Navicular Disease Research Articles

MAGNETIC RESONANCE IMAGING FINDINGS IN HORSES WITH RECENT ONSET NAVICULAR SYNDROME BUT WITHOUT RADIOGRAPHIC ABNORMALITIES

Seventy-two horses with recent onset of navicular syndrome and normal radiographs were assessed. Horses underwent magnetic resonance (MR) imaging of both front feet. All abnormalities were characterized and the most severe abnormality identified, if possible. Abnormal signal intensity in the navicular bone was the most severe abnormality in 24 (33%) horses. Pathologic change in the deep digital flexor tendon was the most severe abnormality in 13 (18%) horses. Pathologic change in the collateral sesamoidean ligament was the most severe abnormality in 11 (15%) horses. Pathologic change in the distal sesamoidean impar ligament was the most severe abnormality in seven (10%) horses. Multiple abnormalities were observed in 13 (18%) horses in which an abnormality that was more severe than the others could not be determined. Abnormalities were not observed in the navicular bone or its supporting soft tissues in four (5%) horses. Fifty-six horses had abnormalities that were most severe in one limb; in 52 (93%) horses, the most severe abnormalities were in the foot of the most lame limb. In 7% (4/56) of horses, the most severe findings were in the opposite limb, and in 16 horses, the findings on both limbs were similar. MR imaging is a useful technique for evaluating horses with navicular syndrome and can differentiate between multiple abnormalities. This provides a more specific diagnosis which affects further treatment of the horse. Pathologic changes in different locations in the foot can cause similar clinical signs that, before MR imaging, were categorized as one syndrome.

Fine mapping a quantitative trait locus on horse chromosome 2 associated with radiological signs of navicular disease in Hanoverian warmblood horses

Navicular disease or podotrochlosis is one of the main causes of progressive forelimb lameness in warmblood horses. The objective of this study was to refine a quantitative trait locus on horse chromosome 2 for radiological alterations in the contour of the navicular bone (RAC) in Hanoverian warmblood horses. Genotyping was performed in 192 Hanoverian warmblood horses from 17 paternal half-sib groups. The marker set was extended to 58 informative microsatellites including nine newly developed microsatellites. QTL for RAC could be delineated at 32.50-43.13 Mb and a further new QTL for RAC could be identified at 59.08-65.14 Mb. The markers ABGe342 and ABGe343 reached the highest multipoint Z(mean) and LOD scores at 34.42 and 35.23 Mb with genome-wide error probabilities of P = 0.013 and P = 0.064. In addition, significant associations of markers and haplotypes within the QTL could be shown. The results support the location of the QTL on ECA2 associated with RAC. This work is a further step towards the development of a marker test for navicular disease in Hanoverian warmblood horses.

Beurteilung erblicher Defekte und Dispositionen beim Pferd unter tierschutzrechtlichen Gesichtspunkten

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 welfare rights throughout guidelines, established by the state and by breeding associations. Hereditary diseases scientifi cally proven as relevant for animal welfare matters or including a potential risk of pain, suffering or damage, should be regarded as essential criterion in horse breeding. In this context following diseases have to be mentioned in particular: Osteochondritis dissecans, deep fl exor tendon contracture in the foal, navicular disease, tarsal osteoarthritis, hyperkalemic periodic paralysis, Overo-lethal-white- foal-syndrome.

The use of force plate measurements to titrate the dosage of a new COX‐2 inhibitor in lame horses

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. 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. Sixty-four horses that exhibited chronic lameness presumed due to osteoarthritis, including navicular disease, in at least one of the frontlimbs and at a stable level of severity, were included. Horses were treated per os s.i.d. for 7 days as follows: vehicle control, firocoxib at 0.05, 0.1 or 0.25 mg/kg bwt. Force plate analysis of each horse was done for the selected (most) lame frontlimb at trot. Once between Days -19 and -4 (initial examination), and again on Day -2 or -1 (baseline), pretreatment force plate assessments were performed, and thereafter horses were assessed on Days 0, 2 and 6, approximately 10 h post treatment each time. Peak vertical force (PVF) and lameness grades at initial examination and at baseline, and their change from baseline in the 4 different treatment groups were analysed statistically at a significance level of P < 0.05. The PVF results were found to be superior to vehicle control already at Day 0 for 0.25 mg/kg bwt and at Days 2 and 6 for 0.1 and 0.25 mg/kg bwt (P < 0.05). Mean clinical lameness for both concentrations decreased > 1 grade at Day 6. With the dosage of 0.25 mg/kg bwt lameness did not improve more than with 0.1 mg/kg bwt. Thus, 0.1 mg/kg bwt s.i.d. was considered to be the effective dose at reducing chronic lameness in horses presumed due to osteoarthritis, including navicular disease.

