is anything surgically that can be done for him. Which makes the situation difficult to swallow. He is not an old horse... sad that he does not many options from here... |
| Member: Paul303 |
Posted on Saturday, Mar 25, 2006 - 1:37 am: April, he is such a beauty.....so sleek and well turned out...it's hard to believe this type of problem belongs to the horse in your picture. He is not an old horse, nor does he look debilitated by pain from a chronic condition. I am so saddened by the burdens you've carried and I am reminded how inconsequential are mine, in comparison. |
| Moderator: DrO |
Posted on Saturday, Mar 25, 2006 - 7:31 am: April on reviewing the history and studying the radiographs, it seems unlikely this is a fracture. Large fractures of the type that might be in your images do not start as an intermittent lameness problem and the bilateral nature speaks volumes about this likely being the congenital defects. Instead I believe the unusual shape of the nb bones is causing trauma to the DDF and possibly where it articulates with the back of the coffin and pastern bone with the result being inflammation. I don't really see how having a scan done is going to change anything assuming the veterinarian is sure of the localization for the source of pain to the navicular area.Shoeing for comfort and bute as needed seems a very reasonable plan to me. If you wanted to try something, treating it like a fracture is not a bad idea. The NB fracture technique we describe in our article is designed to relieve stress on the bone so that it can heal. Because I do not have any better suggestions you could treat your horse this way with phenylbute added for the first 14 days, to allow the inflammation to resolve. I think the chance this will cure him is poor but you may find him more comfortable at the end or you may find that elevating the heels remarkably keeps him sounder. DrO |
| Member: Lilly |
Posted on Saturday, Mar 25, 2006 - 8:43 am: April,Have you ever discussed your horse's case with an equine podiatrist? I live in VA and we have a podiatrist up here who does amazing work. Here is her website if you are interested. Maybe she could give you some ideas or recommend a podiatrist closer to you. www.serenityequine.com Take care. Ann. |
| Member: 3wishes |
Posted on Saturday, Mar 25, 2006 - 9:19 am: Dr. O-Thank you very much for your input. I sincerely appreciate your advice/comments. Ann- Not yet... but thank you for the link. I will certainly look into contacting a podiatrist. Lee- Your words meant a great deal to me. Thank you. Will update with any progress. |
| Member: 3wishes |
Posted on Saturday, Mar 25, 2006 - 9:25 am: Dr O,Do you think that his violent reaction to be nailed could be caused by pain? I have always believed it was not behavioral, but before the x-rays... it was unclear. And will he likely always require sedation to be shod? (My vet plans on blocking and sedating when he is done on the 31st). |
| Member: Sparky |
Posted on Saturday, Mar 25, 2006 - 1:27 pm: April - your emotional connection to this horse is really heartwrenching. I have followed a site called Amerdon for quite a few years. They have a product called Rapid Response. I have not used their product but it always interests me as to their testimonials. It might be worth talking to them. The internet is such a vast way of getting information but also who knows what is really true or not? Making him comfortable is your priority from what I can understand and I wish you success.Here is the website address www.amerdon.com Good luck janet |
| Moderator: DrO |
Posted on Saturday, Mar 25, 2006 - 7:33 pm: It is possible but I am more inclined to believe that it was the pain caused in the opposite foot. You could try pretreating with bute 4 to 6 hours before shoeing to see if this helps.As I frequently must, I will point out that the Ameridon product of Rapid Response has no objective evidence supporting any of its claims and their brochures are very misleading often exclaiming over ingredients (minerals, essential amino acids, vitamins) that can be found in adequate amounts in hay. Concerning some of the ingredients that may have nutritional or nutraceutical benefit they do not publish the amounts of the substances found in their products. However these ingredients are available for much less than the 40 to 80 dollars a quart the RR cost and at 4 oz daily this comes to 5 to 10 dollars a day for a product of uncertain make up. If someone has the nutritional makeup including concentrations I would be glad to review it. DrO |
| Member: 444444 |
