Dr. Teskey on
navicular and nerving
Dr. Teskey is a Martha Olivo Hoof Groom
Mentor, in addition to being a veterinarian. Here he discusses navicular
as being the result of improper hoof form, and warns against 'nerving'
treatments, which are popular for navicular. In addition to the risks he
discusses on nerving, I would add the additional problems it creates:
1. If the horse cannot feel the ground
with his feet, he will be less sure-footed. He can easily fall on his
rider while negotiating rough terrain. I think trail riding a nerved horse
is too risky.
2. If the horse cannot feel his hooves,
he could have advanced founder, abscessing, or puncture wounds left untreated
because he does not appear to be lame.
Bringing
the Sparkle Back in to Crystal's Life
by Dr. Tomas G. Teskey, D.V.M.
Hereford, AZ, U.S.A.
tomasteskey@yahoo.com 520-366-0707
I was recently approached about consulting with a dressage stable owner
and his plans to purchase an eight year old Swedish warmblood mare that
had been diagnosed with navicular syndrome. He was interested in just
using her as a brood mare since she was approaching "middle age" and the
lameness problem was "incurable". I was informed that her fantastic
breeding and records in the show ring would likely make her foals highly
desirable. The previous owner was selling the mare because she was
unable to afford the necessary surgery that the mare needed to remain
sound and usable. Her veterinarian was planning on performing a digital
neurectomy on both front lower legs of the mare and has been in touch
with this potential new owner about following through with the necessary
procedure. This stable owner decided to purchase this unsound eight year
old mare at a much reduced price, and has been in consultation with me
from the time she stepped foot on his property. This was six and a half
months ago. He has also been in contact with the referring veterinarian
over this time and has kept her informed of our progress in treating
this mare for her diseased front feet.
One of his original questions for me before I met him or this mare,
"Crystal", was as follows:
He writes in his email, "I'm hoping you can help me out. I've just
purchased a broodmare with navicular. Would it be possible for you to
provide me with some information before breeding this mare? I looked at
the x-rays with the previous vet and she suggesting cutting the nerves
on this mare and didn't understand why the previous owner hadn't done it
sooner. What are the pro's and cons of this nerve cutting? Thank you for
your time."
My response to him four months ago was as follows, and with his
permission I am sharing this information with any and all of you who
would like to explore with me what has traditionally been happening with
these horses and why it is high time we reevaluate the way we think
about and treat these very common hoof problems:
The procedure you are referring to is known as a "neurectomy". It is
generally performed on horses that have had chronic pain problems in
their feet, most notably "navicular" problems. The horse is put under
general anesthesia and the digital nerves on both sides of the lame leg
AND the more sound leg are isolated and cut--most often a section of the
nerve on both sides is removed and the ends "capped" with the leftover
nerve sheath. The reason that both legs are surgicated is because most
horses end up quite lame in the leg opposite the originally lame one if
it is left intact. Thus, one can easily appreciate that even though a
horse only shows lameness in one of the forelegs, both are affected in a
horse with "navicular" disease or "navicular" syndrome. The result of
the surgery is that the horse loses sensation from this point downward
and is unable to feel the pain from the diseased foot anymore. Usually
the limping that was due to the pain in the area goes away and the horse
can continue to be used. The horse is thus returned to "soundness".
This procedure costs anywhere from $250 to $1500 depending on where it
is done and who does it. It is "effective" for around one to two
years--sometimes not that long, sometimes longer, but all of these
horses eventually regrow some nerve connections and regain sensation of
the area that was originally desensitized. The lameness then returns and
the procedure can be repeated at that time to keep the horse sound.
As you can easily see, this procedure addresses only one thing for the
horse and the owner: the head bobbing lameness.
There are some very real and potentially devastating negative side
effects of digital neurectomies in horses. Often times the raw ends of
the nerves become irritated to the point of developing extremely painful
nerve tumors called neuromas, leading to further surgeries to remove
them. Other times, the digital arteries and veins that lie immediately
parallel to the cut digital nerves become scarred and the resulting
stagnation of circulation leads to foundering of the worst degree.
Localized infections, scarring of tendinous and ligamentous structures
and unsightly swellings are also common. Thus, a procedure designed to
provide temporary relief from a widely misunderstood type of lameness
often leads to further pain, loss of use and early death for these
affected horses. Performing these surgeries is severely disruptive to
the horse's lower leg anatomy, physiology and energy patterns, and
commonly leads to irreparable damage.
"Navicular" problems, often referred to as "heel pain" or "caudal heel
syndrome" start presenting symptoms in horses as young as two and three
years old when their hooves are either allowed to overgrow into a
deformed shape, and/or their feet shod at this young age. The
still-developing coffin bones and sensitive inner hoof structures are
surrounded, constricted and over-pressurized by the
progressively-deforming hoof capsules, starving them of vital movement
and circulation, yet forcing them to attempt to function and survive in
a physiologically stagnant state. Older horses are also plagued by what
is termed navicular disease and innumerable other hoof problems when
their hooves also succomb to deformities in structure and stagnation of
function. These lamenesses occur after longer periods of what is
traditionally thought to be the "best hoof care possible". When this
"best hoof care possible" consists of infrequent trimming and/or
shoeing, it is no mystery, but rather a highly predictable and
physiologic certainty, that these horses will suffer from hoof
deformities and possibly debilitating lamenesses. "Killing me softly"
takes on new meanings when it comes to the effects of the steel
horseshoe on our equine companions.
