Navicular Syndrome in horses refers to a condition affecting the navicular bone and its associated structures within the hoof, often leading to forelimb lameness. The syndrome encompasses a variety of pathologies, including inflammation or degeneration of the navicular bone, the surrounding soft tissues, and the navicular bursa. It is often diagnosed through a combination of clinical examination, imaging techniques such as radiography or MRI, and response to diagnostic analgesia. Factors contributing to Navicular Syndrome may include genetics, conformation, workload, and hoof imbalance. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, diagnosis, management, and treatment options for Navicular Syndrome in equine patients.
Larsen EA, Williams MR, Schoonover MJ, Jurek KA, Young JM, Duddy HR.Navicular syndrome is a common cause of forelimb lameness in horses. Beyond changes to the navicular bone itself, horses with a clinical diagnosis of navicular syndrome often have pathology associated with other components of the navicular apparatus, including the navicular bursa, deep digital flexor (DDF) tendon, collateral sesamoidean ligaments, and impar ligament. Palmar digital neurectomy (PDN) is often used as a salvage procedure for horses diagnosed with navicular syndrome that become unresponsive to medical management. There are many potential complications associated with PDN, some of ...
Reiser V, Reiser A, Licka TF.To identify and measure radiolucencies at the solear margin of the distal phalanx in radiographs of healthy and laminitic hooves. Methods: Clinical records and dorsoproximal-palmarodistal radiographs of equine forelimbs with radiological diagnoses of either laminitis (n = 40, L) or navicular syndrome (n = 40, NS). Methods: Outlines of the radiolucent structures at the solar margin were drawn in ImageJ, and a customized novel plugin "Arteries Analyzer/ImageJ" was used for measurements. The diverging radiolucencies outside the terminal arc of the distal phalanx were differentiated as arterial ch...
Chanda M, Puangthong C, Pathomsakulwong W, Apichaimongkonkun T, Leklub J.Two horses diagnosed with underrun heels leading to navicular syndrome were fitted with Z-bar shoes. They occasionally showed moderate lameness on the affected legs after the sixth and tenth consecutive farrier adjustments. The affected hooves were sensitive to compression of the frog and sole in their palmar regions. Modified Z-bar shoes were created and shod on the lame legs based on previous with regional anaesthesia and recent clinical examination. The lameness scores were slightly improved at the first shoeing with the modified Z-bar shoes but were markedly improved at four and eight week...
Salinas P, Lira-Velásquez D, Bongiorno A, Sandoval C.The aim of this study was to quantify the distribution of aligned and non-aligned collagen in cross-sections of the superficial digital flexor tendon (SDFT) and deep digital flexor tendon (DDFT) in different levels of the distal forelimb of equines diagnosed with NS (Navicular Syndrome). Sixty equine forelimbs were collected. Was compared two groups (NA, Not affected vs. NS-group) by t-Student. Diagnosis of NS was based on clinical and lameness examination, diagnostic analgesia and radiological findings. The proportion of aligned and non-aligned collagens at 2 levels for the SDFT and 3 levels ...
Pollard D, Wylie CE, Newton JR, Verheyen KLP.Euthanasia is a complex topic, with animal owners using multiple factors to shape their decision-making process. Previous epidemiological studies have described causes of equine mortality in specific populations, but there is limited evidence regarding factors contributing specifically to equine euthanasia in Great Britain (GB). This observational study used a prospective cohort design: the objectives were to describe owner-reported reasons for euthanasia, estimate the rate of euthanasia and identify associated factors in horses/ponies enrolled in a web-based epidemiological study of laminitis...
Mitchell A, Watts AE, Ebetino FH, Suva LJ.Bisphosphonates (BPs) are a family of molecules characterized by two key properties: their ability to bind strongly to bone mineral and their inhibitory effects on mature osteoclasts and thus bone resorption. Chemically two groups of BPs are recognized, non-nitrogen-containing and nitrogen-containing BPs. Non-nitrogen-containing BPs incorporate into the energy pathways of the osteoclast, resulting in disrupted cellular energy metabolism leading to cytotoxic effects and osteoclast apoptosis. Nitrogen-containing BPs primarily inhibit cholesterol biosynthesis resulting in the disruption of intrac...
