Navicular: Heel Pain Giving You a Headache?

I have a 6 yo Quarter Horse mare that I compete in Western Pleasure, who has recently started exhibiting some of the early signs of Navicular disease. Sometimes she’s a little ouchy on her front feet when ridden on hard ground; taking short, shuffling strides and she’s started to stumble a little more than she used to. The farrier was out to shoe her recently and when he hoof tested her, she did exhibit some signs of soreness in her hooves. He recommended some corrective shoeing as she is a big mare with small feet (relative to her size) and very upright pasterns and since then she has been much improved. However, I know that given her conformation the likelihood of her developing further problems down the road is high. I want to do everything I can to keep her healthy and sound because she’s a great mare. Are there any supplements that you could recommend to help keep her sound? BG, California

Dear BG,

Navicular disease is a very complicated subject that experts are still trying to figure out, starting with the challenging terminology. Navicular Disease is specifically defined as a chronic forelimb lameness associated with pain arising from the navicular bone. Navicular Syndrome, on the other hand, is a degenerative disease process involving at least one of many structures located in the back aspect of the hoof. These structures can include the navicular bone, but they can also include the navicular bursa, the joint between the coffin bone and the second pastern bone, the deep digital flexor tendon (DDF), the impar ligament, or the collateral sesmoidean ligament. See what I mean by a complicated subject with challenging terminology?

Although it sounds like you’re on the right track, I encourage you to involve your veterinarian as well as your farrier in a definitive diagnosis of what’s causing your mare to begin to travel poorly. A complete and thorough lameness examination with flexion tests, wedge tests and other manipulatory assessments, followed by local blocks, then imaging (x-rays, ultrasound, even MRI or CT) may narrow down the cause of your mare’s foot pain and help the three of you develop the best treatment and management plan for her. Options include:

• Rest
• Therapeutic trimming and shoeing
• Anti-inflammatory medications and supplements
• Substances which alter blood flow in the foot (isoxsuprine, acepromazine)
• Therapeutic compounds injected directly into the joint, bursa or tendon sheath
• Compounds for arthritis given intramuscularly or intravenously (Adequan, Legend)
• New treatments tiludronate and shock wave therapy
• Palmar digital neurectomy “nerving” as a last resort surgery

Since you specifically asked about the role of supplements and navicular, I’ll provide a little more detail in that area. Rather than keep horses on non-steroidal anti-inflammatories like “bute” long-term, some veterinarians are recommending natural inflammation-fighters like Boswellia, Yucca and Bromelain. Devil’s Claw is another option. And because some causes of navicular syndrome are joint-related, supplementing with glucosamine, chondroitin sulfate, HA and MSM might be a good idea. Finally, there are some ingredients which can be fed to horses to increase blood flow in the foot, such as arginine and citrulline (precursors of nitric oxide). N-acetyl cysteine and niacinamide have been shown to help protect the cells that line blood vessels, two other good ingredients to have on board. Genetics definitely plays a part in navicular disease and syndrome but there are some things you can do to help your horse involving hoof care, workload, medications and supplements.

Lydia Gray, DVM MA, is the Staff Veterinarian for SmartPak. Prior to joining SmartPak, Dr. Gray served as the first-ever Director of Owner Education for the American Association of Equine Practitioners. She has authored numerous articles in publications such as The Horse, Horse Illustrated, Western Horseman and a variety of veterinary journals and magazines. Dr. Gray is also a frequent speaker at horse expos, veterinary conventions and other events. After graduating with honors from the University of Illinois College of Veterinary Medicine and receiving her Master's Degree in Interpersonal and Organizational Communication, she practiced at the Tremont Veterinary Clinic for several years. Dr. Gray is active in the American Veterinary Medical Association and Illinois State Veterinary Medical Association. She enjoys training and showing her Trakehner, Newman, in both combined driving and dressage, and is a USDF “L” Program Graduate (with distinction). Find Dr. Gray on Google+

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18 comments on “Navicular: Heel Pain Giving You a Headache?
  1. Danielle k says:

    My 7 year old Qh has navicular corrective shoeing didn’t help and neither did drugs, the vet strongly recc nerving since he wasn’t responding to anything else he had both from legs done over 6 years ago and he was in a drug study with the vet for a French drug called Tildren, to this day he is still ridden ( less than before ) wtc n trail rides and is sound his stride is just a little shorter.