Given that all of these "navicular" horses can be shown to have
deformities in the outward appearance of their hooves, it would seem
logical to direct our efforts towards improving their abnormal hoof
form, reversing the trends that are causing these deformities and
provide for the horse a situation that promotes good hoof form. Cutting
the digital nerves in these horses provides absolutely nothing that is
honestly therapeutic for them. It is a medically unsound procedure, but
it is prevalent in our modern day "use and abuse" philosophy of keeping
horses going--doing this in a day and age where we now have an excellent
understanding of why these horses end up with "navicular" pain is
totally unnecessary and irresponsible--there are no sound medical
reasons to perform these nerve surgeries with the reckless abandon they
are. These procedures are an excellent example of how simple ignorance
of proper hoof form and function allows horse owners and their
veterinarians to perform them. Terms like "salvage procedure" have
become widely used to describe such procedures that prolong the useful
life of the animal strictly for the human's monetary benefit. Addressing
the real problems of the deformities in the feet and how to reverse them
with proper trimming and lifestyle will win out as the only acceptable
alternative for these animals and their human stewards, and the true
salvage in terms of the lives of horses will be realized.
Performing digital neurectomies on heel-sore or foot-sore horses
promotes further degeneration of the entire lower leg and hooves in
these animals, because it disrespects and disallows what the entire
animal needs to achieve a more proper hoof form and normal function.
Instead of cutting the nerves to a part of the horse's anatomy and
achieving a completely false sense of "soundness", we are alternatively
able to nurture these unsound horses and their deformed feet to attain
correct hoof form and thus proper and vital physiologic function.
Natural exfoliation, vital mechanical hoof movements, energizing
sensation and exquisite protection are just a few of the important
functions horses' hooves need to have, and this is precisely what they
achieve with proper hoof care. This leads us and our horses on a direct
path to an honest soundness, far outpacing conventional western
veterinary medical techniques and promoting the physical and
psychological health of the entire horse, rather than disrupting a part
of the horse's vital anatomy, which only leads to further deterioration,
loss of use and early death.
As it is improperly trimmed and/or shod horses that are the ones
affected by "navicular syndrome", we know that promoting sound,
naturally shaped hooves along with adequate movement on firm terrain is
essentially a life-promoting and life-saving, honestly therapeutic form
of treatment--it is this type of treatment I will prescribe for horses
that I tend to, as it is the only treatment that respects the nature of
the horse. Drugs such as isoxsuprine, nitrous oxide, nitroglycerin,
phenylbutazone and flunixin meglumine do nothing to improve the deformed
feet in these affected horses. Eggbar shoes, reversed shoes, special
pads, natural balance shoes, wedge pads, impression material, shoes with
rails and/or frog inserts, or any other artificial appliance attached to the bottom of the horse, cannot possibly be honestly therapeutic for
horses with navicular problems or other hoof ailments. It is a
physiologic impossibility; they can only serve to further the
deformities and damage to the horses to which they are nailed, perhaps
prolonging the development of further, inevitable symptoms until years
down the road, but still furthering the damage all the while. There is
not a single case of a horse with severe "navicular disease" that has
been cured by the application of an appliance to the foot. Cured, and/or
sound, would be defined as a horse that is able to walk, trot and run at
liberty on their own feet in a soft environment with animation,
impulsion and without lameness. It is the promotion of natural hoof form
and thus proper hoof function which allows horses to heal from the
insults previously afforded them by improper trimming, shoeing and/or
lifestyle, and they heal remarkably well if we respect their fascinating
anatomy and it's wonderfully simple physiology. Providing this option to
horse owners when they are faced with whether to pay for a "salvage
procedure" or provide for what their horse honestly needs is what the
natural hoof care movement is about. These are life and death situations
for our horses and it saves horses' lives every day.
It is ironic that honest, well-intentioned people across the land are
spending their hard-earned money on treatments that are making their
horses more unsound and more unusable in the long run. Terms such as
"therapeutic shoeing" or "corrective shoeing" will soon be exposed for
the oxymorons they are, and interested parties such as insurance
companies and horse-leasing operations will soon question such
practices, and will not stand idly by while shelling out millions of
dollars to pay for such appliances and other "treatments" such as
neurectomies that only serve to worsen the conditions of the animals to
which they are responsible. Alas, this is the age we now live in...an
age of transition for ourselves as well as our horses. Our
responsibilities are great, the knowledge is there, and it is coming to
an area near you.
Tomas Teskey D.V.M.
P.S. "Crystal" is walking and trotting soundly (with animation and
impulsion) in the last three weeks of her "treatment" that I have
prescribed, and is working with an alertness and vitality that a few
short months ago was gone from her life. She lives in a large 50 foot by
100 foot turnout on the far side of the boarding stable property with
another gelding that she likes to boss around, has free choice grass hay
and minerals, receives a variety of other herbs and vegetables daily and
will be foregoing her previously planned pregnancies to go back in to
the show ring and jumping circuit in the Spring. The previous owner and
veterinarian have so far been uninterested in visiting her in her new
setting with her new lifestyle, but twenty other boarders are keenly
aware of where this crippled mare was four months ago and where she is
headed now...these are the people that have been keeping the previous
owner, veterinarian and two farriers updated on Crystal's progress. I
will now be turning over the hoof trimming duties to her new owner, as
he has been an excellent student of the hoof under my supervision and
has demonstrated a willingness and good ability to groom her
much-improved hooves. There are also several other boarders who will
continue their hoof grooming classes with me and be taking care of their
horses' feet very soon. He and Crystal will be showing regionally
starting in March.
