PATHOLOGY
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Navicular
Disease

Tendon Adhesion

Pedal Osteitis
& Periostitis

Suspensory
Desmitis

Ethmoid
Hematoma

Navicular Disease

SIGNALMENT

Thoroughbred 12 year old Mare, Event horse

HISTORY

Left Front penetrating wound to the digital flexor tendon sheath repaired by referring DVM
Padded shoes for a period of two years to alleviate pressure
Suddenly dead lame, revealing an absess, two corns, and a crack on the right front hoof.
Stall rest for four months, still not completely sound

PRESENTATION

1o out of 5o lameness on the right front, 2o out of 5o lameness on circling
80-90% Improvement with palmar digital analgesia, with increased lameness on the left foot after blocking
Mild increases in improvement with sequential blocks.

DIAGNOSTICS

 
   

Ultrasonography

Nuclear Medicine

Radiology

Magnetic Resonance Imaging

 
         

DIAGNOSIS AND PROGNOSIS

The clinical, scintigraphic, and MRI findings support the diagnosis of early deterioration of the navicular bone. Specifically, thre are aerosive lesions along the palmar cortex of the navicular bone and early adhesion ofrmation with the deep digital flexor tendon. Fortunately, the disease process has not progressed to involve the cortical medullary junction or the medullary cavity of the navicular bone and the radiographs show mild abnormalities along the distal border.

TREATMENT

Corrective shoeing will be the mainstay of therapy in this case. The redistribution of weight and alleviation of load on the deep digital flexor tendon and navicular bone will hopefully help the current situation and delay progression of hte disease process.

Isoxusuprine tablets to increase blood flow to the navicular bone.

Judicious use of phenylbutazone from time to time for pain management may be required

Injections into the distal and proximal interphalangeal joint with Hyaluronan and corrtical steriods may alleviate inflammation and improve the situation. The navicular bursa ought to be reserved for future injections if needed

Additional treatments such as biphosphonate administration and neurectomy could also be considered.

         
 
Copyright © 2006 - University of Pennsylvania School of Veterinary Medicine, All rights reserved.
Faculty: Dr. Alexia McKnight
Student:Charles Bradley 2009