Studies Regarding Treatment in Navicular Disease

The study we have performed was conducted during 2006-2007, on a number of 16 horses, aged between 4 and 18 years, belonging to f ollowing breeds: Quarter Horse, Dutch Warmblood, Thoroughbred, Passo Fino, Hanoverian, Selle Francaise. There is no direct correlation between the age and incidence of this degenerative process. The therapy of this disease has sought the combinat ion between medical treatment and recovery one, and surgical treatment when the resul ts of medical treatment and the recovery were negative.

Pressure distribution between the deep digital flexor tendon and the navicular bone, and the effect of raising the heels in vitro

The objectives of this study were to topographically map pressure distribution across the palmar surface of the navicular bone in response to forces applied by the deep digital flexor tendon (DDFT), and evaluate the effect of raising the heels in vitro . A rig was constructed to hold an equine cadaver limb and apply controlled pressure to the navicular bone from the DDFT. Pressure-sensitive paper was used to quantify and map the resultant pressure. Changes in response to heel wedges (5 degrees and 10 degrees ) were recorded. The areas subject to maximum pressure from the DDFT were: the central ridge, the paired symmetrical areas adjacent to the ridge and the distal edge of the palmar bone surface. These regions correspond to the known sites of navicular pathology. Heel wedges redistributed the pressure exerted on the palmar surface of the navicular bone, with measurements varying depending on fetlock angle and wedge angle. These in vitro results support the hypothesis that inappropriate forces exerted via the DDFT on the bone cause navicular disease. However, they throw doubt on the practice of shoeing such horses with heel wedges as the redistribution of pressure may increase the force exerted on regions predisposed to disease.

Röntgenreizbestrahlungen beim Pferd

Radiation therapy in benign diseases has been used as a successful treatment method in human medicine for more than one hundred years. In the radiophysical section the different radiation qualities are described concerning depth, doses and practical performance in the horse. Doese measurements were performed in a separated leg of a horse in order to achieve the best dose distribution in the radiation technique of the navicular disease. In the radiobiological section of this article the biological effects of the various mechanisms and tehir influence on the joints and soft tissues are explained. The fractionation scheme of 1 Gy per session to total doses of 6 Gy are accepted from the human medicine. Two radiotherapy machines with X-ray energies of 50–200 keV and a special equipment in the rediation rooms are described. First experiences in 250 horses until the end of 2008 will follow. In the largest group of patients of 24 horses with navicular disease 17 can be ridden after the treatment as before. Very good results can be achieved in inflammatory diseases of the different tendons in extremities. So far there are many other indications for a radiation therapy in benign diseases. They are compared with those in the human medicine. The advantage of this radiation technique in a sedated horse is the fact that there is no need for a tube attached to the treated region that would disturb the animal. The performance ist not difficult, there are no side effects. The radiation therapy can be combined with other treatment modalities.

Aspects of the pathogenesis of podal arthritis of the horse as an important part of navicular syndrome

Aspects of the pathogenesis of podal arthritis of the horse as an important part of navicular syndrome

Pull‐Through Technique for Palmar Digital Neurectomy: Forty‐One Horses (1998–2004)

To report outcome of horses treated for navicular syndrome using a pull-through (PT) technique for palmar digital neurectomy (PDN). Retrospective study. Horses (n=41) with navicular syndrome (NS). 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. One year after PDN, 36 horses (88%) were free of lameness. Mean survival with no lameness after surgery was estimated at 4.14+/-0.33 years (median, 5 years). PT-PDN technique resulted in soundness for 88% of horses for at least 1 year. PT-PDN was easily and quickly performed without specialized equipment, and had a low incidence of complications. The PT technique is an effective and viable alternative surgical method for PDN.