  2. Ashley says:

    My horse was diagnosed with navicular in may. We also did the tildren drug. It has already improved her xrays. She also has her coffin joint injected, low dose bute therapy and corrective shoeing. And so far so good :)

  3. wendy says:

    I am so sorry you are going through this with your mare. Is the above picture of your mare’s foot? Because in the photo the horse’s heel is not bringing support to th heel. Which these type of heels are common in shod horses. I would consider getting another farrier or two to look at your horse as well. They don’t have to trim her but give you their thoughts. Please take the time & check out Pete Ramey (he is a barefoot trimmer) I am a barefoot horseman & this style of trimming has helped many a horse. & Easycare boots may add some extra support during transition or longer rides. I feed a supplement called Remission. It is made for founder prone horses but I love the ingredients for my gelding who has an old nasty injury his front (sole) hoof.

  4. Rebecca says:

    It really is worth studying up on the “barefoot” methods (all of which are not equal) however I do believe that Pete Ramey is a credible resource, as is Dr. Robert Bowker (Univ. of Mich). These gentlemen have directly and indirectly (through educating others) restored soundness to countless so-called “Navicular” horses. I own one. She is 7 and has a lovely floating extended trot in her iron free hooves. Just be prepared for it to take time. In my case, I rode with boots on her hooves for 6 months. Understand that it takes diet, movement and frequent trims. But SO worth it. Educate yourself- true “natural” hoof care strives to support the hoof in growing to its optimal shape and proportions, where it can support the horse best. A side benefit- my mare went up a boot size- she is a little footed horse too, but is a 0 now. 18 months ago she was a 00. Oh, she also was a stumbling shuffling western pleasure horse… she jogs beautifully balanced now, no toe stabbing!

  5. Michelle says:

    Dr. Gray – Thank you for your thoughtful, thorough response. My 13yo has Navicular syndrome of most of the structures mentioned and nerving was not an option due to the high level of damage. You would not believe (or maybe you would) how often people tell me their horse had navicular and was fine after x, y & z. I had to stop using the term “navicular” altogether because its frustrating to have people tell you your horse will be rideable again one day when you know he won’t.

    • Ana says:

      did you try pulling the shoes and setting the horse on permanent turnout with regular trims? It’s most people’s last resort but usually is the one that works best. forgot to mention thrush has to be gone for anything else to work. If the tendon is too far gone the horse may not get back to 100% but should improve significantly unless the bone changes are so great that they rub and further damage the tendon. (don’t even know if that happens but theoretically it could)

  6. Stacy says:

    One of our horses was diagnosed with navicular ‘syndrome’ in that the vet didn’t see any changes on the xrays, but the horse nerve blocked sound in that area. For that horse (not all will be the same) my vet recommended pulling his shoes for a year. He was sound in about a month!!! We have kept him sound and now barefoot (vet says we can put shoes back on, but why at this point?). That was 3 years ago. the horse is 15 years old now.

  7. Ana says:

    saddly the only thing I’ve tried that works is making sure the back of the hoof gets to work as a whole, wich necessarily implies that the hoof mechanism can function as freely as you can enable it. This means barefoot on “giving” tough soil (pea gravel for instance), or booted with frog pressure pads, or lastly, shod in some flexible plastic shoe with a complete hoof botom filing of silicone.
    Best thing is to experiment and see what makes the horse land less toe first. would also heartily recommend No-Thrush if that is an issue. Never tried anything that worked so fast and so well.

    drugs, nerve severings, corrective shoeing all can work for some time, but none can actually fix the problem and the horse will eventualy turn useless. The bone damage isn’t the issue, the tendon damage is, and for anyone with experience in healing tendon damage, they know how long and careful it has to be. But usually a year should be enough if exercise is kept under check in gradual increments.

  8. Tracy says:

    Does Smartpack offer a “package” for Navicular horses?