Schoonover MJ, Whitfield CT, Young JM, Sippel KM, Payton ME.OBJECTIVE To determine effects for 2 IV regional limb perfusion (IVRLP) protocols involving tiludronate on lameness of horses with navicular syndrome. ANIMALS 15 horses with bilateral forelimb navicular syndrome. PROCEDURES Shoeing and anti-inflammatory injection into the distal interphalangeal joint (DIPJ) of both forelimbs (day 0) were performed on all horses. On day 14, horses received 1 of 3 IVRLPs consisting of 0.1 mg of tiludronate/kg (low-dose tiludronate [LDT]; n = 5), 0.2 mg of tiludronate/kg (high-dose tiludronate [HDT]; 5), or saline (0.9% NaCl) solution (placebo; 5); treatments wer...
Düsterdieck-Zellmer KF.Systemic administration of tiludronate or clodronate decreases lameness in some horses suffering from navicular syndrome within 2-6 months of treatment. In horses that fail to respond to the first treatment, a follow-up treatment may still improve the lameness. Horses with a lameness duration of less than 6 months have better odds of experiencing improvement in lameness. Bisphosphonate (BP) treatment can result in renal damage, and it is recommended to assess renal function prior to and after treatment. Horses with pre-existing renal compromise should not be treated with BP, as this may promot...
Whitfield CT, Schoonover MJ, Holbrook TC, Payton ME, Sippel KM.To determine effects of 2 tiludronate administration protocols on measures of lameness in horses with navicular syndrome (NS). Methods: 12 horses with bilateral forelimb NS. Methods: Horses were randomly assigned to receive tiludronate (1 mg/kg), diluted in 5 L of isotonic electrolyte solution and delivered through a jugular vein catheter (systemic treatment group; n = 6), or tiludronate (0.1 mg/kg), diluted with saline (0.9% NaCl) solution to a total volume of 35 mL and delivered into the lateral digital vein of each forelimb with an IV regional limb perfusion (IVRLP) technique (IVRLP group; ...
Back W, MacAllister CG, van Heel MC, Pollmeier M, Hanson PD.Lameness is a highly prevalent condition in horses and the principal cause of removal from athletic activity. In clinical studies to evaluate nonsteroidal anti-inflammatory drug therapies, force plates are commonly used to assess improvement of lameness objectively. Objective: To use a force plate to determine the optimal dose of a new COX-2 inhibitor (firocoxib) that will reduce lameness, when administered orally to horses once daily. Methods: Sixty-four horses that exhibited chronic lameness presumed due to osteoarthritis, including navicular disease, in at least one of the frontlimbs and at...
Mählmann Ch, Steiger A.Persons involved in equine breeding, namely veterinarians, horse breeders and breeding association judges, often lack of an apropriate consciousness about the relevance of heritability or supposed heritability of common horses diseases, which might play a distinctive role in the aetiology of numerous of these diseases. Executing animal welfare rights in equine breeding, the major concern should focus on an objective evaluation of pain, suffering and damages caused by different hereditary diseases. The basis of assessment for hygienic breeding has to be defi ned according to the actual animal w...
Maher O, Davis DM, Drake C, Myhre GD, Labbe KM, Han JH, Lejeune SS.To report outcome of horses treated for navicular syndrome using a pull-through (PT) technique for palmar digital neurectomy (PDN). Methods: Retrospective study. Methods: Horses (n=41) with navicular syndrome (NS). Methods: Medical records (1998-2002) for horses that had NS and failed to respond to conservative management that had unilateral or bilateral forelimb, biaxial PDN were reviewed. Outcome for up to 6 years was obtained by telephone questionnaire or lameness examination. Survival analysis was used to assess time to recurrence of lameness. Results: One year after PDN, 36 horses (88%) w...
Bidwell LA, Brown KE, Cordier A, Mullineaux DR, Clayton HM.Perineural analgesics are used for lameness diagnosis but the duration of effect, knowledge of which would provide valuable information when performing subsequent blocks, is unknown. Objective: To evaluate the duration of a palmar digital nerve block using force plate measurements. Methods: Ten horses diagnosed with unilateral navicular syndrome were trotted at range of 3 +/- 0.15 m/sec over a force plate to record ground reaction forces for 5 trials of each forelimb. Data were recorded before nerve block, and then at 15 mins, 1, 2 and 24 h post nerve block. Results: Before nerve block, peak v...