Posted on Saturday, Mar 25, 2006 - 8:05 pm: April, Please don't give up. I urge you to go to the AMERDON site and to call Sharone. I have used all the different Rapid Response products for a wide variety of issue with miraculous results. When my colt was 3 months old he ran into a fence tore his face from a 1/4" below his eyes to nearly the top of his nostrils. He crushed his sinuses, nasal cavity and skull. He also crushed his chest and ran his knee through the fence. Dr Caudle happened to be here and said all he could do was sew the face back on, suture the knee and as for the chest we'd just have to see. Although he didn't say so at the time he didn't think Promise would make it through the night. I slept in the stables with he and his mother. Doc called the next am to see if we made it through the night. The surgeons at the U of Ga told Doc I needed to get him down there quickly or he would never be able to breathe. I opted not to go as he was doing well. The long and the short, Doc thought he would need 6 mos to heal. In three weeks he had removed all the stitches and Promise was out running in his paddocks. At 8 months as a result of the crushed chest his left hoof became clubbed and the shoulder had atrophied (it was 1/4 the size of the right). At first Doc thought it was OCD later he and two other vets thought we were dealing with a cyst and that I needed to take him for surgery. (His left leg was about 2 inches shorter than the right giving him a terrible limp) Again I opted for Rapid Response. I talked at length with Sharone who had me rub RR externally and give him a heat pack treatment for 20 minutes twice a day plus 4 oz internally 2x a day. In three months the club hood had grown into a beautiful hoof matching the right, the muscle mass in the left shoulder had returned and the protruding chest of the brest cartlidge on the left was almost the symetrical to the right. Today at nearly four Promise is 16.1 hands and a magnificent loving creature. Doc calls him my miracle boy.I have used RR for a wide variety of issues, laminitus, colic (if I see any of my herd experiencing the symptoms of colic I pour RR in my hand and they lap it up -- I use TTouch and we are out of the woods within minutes), lameness and maintenance (Promise gets a dose every day and will for the rest of his life!) My TW Anna has issues with a locking stifle so she gets it daily too as well as externally with a heating pad (I do all the up and down the hills for her too and my herd freely roams the farm) Just go to the site and see what you think. I personally would not be without RR in my barn refrig. (I use some of the other products too.) Blessings to you on your journey with Jack he is so lucky to have you. Sue |
| Moderator: DrO |
Posted on Sunday, Mar 26, 2006 - 10:58 am: Sue, no one is suggesting that April should give up on this horse but the severity of this condition must be understood in order for proper decisions to be made.I cannot comment on your wound not having seen it but if I had a quarter for every wound or illness that the owner thought was going to have to be put down that turned out just fine I would not have to charge for membership on this site. There is a horse in our stalls right now that the owner thought for sure would have to be put down (stating this half a dozen times) as the skin on the hind leg had been degloved half way down the cannon. Even if the stitches don't hold this hind leg will heal just fine. Your specific example was not the miracle of Amerdon RR but the miracle of natures ability to heal aided by the good Dr Caudil's first aid and veterinary skills. RR is made up primarily of sugars, if we can take the order of ingredients as representing the relative amounts of each, and other commonly found chemicals and nutrients that have no known miracle properties. Since this is such a controversial subject let's take the list of ingredients directly from the site, list them in the order they are listed and discuss what each is: MUCOPOLYSACCHARIDES: The sugar component of proteoglycans such as glycosamines. MONOPOLYSACCHARIDES: Chains of sugar greater than 10 sugar molecules in length. PROTEIN POLYSACCHARIDES: This term has no definitive meaning and could be same thing as the first ingredient. GLUCOSE: simple sugar OLIGOMERIC PROANTHROCYANIDINS: This is an incorrect spelling of a sub-class of polyphenols generally referred to as tannins. The correct spelling in proanthocyanidin. They are found in plants, particularly best known in grape seed and leaves. In vitro they have been shown to have antioxidant properties however in careful studies there have been no benefits to healing (Brooker S, Martin S, Pearson A, Bagchi D, Earl J, Gothard L, Hall E, Porter L, Yarnold J. Double-blind, placebo-controlled, randomised phase II trial of IH636 grape seed proanthocyanidin extract (GSPE) in patients with radiation-induced breast induration). However the toxic effects on living cells of this chemical have been explored for killing cancer cells. By using the spelling they provide when you do the research in PubMed you do not find any of the adverse effects of this chemical class on living cells. PROTEIN GLUCOSAMINES: this may be unprocessed glucosamines still on the protein (collagen)skeleton as would be found in simple ground up cartilage. It is uncertain if the body can use this form of glucosamine. LIPOGLUCOSAMINES: a little explored class of chemicals elaboratd by bacteria. Best