Manometry in the navicular bursa for diagnosis of the navicular syndrome in horses: An experimental study

Manometry in the navicular bursa for diagnosis of the navicular syndrome in horses: An experimental study

Computer Tomography: A Novel Diagnostic Technique used in Horses

In Veterinary Medicine, Computer Tomography (CT scan) is used more often in dogs and cats than in large animals due to their small size and ease of manipulation. This paper, however, illustrates the use of the technique in horses. CT scan was used in the diagnosis of two conditions of the head and limbs, namely alveolar periostitis and Navicular disease. The advantages of the technique are evident in the clarity with which the lesions are seen, as well as the precise identification of the affected tooth or bone. The Kenya Veterinarian Vol. 21 2001: pp. 32-33

Mapping the horse genome and its impact on equine genomics for identification of genes for monogenic and complex traits – a review

Abstract. Since the beginning of investigation in the horse genome in the early nineties, there has been a great progress, especially during the last five years. At the beginning the exploration of monogenic hereditary diseases was one of the main aims, and the causal mutations of several diseases in the horse have been unravelled. The inheritance of coat colours has been explored very detailed, and there exist gene tests for different coat colours. Information about coat colours and inherited diseases is very important for the breeders and helps avoiding the appearance of lethal genetic factors or undesirable diseases. The most important achievements of horse genome analysis were well-developed linkage, radiation hybrid and cytogenetic genome maps including more than 2950 loci. These maps support comparative analysis of equine hereditary diseases. The present known gene mutations for five diseases in horses have human homologs. Studies on multifactorial diseases such as osteochondrosis and navicular bone disease and on fertility and temperament are underway. At the moment, the whole equine genome is sequenced as it has been done for the human genome and also for other animal genomes. Horse breeding will greatly benefit from identification of QTL for multifactorial traits and gene mutations for congenital anomalies, diseases and performance traits.

Morphologic changes associated with functional adaptation of the navicular bone of horses

Failure of functional adaptation to protect the skeleton from damage is common and is often associated with targeted remodeling of bone microdamage. Horses provide a suitable model for studying loading-related skeletal disease because horses are physically active, their exercise is usually regulated, and adaptive failure of various skeletal sites is common. We performed a histologic study of the navicular bone of three groups of horses: (1) young racing Thoroughbreds (n = 10); (2) young unshod ponies (n = 10); and (3) older horses with navicular syndrome (n = 6). Navicular syndrome is a painful condition that is a common cause of lameness and is associated with extensive remodeling of the navicular bone; a sesamoid bone located within the hoof which articulates with the second and third phalanges dorsally. The following variables were quantified: volumetric bone mineral density; cortical thickness (Ct.Th); bone volume fraction, microcrack surface density; density of osteocytes and empty lacunae; and resorption space density. Birefringence of bone collagen was also determined using circularly polarized light microscopy and disruption of the lacunocanalicular network was examined using confocal microscopy. Remodeling of the navicular bone resulted in formation of transverse secondary osteons orientated in a lateral to medial direction; bone collagen was similarly orientated. In horses with navicular syndrome, remodeling often led to the formation of intracortical cysts and development of multiple tidemarks at the articular surface. These changes were associated with high microcrack surface density, low bone volume fraction, low density of osteocytes, and poor osteocyte connectivity. Empty lacunae were increased in Thoroughbreds. Resorption space density was not increased in horses with navicular syndrome. Taken together, these data suggest that the navicular bone may experience habitual bending across the sagittal plane. Consequences of cumulative cyclic loading in horses with navicular syndrome include arthritic degeneration of adjacent joints and adaptive failure of the navicular bone, with accumulation of microdamage and associated low bone mass, poor osteocyte connectivity, and low osteocyte density, but not formation of greater numbers of resorption spaces.

Injection of Ringer solution into the navicular bursa for the diagnosis of the navicular syndrome in horses: An experimental study

Injection of Ringer solution into the navicular bursa for the diagnosis of the navicular syndrome in horses: An experimental study

Use of force plate analysis to assess the analgesic effects of etodolac in horses with navicular syndrome