Erkert RS, Macallister CG.Isoxsuprine hydrochloride has been suggested for use in horses for treatment of navicular syndrome and laminitis. The drug has been shown to be a beta-adrenoreceptor antagonist with beta-adrenoreceptor agonistic properties, with both characteristics contributing to vasodilation and uterine relaxation. In addition, the drug is capable of decreasing blood viscosity and platelet aggregation. Studies have shown i.v. isoxsuprine to have a plasma half-life of <3 h with a large apparent volume of distribution. Cardiovascular effects resolve rapidly following i.v. administration, but are absent wit...
Weil M, Litzke LF, Fritsch R.Thirty-six lameness free horses and 119 horses with lameness of the distal forelimb including the carpus were evaluated through thermography. Examination was done with an infrared thermography camera "Thermovision 470" and a specially developed analyzing software program. Temperature differences between corresponding regions of the left and right forelimb were determined and scrutinized statistically between various lameness groups. By creating temperature differences between both limbs a parameter for skin temperature was found which is independent of surrounding temperature. In lameness free...
Honnas CM, Welch RD, Ford TS, Vacek JR, Watkins JP.The medical records of 12 horses with septic arthritis of a distal interphalangeal joint were reviewed to determine clinical features and response to treatment. Sepsis was caused by trauma or an injection that resulted in an open or contaminated distal interphalangeal joint. All horses were severely lame. Treatment included broad-spectrum parenterally administered antimicrobial drugs (ten horses), percutaneous through-and-through joint lavage (eight horses), indwelling drains (three horses), immobilization of the limb in a cast (three horses), intraarticular injection of sodium hyaluronate (on...
Steiss JE, White NA, Bowen JM.Electroacupuncture was used to treat lameness in horses and ponies with chronic laminitis (n = 10) or navicular disease (n = 10). A clinical trial was conducted with random allocation of equal numbers of animals to control and treatment groups. Acupuncture was performed three times per week for four consecutive weeks. The degree of lameness was assessed by 1) a grading scheme, 2) measurement of stride lengths and 3) analysis of weight distribution using a force plate. Although seven out of ten animals with chronic laminitis improved clinically during the trial, there were no statistically sign...
Colles CM.Twenty horses suffering from navicular disease were treated with warfarin given orally. The dosage was to effect, to give a 2 to 4 second prolongation of the one stage prothrombin time (OSPT). Dosage was initially at a rate of 0.018 mg/kg, changing the dose by amounts of 20 per cent until the required dose was achieved. Final dose rates varied from 0.012 mg/kg to 0.75 mg/kg. All the cases treated received warfarin daily throughout the trial. Seventeen of the animals became sound and the remaining 3 showed a marked improvement in their gait. The mean of the ages of the horses was 7.5 years, the...
Pollard D, Wylie CE, Newton JR, Verheyen KLP.Euthanasia is a complex topic, with animal owners using multiple factors to shape their decision-making process. Previous epidemiological studies have described causes of equine mortality in specific populations, but there is limited evidence regarding factors contributing specifically to equine euthanasia in Great Britain (GB). This observational study used a prospective cohort design: the objectives were to describe owner-reported reasons for euthanasia, estimate the rate of euthanasia and identify associated factors in horses/ponies enrolled in a web-based epidemiological study of laminitis...
Mitchell A, Watts AE, Ebetino FH, Suva LJ.Bisphosphonates (BPs) are a family of molecules characterized by two key properties: their ability to bind strongly to bone mineral and their inhibitory effects on mature osteoclasts and thus bone resorption. Chemically two groups of BPs are recognized, non-nitrogen-containing and nitrogen-containing BPs. Non-nitrogen-containing BPs incorporate into the energy pathways of the osteoclast, resulting in disrupted cellular energy metabolism leading to cytotoxic effects and osteoclast apoptosis. Nitrogen-containing BPs primarily inhibit cholesterol biosynthesis resulting in the disruption of intrac...
Back W, MacAllister CG, van Heel MC, Pollmeier M, Hanson PD.Lameness is a highly prevalent condition in horses and the principal cause of removal from athletic activity. In clinical studies to evaluate nonsteroidal anti-inflammatory drug therapies, force plates are commonly used to assess improvement of lameness objectively. Objective: To use a force plate to determine the optimal dose of a new COX-2 inhibitor (firocoxib) that will reduce lameness, when administered orally to horses once daily. Methods: Sixty-four horses that exhibited chronic lameness presumed due to osteoarthritis, including navicular disease, in at least one of the frontlimbs and at...
