Bilateral Navicular Disease

Patient History/PE:​

  • 5-year-old QH mare with bilateral forelimb lameness.​

  • Previous diagnoses: navicular syndrome and left front navicular bone cyst.​

  • Coffin joint injections (steroid and arthramid) no longer effective.​

  • Responds to anti-inflammatories but not currently on any.​

Exam findings:​

  • 3/5 LF lame.​

  • Positive to distal limb flexions of bilateral forelimbs.​

  • PD nerve block on LF switched lameness to 1/5 RF.​

  • Abaxial block on LF resulted in 2-3/5 RF lameness.​

​Diagnosis:​

  • Bilateral podotrochlear apparatus abnormalities:​

  • Moderate to marked navicular bone changes (greater on LF).​

  • LF deep digital flexor tendinopathy with dorsal border tears near navicular bursa.​

  • Mild bilateral deep digital flexor and impar enthesopathy.​

  • Mild bilateral distal interphalangeal joint effusion.​

  • Subtle subchondral contour defect in RF distal P2.​

  • Minimal bilateral fetlock osteoarthritis.​

Treatment/Outcome: Owner elected to discuss retirement options for the mare.​

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