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Navicular disease in the horse

1996; Elsevier BV; Volume: 16; Issue: 1 Linguagem: Inglês

10.1016/s0737-0806(96)80061-x

1542-7412

R. J. ROSE,

Tendon Structure and Treatment

Summary Navicular disease results in a chronic, progressiveforelimb lameness that is usually bilateral. Although many different horse breeds can be affected, Quarter Horses and Warmbloods appear particularly susceptible. The peak age incidence appears to be in horses aged 6–10 years. The condition has been recognized for many years and has been the source of debate and conflict for at least the last 50 years. Much of the confusion has been caused by different criteria used to establish a diagnosis. In a large series of cases examined at the University of Sydney, only 30 percent of horses that were eventually diagnosed as having navicular disease showed a positive response to hoof testers applied across the middle third of the frog. In contrast, more than 80 percent of horses with navicular disease showed a marked increase in lameness following pastern and fetlock flexion. All horses diagnosed became sound following a palmar digital nerve block and all had positive findings on radiography. However, radiography could not be utilized as a sole diagnostic technique because some horses with radiographic abnormalities of the navicular bone did not show clinical signs of navicular disease. To establish a diagnosis of navicular disease, the following criteria should be met: 1) A chronic progressive unilateral or bilateral forelimb lameness, 2) Pain in areas proximal to the foot has been excluded as a possible cause of the lameness, 3) Other conditions that could cause pain in the palmar heel region are excluded, 4) The lameness is eliminated or substantially improved following a palmar digital nerve block, and 5) There are radiographic abnormalities on upright pedal and/or skyline views of the navicular bone. Treatment of navicular disease has usually fallen into categories of a) pain alleviation, b) drugs with vascular or hemodynamic effects, or c) changing biomechanics either by corrective trimming or corrective shoeing. None of these treatments have been universally accepted and debate about their efficacy is allied to theories about the etiology.