To evaluate the musculoskeletal analgesic effect of etodolac administered PO every 12 or 24 hours in chronically lame horses by use of force plate analysis. 22 horses with navicular syndrome. Horses received etodolac (23 mg/kg, PO, q 12 h; n = 7), etodolac (23 mg/kg, PO, q 24 h; 8), or corn syrup (20 mL, PO, q 24 h; control treatment; 7) for 3 days. Combined forelimb peak vertical ground reaction force (PVF) was measured via force plate analysis before the first treatment (baseline) and at 6, 12, 24, and 36 hours after the last treatment. Differences in mean PVF (mPVF) between baseline and subsequent measurements were analyzed (repeated-measures ANOVA) and evaluated for treatment and time effects and treatment-time interaction. Once- or twice-daily administration of etodolac resulted in significant increases in mPVF from baseline at 6, 12, and 24 hours after the last treatment, compared with the control treatment. There were no significant differences in mPVF between the etodolac treatment groups at any time point. In both etodolac treatment groups, there was a significant increase in mPVF from baseline at 6, 12, and 24 hours, compared with that at 36 hours. Etodolac-associated adverse effects were not detected. In horses with navicular syndrome, once-daily oral administration of 23 mg of etodolac/kg appears to provide effective analgesia for as long as 24 hours. Twice-daily administration of etodolac at this same dose does not appear to provide any additional analgesic efficacy or duration of effect.

Navicular disease: a review of what's new

Equine Veterinary JournalVolume 38, Issue 1 p. 82-88 Navicular disease: a review of what's new A. B. M. Rijkenhuizen, Corresponding Author A. B. M. Rijkenhuizen Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12, 3584 CM Utrecht, The Netherlands.Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12, 3584 CM Utrecht, The Netherlands.Search for more papers by this author A. B. M. Rijkenhuizen, Corresponding Author A. B. M. Rijkenhuizen Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12, 3584 CM Utrecht, The Netherlands.Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12, 3584 CM Utrecht, The Netherlands.Search for more papers by this author First published: 05 January 2010 https://doi.org/10.2746/042516406775374216Citations: 27AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume38, Issue1January 2006Pages 82-88 RelatedInformation

Histopathology in horses with chronic palmar foot pain and age‐matched controls. Part 2: The deep digital flexor tendon

Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. Abnormalities of the deep digital flexor tendon (DDFT) may contribute to palmar foot pain; ageing degenerative changes may be seen in horses free from lameness; and horses with lameness are likely to have a greater severity of abnormalities than age-matched horses with no history of foot pain. Feet were selected from horses with a history of uni- or bilateral forelimb lameness of at least 2 months' duration. Histology of the DDFT from the level of the proximal interphalangeal joint to its insertion were examined and the severity of lesions for each site graded. Associations between lesions of the navicular bone, collateral sesamoidean ligaments (CSL), distal sesamoidean impar ligament, navicular bursa, distal interphalangeal (DIP) joint synovium and collateral ligaments of the DIP joint and DDFT were assessed. There was no relationship between age and grade of histological abnormality of the DDFT. There were significant histological differences between groups for lesions of the dorsal layers of the DDFT, but not for lesions of the palmar aspect. There were significant associations between histological grades for the superficial dorsal layer of the DDFT and flexor aspect of the navicular bone; and between the deep dorsal layer of the DDFT and the proximal border and medulla of the navicular bone. The navicular bursa grade was correlated with grades for the superficial dorsal, deep dorsal and deep palmar layers of the DDFT. The histological grades for the CSL and the superficial dorsal layer of the DDFT were also associated. Pathological abnormalities in lame horses often involved the DDFT in addition to the navicular bone. Vascular and matrix changes may precede changes in the fibrocartilage of the navicular bone. Identification of factors leading to vascular changes within the interstitium of the DDFT and changes in matrix composition, may help in future management of palmar foot pain.

Histopathology in horses with chronic palmar foot pain and age‐matched controls. Part 1: Navicular bone and related structures

Causes of palmar foot pain and the aetiopathogenesis of navicular disease remain poorly understood, despite the high incidence of foot-related lameness. Abnormalities of the collateral sesamoidean ligaments (CSLs), distal sesamoidean impar ligament (DSIL), deep digital flexor tendon (DDFT), navicular bone, navicular bursa, distal interphalangeal (DIP) joint or collateral ligaments (CLs) of the DIP joint may contribute to palmar foot pain. Feet were selected from horses with a history of unilateral or bilateral forelimb lameness of at least 2 months' duration that was improved by perineural analgesia of the palmar digital nerves, immediately proximal to the cartilages of the foot (Group 1, n = 32); or from age-matched control horses (Group 2, n = 19) that were humanely destroyed for other reasons and had no history of forelimb foot pain. Eight units of tissue were collected for histology: the palmar half of the articular surface of the distal phalanx, including the insertions of the DDFT and DSIL; navicular bone and insertion of the CSLs; DDFT from the level of the proximal interphalangeal (PIP) joint to 5 mm proximal to its insertion; synovial membrane from the palmar pouch of the DIP joint and the navicular bursa; CLs of the DIP joint and DSIL. The severity of histological lesions for each site were graded. Results were compared between Groups 1 and 2. There was no relationship between age and grade of histological abnormality. There were significant histological differences between groups for lesions of the flexor aspect, proximal and distal borders, and medulla of the navicular bone; the DSIL and its insertion and the navicular bursa; but not for lesions of the CSLs, the dorsal aspect of the navicular bone, distal phalanx and articular cartilage, synovium or CLs of the DIP joint. Pathological abnormalities in lame horses often involved not only the navicular bone, but also the DSIL and navicular bursa. Abnormalities of the navicular bone medulla were generally only seen dorsal to lesions of the FFC. Adaptive and reactive change may be occurring in the navicular apparatus in all horses to variable degrees and determination of the pathogenesis of lesions that lead to pain and biomechanical dysfunction should assist specific preventative or treatment protocols.