known in the recognition between the symbiotic nitrogen fixing bacteria with that of its host plant, like soybeans and alfalfa. No known medical use. PAPIANE: There are no entries in pubmed or medical dictionary for this substance and I suspect they mean papain. If this is true this is a family of proteases found in nature. Many papian-like proteases are found in plants, viruses, bacteria, and even some human disease processes. Like most enzymes this is a protein that would not be absorbed from the gi tract intact and in fact considering its actions of breaking down proteins would not want to be absorbed. CARBOHYDRATES DERIVED FROM INULIN PLANT SUGAR: sugar NATURALLY OCCURRING AMOUNTS OF MINERALS (MAGNESIUM, CALCIUM, AND POTASSIUM): minerals found in adequate to excess in good forages. VITAMINS A, D, AND E: ditto above. If you ground up some cow cartilage, added corn syrup, a tsp of papaya, and ground whole alfalfa sprouts you could make the above label. The deliberately confusing, inaccurate terminology, along with the lack of list of ingredients (the above is simply a list of chemical classes) and the lack of the amount of the nutrients listed makes me more than suspicious. As you know Sue, I never ask anyone to quit using something they think is helping unless I think they are harming the horses. This product appears harmless, but until the company becomes responsible and publishes this information Amerdon Rapid Response should be thought of as a very expensive new age sugar pill, after all it appears to be composed primarily of sugars. I never ask anyone to quit expressing what they think is the truth but I will continue to place this post after every recommendation of this product. DrO |
| Member: 444444 |
Posted on Sunday, Mar 26, 2006 - 11:42 am: That's fair enough and I have asked Sharone of Amerdon to supply us with the list of ingredientsas per your previous post "If someone has the nutritional makeup including concentrations I would be glad to review it." I'll let you know if she responds to my request. I believe in the extra-ordinary power of nature's healing AND I call in a Native American prayer circle, medical intuitives, I douse, heck I'd go out and bay at the moon if it felt like the right thing at the time to make it through a crisis. I've had too many circumstances over the years where my vet has said "There is nothing more that medical science has to offer." And for whatever reason, RR, Bach Remedies, homeopathic tinctures, good luck, my tenacity and the horses will to survive, have some of them still standing in the pasture, happy and comfortable. I also know when it is time to quit and have had to do that 4 times as well in the last nine years. I do appreciate your sage advise, knowledge and opinion. I wouldn't subscribe if I didn't! And I will provide the other side of the story when it seems appropriate! Thanks, Sue It is my belief system that some things just can't be explained in science...and I believe in researching all that science has available. |
| Moderator: DrO |
Posted on Sunday, Mar 26, 2006 - 12:57 pm: There are many things that cannot be explained by science Sue but that really is not the point. The point is when faced with a problem how do we address it to maximize our outcome considering our limited resources.I can't help but think if instead of spending hundreds or thousands of dollars on what to me appears little more than sugar pills that instead you sent this precious and hard earned resource to a child or equine rescue group or perhaps a veterinary or medical research institution that you would maximize the outcome for the world while not changing the outcome of your horse's ailment. Besides improving the world, think of the good karma you generate. Just in case you misunderstand me, I do not say this from a facetious perspective but one of love for this world and my own small attempts at helping it go forward. DrO |
| Member: 444444 |
Posted on Sunday, Mar 26, 2006 - 7:34 pm: I couldn't agree with you more...I live my life by two of my favorite quotes "We must be the change we hope to see in the world" Gandhi;and Margaret Mead's famous quote, "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it's the only thing that ever has."To that end, fourteen years ago I founded an educational and charitable foundation, a 501(c)(3) with a vision "to empower individuals through life changes to see the opportunities and possibilities that abound. Our mission, to provide a safe environment for individuals through workshops, seminars and activities to explore their own potential. Our primary audience is the at risk/high risk children of our county. The US census bureau says that 96% of our children in Macon county fall into that category living in poverty and mostly single parent households. In just the past five years we have had more than 1000 children ages 5-14 at Carpe Diem Farms participating in after school and summer day camp programs. We partner with our school system and other agencies who serve this