1 / 33

Navicular Syndrome and Heel pain in the performance horse

Navicular Syndrome and Heel pain in the performance horse. Phillip D Jones, DVM, MS Diplomate American College of Veterinary Surgeons. Outline. Causes for caudal heel pain Diagnostics and therapies Shoeing recommendations. Caudal heel pain. N avicular syndrome

bevis-browning
Télécharger la présentation

Navicular Syndrome and Heel pain in the performance horse

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Navicular Syndrome and Heel pain in the performance horse Phillip D Jones, DVM, MS Diplomate American College of Veterinary Surgeons

  2. Outline • Causes for caudal heel pain • Diagnostics and therapies • Shoeing recommendations

  3. Caudal heel pain • Navicularsyndrome • Degenerative process that changes the bone-initiation and progression of the disease is a result of excessive and prolonged forces of compression on the bone • Important factors- signalment, conformation, and use

  4. Navicular syndrome • Mild to moderate intermittent lameness • Insidious onset • Perceived as shoulder lameness • Poor confirmation • Bilateral lameness • Lameness switches to contralateral limb after unilateral PD block

  5. Navicular syndrome • Important PE findings -contracted heels -atrophied frog-small foot compared with body size

  6. Navicularsyndrome • Medical therapy -shoeing changes-anti-inflammatory medications -rest • Surgical therapy- PD neurectomy (criteria! & complications!)

  7. Diagnostics • Localization • Palmar Digital Nerve block-Mepivacaine: 1 -1.5ml /nerve

  8. Diagnostics

  9. Navicularsyndrome • Changes within the navicular bone -edema -vascular stasis -enlargement of the nutrient foraminae -cyst-likemedullary areas -subchondral bone changes -changes in the flexor surface -fragmentation of the distal border

  10. Add normal NB

  11. Dyson- Radiographic Interpretation of the Navicular Bone. EVE 2008

  12. Shoeing • Correct or preserve dorsopalmar and lateromedial foot balance • Hoof pastern angle should be straight • Foot trimmed to maintain heel mass and shorten toe to facilitate breakover • Elevation of heel may relieve pressure from DDFT on palmar aspect of navicular bone • Egg bar shoe: greater surface area disperses forces. -Of 55 horses with navicular disease 53% had permanent pain relief of lameness after egg bar shoes in 12-40 month follow up.

  13. shoeing • Key points: • Correct and maintain dorsopalmar and lateromedial balance • Ease breakover • Maintain heel mass • Protect palmar aspect of the hoof from concussion

  14. Medical therapies • Intra-articular injection • Intra-bursal injection • Tilduronicacid (Tildren) • NSAID’s • Isoxuprine-2.2% oral bioavailability

  15. Treatment

  16. Caudal Heel Pain • Desmititis of the collateral ligaments. • Tendonitis of the DDFT at 3 possible locations: -insertion -palmar to the navicular bone -proximal to the navicular bone • Desmitis of the impar ligament. • Desmitis of the distal annular ligament. • Synovitis in the distal interphaleangeal joint. • Synovitis in the navicular bursa. • Cystic lesion in the second phalanx

  17. Treatment

  18. Shockwave • Extracorporeal shock wave -generates a pulse wave within the body • Encourages growth mediators and other cytokines integral to the healing process • Offers temporary pain relief

  19. Fracture Dyson- Radiographic Interpretation of the Navicular Bone. EVE 2008

  20. Bipartite Navicular Bone • Develops as 2 separate centers of ossification that never unite • Unilateral or bilateral • Broad well defined lucent line between the 2 pieces • Horse may be clinically normal, or have episodic lameness in full athletic function • No history of acute lameness as in fracture

  21. Bipartite Dyson- Radiographic Interpretation of the Navicular Bone. EVE 2008

  22. ?

More Related