Navicular "syndrome" is the most common diagnosis for front limb lameness in horses. The veterinary community has taken to prefering the term "syndrome" over "disease" because, to date, there is nothing conclusive that indicates it is a disease (meaning a pathological condition characterized by an identifiable group of signs or symptoms) as opposed to simply a group of commonly recurring symptoms of unknown origin. The reason for this is that there is no one thing that goes wrong within the hoof. We only know that something happens. It could be 'something' to do with the navicular bone itself and/or the ligaments attached to it and/or some other structure within the hoof all leading to the Bottom Line: the horse is lame, it is coming from within the hoof, it isn't getting better, and no one seems to know exactly why.
If the word "navicular" has come up in discussions with your vet and/or farrier as a way to explain your horse's off and on again lamess or mysterious 'not-rightness' (perhaps he's been stumbling, or resisting when he didn't used to) chances are it prompted some research on your part. A "google" search on the phrase "navicular syndrome" results in over 28,000 web page hits with most of the content leaving your mind boggled and your heart sinking. Over and over again the same uncertainties about what causes it and what, if anything, can be done to fix it.
Typically, the causes listed include heredity, conformation, type of work, and hoof form/shoeing. Treatments are never 'cures' but rather management techniques intended to minimize discomfort. These range from various drugs for pain management to surgical solutions such as Neurectomy. Trimming and shoeing recommendations typically include keeping the toes short and supporting the heel with bar shoes. None of these treatments are expected to cure the horse, only to temporarily extend his usefulness until the condition becomes unmanageable. At this point the horse is either retired (hopefully with minimal pain) or euthanized. This usually comes after years of trying new shoeing strategies, various drugs, and/or extended periods of rest to little avail. The march of time takes its toll and finally time, money and emotional energy run out.
We have a much different outlook on the Navicular Syndrome issue (as well as other hoof related problems like low ringbone or even founder). Most of the 'causes' associated with the Navicular Syndrome diagnosis are merely distractions. The bottom line with every single case we've encountered (as well as the many hundreds if not thousands of cases other barefoot hoof care practitioners have seen) is hoof form, movement, hoof form, nutrition and, did we say, hoof form!
The challenge for owners with horses who have a confirmed diagnosis or even a presumed diagnosis is facing the facts. The stresses associated with poor hoof form exacerbated by shoeing is the primary driver behind navicular pain. The other 'causes' such as conformation or type of work just add to an already untenable situation for the horse. So it comes down to how willing is the owner to commit to the process of healing the horse? If the owner is willing to make the necessary changes to the horse's hoof care, diet, and lifestyle the horse has a very high chance of returning to soundness--not just pasture sound but performance sound.
Here's what we know. Most hoof problems are the accumulated result of poor hoof form (from the day your horse was born due to poor trimming practices), improper nutrition, and inadequate movement. We also know that all horse's feet will respond to proper treatment. Some recover more quickly than others (some as quickly as immediately to a month or two or as long 6 months to a year); some are able to make more progress than others; but most horses, even those who are on the verge of euthanasia, can be up and running around again in time.
Why is removing the shoes so important to the process?
If a healthy well formed foot has a shoe put on for a short time it isn't likely to do much damage. But most horses are living with some level of deformity in their feet. So much so that most people would not recognize a deformed foot because that is how they all look! But it is these very same deformities which will lead many if not most to eventual pain. The horse's foot is an elastic structure. It is intended to move as the horse moves and it is continually forming and reforming itself. When we encase the hoof in steel the foot looses its natural elasticity and like a muscle that doesn't move the internal structures start to atrophy. The foot then begins to collapse in on itself, the heels contract and slip under and the toes drift out in front. Sometimes the laminae stretches away from the coffin bone. Let this continue for 10 or 15 years and this is why so many teen aged horses are the ones coming up as 'navicular'. We have to take the shoes off and encourage the horse to move around (which is why 24x7 turnout is recommended) so that the atrophied structures inside the hoof start to 'wake up' and grow again. Frogs start to plump up again, toes shorten, heels widen and stand up and soundness returns.
Show me the research!
It is entirely reasonable to ask, if this is the better approach to solving my horse's problem why then is my vet or farrier not suggesting it? Because change is hard! The assumption and expectation that horses need shoes is very engrained into our equestrian culture. However this is changing. There is a growing contingent of vets and farriers who are advocating for a barefoot solution. Dr. Hiltrud Strasser paved the way 20 years ago. It was a most controversial start. However, over the last ten years or so it seems that interest began to grow exponentially. Due in large part to the internet and its role in fostering community and information sharing. Dr. Robert Bowker is a leading veterinarian whose research is adding considerable depth to our understanding of how a physiological barefoot trim benefits the horse.
Farriers as well are discovering that with improved trimming techniques they are getting more horses sound while barefoot. Some are even converting their entire business to barefoot. A few farriers have lead the way like Pete Ramey, Jaime Jackson, and Gene Ovnicek which has opened a whole new world of opportunity for a career in barefoot hoof care.
Education is the critical success factor. Not just horse owners but farriers and vets as well. The internet has been a catalyst for change. Whereas, in the past, people who believed that 'barefoot was best' were isolated, today there is a strong support community available to those who seek out the information. More and more people are finding that even performance horses can do well without shoes. The most difficult step is the first one because often times, especially for professionals, to choose barefoot today means admitting to having been wrong yesterday. To that all there is to do is remember the words of Maya Angelou, "You did what you knew how to do, and when you knew better, you did better."
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