audience. (We have done it long enough that young adults who have graduated from high school have come back to volunteer in the summers.) We do it all for free, there is no paid staff - I have not had a salary from the foundation in 14 years and work outside jobs to earn my way in the world. We raise money through grants and individuals and community agencies (Rotary, churches, women's clubs....) We have held an annual fundraiser "Be a Star for a Child" for the past three years which has raised $90,000 for our childrens' programs.Local artists and stores have donated to our auctions making a difference for the children. Utilizing the equine staff and colleagues we teach communication, team work, leadership, enhancing self-esteem, overcoming fears and much more. We have an awesome art program and teach a lot of Native American lore. In addition the children participate in a nature program learning to appreciate all that we have on our mountain and plateau which didn't freeze during the ice ages and is a temperate rain forest. We are truly a small band of committed individuals making a difference! None of us has wealth by the standards measured in bank accounts instead our personal wealth is measured by our self-satisfaction in perhaps having an impact on one child. We have also worked with the women and children in our women's shelters. We work with teenagers 15-17 who have been adjudicated by the court to have to do community service. We work with the Literacy Council having the children come out and read to the horses, dogs and cats. We provide an equine adventure to our local daycare centers, HeadStart, church youth groups and homeschoolers. Individuals who have wanted to replicate the work we do here in their communities have come from Canada, Virginia, Minnesota and Florida to intern and to participate. Personally I support laminitis research and I am presently working on a manual for owners on the subject. I support many animal and children causes. We are also environmentally committed. Our forty-four acres was formerly an asphalt plant. We have spent nine years cleaning it up. Since the death of my brother five years ago a group of his friends from Florida have volunteered two weeks every year to paint, build and clean up. We have taught the children about composting and sell "Promising Results" to local landscapers, nurseries, farms and gardeners to benefit the children's programs. All of my horses with the exception of three have been others throw aways who we have given a forever home. I receive calls weekly to accept horses and when I am full I have personally helped place many in loving homes. In addition to our seven horses we have five cats and four dogs. Three cats were throw aways, one showed up on the doorstep and one under the hood of a car! Two dogs showed up 9 and 6 years ago and two came from Southern Shih Tzu Rescue in Anniston, AL. One,now 3 years old, Miracle, was born blind and deaf and teaches all of us daily to be happy with what you are dealt! The other was a shelter surrender. So you see, I do believe that I do my part to make the world a better place and make it go forward. Rest assured,I generate good karma! I hope that you will agree to disagree on the merits of RR. What you see as a sugar pill I see as hope and life is about our perception --- science or not. As I said before, I respect all that you offer on this site and wouldn't subscribe otherwise. If you would like to read more about us you can go to our web site carpediemfarms.org If you would like to receive our newsletters and mailings or receive a copy of the twenty minute tv show which was filmed here last August email your mailing address to my website. Namaste, Sue |
| Moderator: DrO |
Posted on Monday, Mar 27, 2006 - 6:38 pm: My hat is off to you and I give you a deep bow for the work you do. We do not need to agree to disagree, let's just agree...agree we will continue to look at the world with an open mind and do the best we can for ourselves and for others. The differences in how we achieve these ends is what makes the world interesting. But your post makes me worry even more about the needless expenditure on....well never mind.DrO |
| Member: 3wishes |
Posted on Saturday, Apr 8, 2006 - 12:29 am: Ann- Dr Floyd will be in Florida at the end of this month and will be treating Jack. I just realized after consulting with her that you had put up that link to her Podiatry center in Virginia. I will let you know how it turns out. Thank you. |
| Member: 444444 |
Posted on Saturday, Apr 8, 2006 - 10:36 am: Dear April, I am so happy for you and Jack to have a consult/treatment scheduled with Dr. Floyd. I so admire all that she has been able to do for our equine friends.I'll be anxious to hear. Sue |
| Member: Lilly |
Posted on Saturday, Apr 8, 2006 - 2:46 pm: April,Thank you for the update. I hope Dr.Floyd will be able to provide your horse some comfort. I look forward to hearing how things turn out. Ann |
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