    • SmartPak SmartPak says:

      Hi Tracy,

      This page talks more about the condition and offers a suggested SmartPak containing Recovery EQ and SmartSox, two supplements that have gotten good reviews from customers who have used them on horses diagnosed with navicular syndrome:
      http://www.smartpakequine.com/health_and_nutrition/diseases_and_conditions/navicular.aspx
      However, because heel pain can have so many different causes and can respond inconsistently to treatment, you may want to work with your veterinarian and create your own SmartPak containing products that benefit your horse the most.

  9. Dennise says:

    I learned more about Navicular from my Equine Massage therapist,she recommended all of the above solutions.One product,and I am sure Smartpak can provide the same ingredients is Rapid Flex.My mar has been on it for a year now and she is doing so much better.The natural ingedients are the key.

  10. Pennie says:

    My 8 yr old mare was diagnosed with “genetic” navicular 2 yrs ago. What had started out as just being stiff in the shoulder and choppy short-strided steps turned into refusal to move off under saddle to a violent change in a normally sweet attitude. Drags showed she should be 3-legged lame. She had a quarter-size hole in her navicular bone. Vet suggested special shoeing, but said he didn’t think she would be able to be ridden but maybe occasionally in good arena soil only and only at a walk. Well, I wasn’t going to give up on her. I researched all kinds of shoeing methods, supplements, nerving, drug therapies, holistic medicines, etc. I ran across an advertisement for Equi-bone by TLC Animal Nutrition. I liked what I read and ordered the product. Within two weeks, my girl was trotting around her paddock. Her attitude had gone from violent lunging at you back to the sweet loving mare. Within one month, she was frisky and playful and was able to return to turn out with her pasture mates during the day. 6 mons after starting Equi-bone, I had my vet x-ray her. There was significant bone regrowth in the navicular bone. Bone spurs were gone. Her sole depth had increased greatly. She would now stand square when barefoot..no filching or shifting her weight or placing one front foot slightly forward. Shoeing her was now easy..previously, she hurt so bad, my farrier had a really hard time ad she couldn’t stand once the shoe was off, had to have her stand on a piece of temperpedic foam. After a year, the hole in her navicular bone was 95% filled with new bone and she was 100% sound. She is still doing wonderful. She hasn’t had a missed step in 2 yrs. I still give her the maintenance dose of Equi-bone. My vet has been extremely pleased and a little shocked at her recovery. I don’t think shoeing alone ( we just did a short toe – 3 in front coronet to toe on a size 0 hoof, a navicular shoe with pour in pads, and gradually raised her heel) or the Equi-bone would have done it. It took both and vigilant daily care to monitor for slight changes and never going more than 4 wks without being reshod. Check out Equi-bone at TLCanimalnutrition.com. It is well worth the try!

    • lori drummond says:

      hello I also have a horse with navicular have ordered the equibone after hearing wonderful reviews on it. my mare also has a whole in her navicular bone . did it really help with that?
      my girl has been on it for only 6 days have not seen any changes yet only her trotting around a bit more then she usually does. I am SO HOPING this product helps her!

  11. Tiffany says:

    If your horse has been diagnosed with navicular diesease or syndrome PLEASE go check out http://www.thenaturalfarrier.com my horse is the case study for navicular on her page…. She went from on the verge of being put down to sound in 3 weeks

  12. Useful information like this one must be kept and maintained so I will put this one on my twitter list! Thanks for this wonderful post and hoping to post more of this!

  13. sandy says:

    just found out that my 3 yr old is navicular and so is my 19 year old they both became navicular at the same time/ we suspect a bad farrier or farriers since they both are navicular and on the same side well the 3 year old is on both front. I have nevcer had one before and all the ones that I have herd of that became navicular where all destroied so this is a shock to me that they can live a long and do well I have always been taught that they ultimatly have a short life. so do I put them through a bunch of unnessary pain or do I put them dowm

  14. This information is very helpful I have a friend that has been experiencing heel pain for about 3 months now, he stands on his feet all day as apart of his work. we thought that changing the shoe would help but I see that the root cause of the discomfort is bigger based on this information. i will be making a call to the doctors office to have this checked out.. Thank You so much..

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