Bidwell LA, Brown KE, Cordier A, Mullineaux DR, Clayton HM.Perineural analgesics are used for lameness diagnosis but the duration of effect, knowledge of which would provide valuable information when performing subsequent blocks, is unknown. Objective: To evaluate the duration of a palmar digital nerve block using force plate measurements. Methods: Ten horses diagnosed with unilateral navicular syndrome were trotted at range of 3 +/- 0.15 m/sec over a force plate to record ground reaction forces for 5 trials of each forelimb. Data were recorded before nerve block, and then at 15 mins, 1, 2 and 24 h post nerve block. Results: Before nerve block, peak v...
Whitfield CT, Schoonover MJ, Holbrook TC, Payton ME, Sippel KM.To determine effects of 2 tiludronate administration protocols on measures of lameness in horses with navicular syndrome (NS). Methods: 12 horses with bilateral forelimb NS. Methods: Horses were randomly assigned to receive tiludronate (1 mg/kg), diluted in 5 L of isotonic electrolyte solution and delivered through a jugular vein catheter (systemic treatment group; n = 6), or tiludronate (0.1 mg/kg), diluted with saline (0.9% NaCl) solution to a total volume of 35 mL and delivered into the lateral digital vein of each forelimb with an IV regional limb perfusion (IVRLP) technique (IVRLP group; ...
Colles CM.Twenty horses suffering from navicular disease were treated with warfarin given orally. The dosage was to effect, to give a 2 to 4 second prolongation of the one stage prothrombin time (OSPT). Dosage was initially at a rate of 0.018 mg/kg, changing the dose by amounts of 20 per cent until the required dose was achieved. Final dose rates varied from 0.012 mg/kg to 0.75 mg/kg. All the cases treated received warfarin daily throughout the trial. Seventeen of the animals became sound and the remaining 3 showed a marked improvement in their gait. The mean of the ages of the horses was 7.5 years, the...
Honnas CM, Welch RD, Ford TS, Vacek JR, Watkins JP.The medical records of 12 horses with septic arthritis of a distal interphalangeal joint were reviewed to determine clinical features and response to treatment. Sepsis was caused by trauma or an injection that resulted in an open or contaminated distal interphalangeal joint. All horses were severely lame. Treatment included broad-spectrum parenterally administered antimicrobial drugs (ten horses), percutaneous through-and-through joint lavage (eight horses), indwelling drains (three horses), immobilization of the limb in a cast (three horses), intraarticular injection of sodium hyaluronate (on...
Steiss JE, White NA, Bowen JM.Electroacupuncture was used to treat lameness in horses and ponies with chronic laminitis (n = 10) or navicular disease (n = 10). A clinical trial was conducted with random allocation of equal numbers of animals to control and treatment groups. Acupuncture was performed three times per week for four consecutive weeks. The degree of lameness was assessed by 1) a grading scheme, 2) measurement of stride lengths and 3) analysis of weight distribution using a force plate. Although seven out of ten animals with chronic laminitis improved clinically during the trial, there were no statistically sign...
Düsterdieck-Zellmer KF.Systemic administration of tiludronate or clodronate decreases lameness in some horses suffering from navicular syndrome within 2-6 months of treatment. In horses that fail to respond to the first treatment, a follow-up treatment may still improve the lameness. Horses with a lameness duration of less than 6 months have better odds of experiencing improvement in lameness. Bisphosphonate (BP) treatment can result in renal damage, and it is recommended to assess renal function prior to and after treatment. Horses with pre-existing renal compromise should not be treated with BP, as this may promot...
Weil M, Litzke LF, Fritsch R.Thirty-six lameness free horses and 119 horses with lameness of the distal forelimb including the carpus were evaluated through thermography. Examination was done with an infrared thermography camera "Thermovision 470" and a specially developed analyzing software program. Temperature differences between corresponding regions of the left and right forelimb were determined and scrutinized statistically between various lameness groups. By creating temperature differences between both limbs a parameter for skin temperature was found which is independent of surrounding temperature. In lameness free...
Maher O, Davis DM, Drake C, Myhre GD, Labbe KM, Han JH, Lejeune SS.To report outcome of horses treated for navicular syndrome using a pull-through (PT) technique for palmar digital neurectomy (PDN). Methods: Retrospective study. Methods: Horses (n=41) with navicular syndrome (NS). Methods: Medical records (1998-2002) for horses that had NS and failed to respond to conservative management that had unilateral or bilateral forelimb, biaxial PDN were reviewed. Outcome for up to 6 years was obtained by telephone questionnaire or lameness examination. Survival analysis was used to assess time to recurrence of lameness. Results: One year after PDN, 36 horses (88%) w...