MAGNETIC RESONANCE IMAGING CHARACTERISTICS OF THE FOOT IN HORSES WITH PALMAR FOOT PAIN AND CONTROL HORSES

Palmar foot pain is a common cause of lameness. Magnetic resonance imaging (MRI) has the potential to detect damage in all tissues of the equine foot, but an understanding of the differences in magnetic resonance (MR) images between feet from horses with and without palmar foot pain is required. This study aimed to describe MR findings in feet from horses with no history of foot-related lameness, and to compare these with MR findings in horses with lameness improved by palmar digital local analgesia. Thirty-four limbs from horses euthanized with a clinical diagnosis of navicular syndrome (ameness >2 months duration, positive response to palmar digital nerve blocks and absence of other forelimb problems) (Group L), and 25 feet from age-matched horses with no history of foot pain (Group N) were examined. For each anatomic structure, MR signal intensity and homogeneity, size, definition of margins, and relationships with other structures were described. Alterations in MR signal intensity and homogeneity were graded as mild, moderate, or severe and compared between Groups L and N. Results revealed that there were significant differences in MR images between Groups N and L. Multiple moderate-severe MR signal changes were present in 91% of limbs from Group L and moderate (none were graded severe) in 27% of limbs from Group N. In most Group L limbs, more than three structures and frequently six to eight structures were abnormal. Concomitant abnormalities involved most frequently the deep digital flexor tendon, distal sesamoidean impar ligament, navicular bone, collateral sesamoidean ligament, and navicular bursa (with significant associations in severity grade between these structures), sometimes with involvement of the distal interphalangeal joint and/or its collateral ligaments. It was concluded that findings on MR images were different between horses with and without foot pain, and that pain localized to the foot was associated with MR changes in a variety of structures, indicating that damage to several structures may occur concurrently and that MR imaging was useful for evaluation of foot pain.

Investigation of the Immediate Analgesic Effects of Extracorporeal Shock Wave Therapy for Treatment of Navicular Disease in Horses

To measure the acute analgesic properties of extracorporeal shock wave therapy (ESWT) in horses with navicular disease using objective ground reaction forces (GRF). Prospective study. Nine client-owned horses with unilateral forelimb lameness caused by navicular disease. Horses were trotted at 3 m/s over a force plate to record pre-treatment GRF of the lame and contra-lateral forelimbs. After ESWT of the lame limb, applied with a radial unit to each of the frog and heel bulb areas with 1500 pulses at 4 bar and 10 Hz, GRF measurements were repeated at 15 minutes and 24-hour intervals for 7 days. From the 5 trials recorded at each time, peak vertical force (PVF) was calculated and averaged. Data were compared between limbs and over time using a 2-way repeated-measures ANOVA. Mean (+/-SD) PVF was significantly different between lame (day 1; 4339+/-626 N) and contra-lateral (day 1; 5236+/-515 N) limbs pre-treatment (P<.05). After ESWT treatment, this difference remained unchanged at 15 minutes and from days 1 to 7. To confirm navicular disease, palmar digital analgesia significantly reduced the lameness (lame 5144+/-430 N; contralateral 5082+/-586 N; P>.05). Single ESWT treatment applied in this manner does not influence lameness in horses with navicular disease. Although many equine regulatory commissions currently ban the use of ESWT before competition, our results suggest that such regulations may be unfounded. Further research is required to determine the long-term analgesic properties of this frequently used treatment modality in equine athletes.