Texas Equine Veterinary Association

www.texasequineva.com • 23 From the time I was a junior in high school, I knew I wanted to be a veterinarian. My interest in horses began in my late teens when I started volunteering in a large animal ambulatory practice. As my familiarity with horses increased, I came to appreciate them for the athletes they are. That's why navicular has been such a frustrating disease throughout my career. During my 35 years in practice, there haven't been a lot of medical options for managing navicular. In the past, a diagnosis of navicular disease in middle-aged performance or sport-horses was usually career-ending. Not only would the horses no longer get to do the job they loved, but also the owners would lose the joy of competing with horses they were invested in financially and emotionally. Even with the bleak outlook, I did my best to manage navicular, typically by implementing a regimen of a vascular-effect drug like Isoxsuprine or aspirin. I'd also prescribe therapeutic shoeing and look for ways to manage footing by recommending the horse try different exercises on different ground. If horses didn't respond, sometimes I'd inject a corticosteroid in the coffin joint or navicular bursa. If the pain was still uncontrollable, I might perform a neurectomy. That was then. Now with the introduction of bisphosphonates—my treatment of choice is Osphos® (clodronate injection)—the prognosis for 60 to 70 percent of my navicular patients has improved significantly. Every day in practice I see a diverse population of equine athletes, everything from Saddlebreds to racehorses to English hunter jumpers to western performance horses. And every day I see a case of navicular in at least one of them. Protocol for prescription I start working up a lameness case the same way I always did: by putting my hands on the horse, asking the owner a lot of questions and getting a good history. Here's a little more detail about the typical clinical scenario when I prescribe a bisphosphonate for navicular: • Consider breed and discipline. Genetics and conformation predispose horses to navicular, as does a horse's discipline. Western performance horses, especially Quarter Horses, experience higher incidents of navicular, but I see the disease in other event horses as well. • Confirm foot pain. Like I said, I start with the basics of a complete examination and history. • Block and image. I do a nerve block and most of the time take digital radiographs. • Recommend advanced imaging. Because dramatic radiographic changes aren't always present, an MRI or CT can help differentiate any soft tissue injuries that might be in the heel region. Not all clients are economically able to opt for additional imaging. In those cases, I rely on the history and radiographs. • Diagnose and prescribe. If the horse shows some evidence of mild to moderate changes in the navicular bone and presents with an appropriate history, I prescribe and administer Osphos according to the product label. Bisphosphonate: Next-Level NAVICULAR TREATMENT By Steve Colburn, DVM Implementing a bisphosphonate treatment protocol has elevated my practice, our client relationships and, most importantly, the prognosis for our navicular patients. Dr. Steve Colburn is owner and founder of Creekside Veterinary Service, a four-doctor practice in Escondido, CA. Dr. Colburn graduated from the University of California, Davis School of Veterinary Medicine in 1984. His wide range of experience in equine practice includes working with racehorses, broodmares and stallions, gaited show horses, western show horses, rodeo performance horses, dressage and jumping horses, and backyard pleasure horses. Dr. Colburn has a special interest in maintaining horses' peak performance, and his team of associate veterinarians employs their respective expertise in managing orthopedic, dental, and reproductive problems. Dr. Colburn prides himself on offering the latest technologies in a comprehensive, caring, and cost-effective manner. He and the team at Creekside Veterinary Service avidly support equestrian riding and advocacy groups in their local community.

• Cover