Chanda M, Puangthong C, Pathomsakulwong W, Apichaimongkonkun T, Leklub J.Two horses diagnosed with underrun heels leading to navicular syndrome were fitted with Z-bar shoes. They occasionally showed moderate lameness on the affected legs after the sixth and tenth consecutive farrier adjustments. The affected hooves were sensitive to compression of the frog and sole in their palmar regions. Modified Z-bar shoes were created and shod on the lame legs based on previous with regional anaesthesia and recent clinical examination. The lameness scores were slightly improved at the first shoeing with the modified Z-bar shoes but were markedly improved at four and eight week...
Erkert RS, Macallister CG.Isoxsuprine hydrochloride has been suggested for use in horses for treatment of navicular syndrome and laminitis. The drug has been shown to be a beta-adrenoreceptor antagonist with beta-adrenoreceptor agonistic properties, with both characteristics contributing to vasodilation and uterine relaxation. In addition, the drug is capable of decreasing blood viscosity and platelet aggregation. Studies have shown i.v. isoxsuprine to have a plasma half-life of <3 h with a large apparent volume of distribution. Cardiovascular effects resolve rapidly following i.v. administration, but are absent wit...
Mählmann Ch, Steiger A.Persons involved in equine breeding, namely veterinarians, horse breeders and breeding association judges, often lack of an apropriate consciousness about the relevance of heritability or supposed heritability of common horses diseases, which might play a distinctive role in the aetiology of numerous of these diseases. Executing animal welfare rights in equine breeding, the major concern should focus on an objective evaluation of pain, suffering and damages caused by different hereditary diseases. The basis of assessment for hygienic breeding has to be defi ned according to the actual animal w...
Schoonover MJ, Whitfield CT, Young JM, Sippel KM, Payton ME.OBJECTIVE To determine effects for 2 IV regional limb perfusion (IVRLP) protocols involving tiludronate on lameness of horses with navicular syndrome. ANIMALS 15 horses with bilateral forelimb navicular syndrome. PROCEDURES Shoeing and anti-inflammatory injection into the distal interphalangeal joint (DIPJ) of both forelimbs (day 0) were performed on all horses. On day 14, horses received 1 of 3 IVRLPs consisting of 0.1 mg of tiludronate/kg (low-dose tiludronate [LDT]; n = 5), 0.2 mg of tiludronate/kg (high-dose tiludronate [HDT]; 5), or saline (0.9% NaCl) solution (placebo; 5); treatments wer...
Salinas P, Lira-Velásquez D, Bongiorno A, Sandoval C.The aim of this study was to quantify the distribution of aligned and non-aligned collagen in cross-sections of the superficial digital flexor tendon (SDFT) and deep digital flexor tendon (DDFT) in different levels of the distal forelimb of equines diagnosed with NS (Navicular Syndrome). Sixty equine forelimbs were collected. Was compared two groups (NA, Not affected vs. NS-group) by t-Student. Diagnosis of NS was based on clinical and lameness examination, diagnostic analgesia and radiological findings. The proportion of aligned and non-aligned collagens at 2 levels for the SDFT and 3 levels ...
Reiser V, Reiser A, Licka TF.To identify and measure radiolucencies at the solear margin of the distal phalanx in radiographs of healthy and laminitic hooves. Methods: Clinical records and dorsoproximal-palmarodistal radiographs of equine forelimbs with radiological diagnoses of either laminitis (n = 40, L) or navicular syndrome (n = 40, NS). Methods: Outlines of the radiolucent structures at the solar margin were drawn in ImageJ, and a customized novel plugin "Arteries Analyzer/ImageJ" was used for measurements. The diverging radiolucencies outside the terminal arc of the distal phalanx were differentiated as arterial ch...
Larsen EA, Williams MR, Schoonover MJ, Jurek KA, Young JM, Duddy HR.Navicular syndrome is a common cause of forelimb lameness in horses. Beyond changes to the navicular bone itself, horses with a clinical diagnosis of navicular syndrome often have pathology associated with other components of the navicular apparatus, including the navicular bursa, deep digital flexor (DDF) tendon, collateral sesamoidean ligaments, and impar ligament. Palmar digital neurectomy (PDN) is often used as a salvage procedure for horses diagnosed with navicular syndrome that become unresponsive to medical management. There are many potential complications associated with PDN, some of ...
