Veterinarians at Rood and Riddle Equine Hospital answer your questions about sales and healthcare of Thoroughbred auction yearlings, weanlings, 2-year-olds and breeding stock. Email us at [email protected] if you have a question for a veterinarian.
Question: What are some of the differences in treatment and prognosis for laminitis vs. navicular syndrome?
Dr. Craig Lesser, Rood and Riddle Equine Hospital: Having the diagnosis of laminitis or navicular syndrome can be terrifying. The diagnosis of either disease has traditionally been considered to be career-ending. However, in recent years with advances in medicine and farriery, many of these horses can return to their previous careers.
The diseases are, in many ways, polar opposites. Most laminitis cases involve inflammation of the dorsal lamina and pain in the toe, whereas navicular syndrome exhibits pain in the back half of the foot.
There are a variety of medical treatments to help reduce inflammation and slow the progression of the disease. However, mechanical stabilization in the form of therapeutic farriery is essential for a positive outcome. The basics of therapeutic farriery are to transfer loads away from structures that hurt to structures that can handle the extra load.
In regards to laminitis, this means protecting and unweighting the toe and recruiting the frog and bar into load sharing, in addition to decreasing the tension on the deep digital flexor tendon (DDFT), which is pulling against the inflamed lamina, causing the rotation. Early intervention is critical. When the condition is treated aggressively before there are any radiographic changes, we will hopefully prevent rotation and get us back to performance faster. However, once there is rotation, it takes a full year for a new healthy hoof to grow out completely. While shoeing these horses, it is essential to have your veterinarian and farrier work together and be willing to change the plan depending on the horses’ response to therapy. There are many different shoeing options with varying application techniques, making treatment very much an art, and what has worked for one horse may not work for the next.
Horses with navicular syndrome can have many of the same concepts apply. Reducing concussion through the back half of the foot, where they are painful, can be achieved with various applications, including pads, heel plates, or floating of certain aspects of the foot. Reduction in the tension of the DDFT as it runs over the navicular bone is often vital, as the tendon uses the bone as a fulcrum for leverage. This can be achieved with stagnant wedges or mechanical wedges with something like a rocker shoe. However, no matter what is placed on the foot as an apparatus, if the trim isn’t correct, they will not function properly, which is why sometimes radiographs can be helpful in guiding this therapy.
Suppose your horse is diagnosed with either of these. In that case, it is important to be aggressive not only with medical therapies but also with mechanical therapies to ensure your athlete makes it back into performance or even so that they have a long and healthy life.
Dr. Craig Lesser, CF graduated from Colorado State University College of Veterinary Medicine in 2015. Following the completion of an internship at Anoka Equine, he moved to Lexington to complete a podiatry fellowship at RREH and has continued with us as an associate. As an extension of podiatry Dr. Lesser has an interest in lameness and imaging.