Vet case studies: living with navicular [H&H VIP]

  • Case study: navicular in horses

    The horse

    Rosie, a 16.1hh Irish Sport Horse (born 2002) is a general all rounder – hacking, lessons, some eventing (BE90 and BE100 level); riding club dressage, occasional holidays with her owner Lucy to Dartmoor and the Quantocks etc. She is shared with another rider who uses her for hacking and flatwork lessons.

    The history

    In summer of 2012, something seemed subtly amiss in Rosie’s way of going. Though she was jumping happily, she seemed tense on the flat at least until thoroughly warmed up.

    Chartered Animal Physiotherapist Jenny Wilson of Bridgefield Physiotherapy, Surrey, treated the horse’s back a few times over the summer but felt she was not improving as she should do and suggested consulting the vet.

    Lucy’s vet, Eamon McLaughlin of Equine Sport Vets in Sussex duly examined her. He scanned her back and found a torn muscle, requiring several weeks lunging instead of riding, and ultrasound treatment.

    Eight weeks later Rosie’s back was mended and she was back in work, but Eamon still felt something was amiss. Watching Rosie on the lunge, he noticed her ‘change’ across her front feet and show a few steps of lameness. Local anaesthetic blocks localised the lameness to the heels.

    X-rays of the front feet revealed changes to the navicular bones.

    “At this stage, I felt the world crumbling beneath my feet,” says Lucy. “I knew the mare I had believed to be worth about £8,000 would now be worth a fraction of that. But on the plus side, Eamon told me not to be too despondent and that the condition was manageable. He said he treated horses who were jumping at the highest levels who had the same sort of navicular changes.”


    Eamon immediately gave Rosie a dose of Tildren (now known as Equidronate), which is not directly anti-inflammatory or pain-killing, but aims to reduce the progression of bony disease, and costs about £650 a treatment.

    He advised that this may need to be repeated at 6-12 month intervals depending on how successful the initial treatment was. The next step was to see if Rosie could be made completely comfortable with changes to her shoeing.

    The Farrier’s role

    Shoeing for this problem is focussed on reducing the load-bearing pressure on the heel region, and reducing strain on this area at the point when the foot leaves the ground. This can be achieved in a number of different ways.

    Eamon emailed radiographs to Rosie’s regular farrier, Chris Carrell, so he could discuss the best course of action with him, as Chris knows her feet well.

    After liaising with Eamon, Chris fitted natural balance shoes on Rosie’s front feet, with gel pads, to give added cushioning.

    Rosie seemed very happy in these. After about a year, in the autumn as the ground became softer, the pads were dispensed with for a time to give Rosie’s frogs some fresh air.

    The outcome

    Rosie has been sound with this regime so far, and has competed successfully in four BE90s through 2013.

    Lucy has everything crossed that she continues to stay sound.

    Eamon has explained that there are other drugs which can be considered should Rosie start to feel sore, such as Navilox (isoxuprine), which increases blood flow to the feet, and systemic anti-inflammatory drugs like ‘bute’.

    The future

    Since Lucy does not have her own land, but uses a good quality (and thus expensive) livery yard close to home she has always in the past sold her horses on before they become old.

    “I toyed with the idea of trying to find Rosie a new home – for nominal money – perhaps to go hunting, and took her on a hunting course and out hunting to see how she was (she was brilliant!).

    “But she does everything I want, and is easy for me to handle on my own when I go competing. I have a fabulous sharer, and I would worry about her if I passed her on.

    “As a very rough guide, Eamon believes we should be able to enjoy, with luck, five good years of work from Rosie yet, perhaps more. And I have started to think about keeping her for the rest of her life, and try to prepare myself for the idea I may eventually have to have her put down in the end, which is something I have not had to do before.”

    The costs

    The price of investigating and treating all of this is substantial. Rosie has had in the region of £1,800 of treatment for her navicular, including a second dose of tildren almost a year after the initial treatment to ensure ongoing effect.

    Happily, Rosie was insured for vets’ fees, but her renewal fee soared to over £1,000. At this point Lucy considered leaving the mare uninsured, but instead swapped to a different firm, insured her for a much reduced value (with exclusions for the front feet), and for BE90 eventing, not BE100, and pretty much halved the premium.

    The natural balance shoeing with pads is pricey too — £105 a time, without stud holes. Chris Carrell alerted Lucy to the fact that some insurance policies cover remedial shoeing, so Lucy’s insurance firm paid for the pads until her policy expired.


    Farrier Chris Carreltel 07788 971 942 www.cjcarrel.co.uk

    Physio Jenny Wilson, tel: 01252 821 581 Bridgefield Physiotherapy. www.bridgefieldphysio.co.uk

    Vet: Equine Sport Vets, Sussex tel: 01403 731213