Heredity of navicular disease

Summary

Bone structure, nutrient canals, form and definition, and a total evaluation of both fore navicular bones were radiologically evaluated in 169 three‐ and four‐year‐old Dutch warmblood mares divided into eleven daughter (half sister) groups. On the basis of the ‘total evaluation’, differences between the three‐and four‐year‐old horses were detectable. Using the ‘total evaluation’, significant differences were found between daughter groups consisting of three‐year‐oldmares. These differences support the theory that podotrochleosis may be (partly) due to the presence of genetic factors. The possibilities concerning selection are presented. The results of the radiological evaluation of the stallion do not have predictive value as far as his progeny is concerned.     

Heredity of navicular disease

Bone structure, nutrient canals, form and definition, and a total evaluation of both fore navicular bones were radiologically evaluated in 169 three- and four-year-old Dutch warmblood mares divided into eleven daughter (half sister) groups. On the basis of the 'total evaluation', differences between the three- and four-year-old horses were detectable. Using the 'total evaluation', significant differences were found between daughter groups consisting of three-year-old mares. These differences support the theory that podotrochleosis may be (partly) due to the presence of genetic factors. The possibilities concerning selection are presented. The results of the radiological evaluation of the stallion do not have predictive value as far as his progeny is concerned.     

Current concepts of navicular disease

Navicular disease is unlikely to be a single disease. The close anatomical and functional relationships between the navicular bone, collateral sesamoidean ligament, distal sesamoidean impar ligament, deep digital flexor tendon, navicular bursa and distal interphalangeal joint result in the frequent occurrence of combinations of injuries. There are a number of different pathological processes that affect the navicular bone, which probably have different aetiopathogeneses. While there is strong evidence that biomechanical forces may result in failure of functional adaptation and excessive modelling, it is likely that each disease or injury type has a multifactorial cause.     

A fresh look at white line disease

White line disease occurs secondary to a hoof wall separation. Clinical signs may vary from not being lame to severe lameness with rotation of the distal phalanx depending on the extent of the disease affecting the inner hoof wall. The author has found that removal of the hoof wall overlying the diseased area combined with the appropriate farriery is the most important aspect of therapy.     

The arterial supply of the navicular bone in adult horses with navicular disease

A macroscopical, arteriographical and histological study was made of the arterial supply of the navicular bones of horses with clinical and/or radiographic signs of navicular disease. Based on the clinical and radiological findings the navicular bones of 40 Warmblood horses are divided into four different groups. In the pattern of the arteriogram obvious changes are noticed: an imbalance and a distal to proximal shift between the distal and proximal arterial supply occur, indicating a reduction of the distal blood supply with a compensatory reaction of the proximal, medial and lateral supply. The changes in the pattern of the arteriogram are histologically defined by arterio(lo) sclerosis and newly formed arteries. The presence of radiologically visible nutrient foramina is associated with a changed pattern in the arteriogram, increased bone remodelling and fibrosis. Ischaemia and increased pressure (hypertension and/or increased intra-articular pressure) are considered to be responsible for changes in form and number of radiologically visible nutrient foramina.     

Biochemical characterisation of navicular hyaline cartilage,navicular fibrocartilage and the deep digital flexor tendon in horses with navicular disease

The study hypothesis was that navicular disease is a process analogous to degenerative joint disease, which leads to changes in navicular fibrocartilage and in deep digital flexor tendon (DDFT) matrix composition and that the process extends to the adjacent distal interphalangeal joint. The objectives were to compare the biochemical composition of the navicular articular and palmar cartilages from 18 horses with navicular disease with 49 horses with no history of front limb lameness, and to compare navicular fibrocartilage with medial meniscus of the stifle and collateral cartilage of the hoof. Cartilage oligomeric matrix protein (COMP), deoxyribonucleic acid (DNA), total glycosaminoglycan (GAG), metalloproteinases MMP-2 and MMP-9 and water content in tissues were measured. Hyaline cartilage had the highest content of COMP and COMP content in hyaline cartilage and tendon was higher in lame horses than in sound horses (p<0.05). The concentration of MMP-2 amount in hyaline cartilage was higher in lame horses than in sound horses. The MMP-2 amounts were significantly higher in tendons compared to other tissue types. Overall, 79% of the lame horses with lesions had MMP-9 in their tendons and the amount was higher than in sound horses (p<0.05). In horses with navicular disease there were matrix changes in navicular hyaline and fibrocartilage as well as the DDFT with potential implications for the pathogenesis and management of the condition.     

Locomotor characteristics of horses with navicular disease

OBJECTIVE: To determine whether force-plate evaluation of horses with navicular disease would reveal an abnormal gait that persists despite loss of sensation to the palmar foot region, which may predispose such horses to navicular disease. ANIMALS: 17 clinically normal Thoroughbreds and 8 Thoroughbreds with navicular disease. PROCEDURE: Data on ground reaction forces were obtained in trotting horses, using a force plate. Force-time curve variables for clinically normal horses were derived from 4 points at the beginning and 4 points at the end of the vertical and craniocaudal horizontal plots. Principal component analysis was undertaken separately on beginning-of-stride and end-of-stride data, and the first 2 components were represented graphically. Rotation matrices were applied to equivalent data for horses with navicular disease before and after disruption of sensation by administration of a palmar digital nerve blockade. RESULTS: Prior to nerve block, horses with navicular disease differed significantly from normal horses for beginning-of-stance phase and end-of-stance phase variables. After nerve block, horses with navicular disease maintained the same significant differences from clinically normal horses only for variables at the beginning-of-stance phase. CONCLUSIONS AND CLINICAL RELEVANCE: Horses with navicular disease have abnormal limb-loading force patterns that are not altered by loss of sensation in the palmar region. These abnormal patterns were detected in a horse without navicular disease. Some horses are predisposed to navicular disease as a result of an inherent abnormal gait pattern. Analysis of gait patterns could be used for detection and appropriate management of horses susceptible to development of navicular disease.     

Role of navicular bone shape in the pathogenesis of navicular disease: a radiological study

From progeny lists of 30 Dutch Warmblood sires, 586 3-year-old females by these stallions were randomly selected, each progeny group aimed at 20 animals for statistical reasons. The front feet of the sires and female progeny were examined radiographically using lateromedial and dorsopalmar upright pedal projections. The radiological features associated with navicular disease were classified 0–4 using a standardised classification, grades 3 and 4 representing the more severe changes. The shape of the proximal articular border of the navicular bone outlined on the dorsopalmar view was classified 1–4: l=concave; 2=undulating; 3=straight; 4=convex. A significant shape-grade association was found, the highest grades 3 and 4 incidence associated with shape 1 and the lowest grades 3 and 4 incidence demonstrated by shape 4. In shapes 1 and 2, navicular bones grades 3 and 4 features were mainly characterised by inverted flask-shaped channels. In shape 3, navicular bones grades 3 and 4 were dominated by enthesiophytes. These findings indicate an apparent shape predisposition to radiological changes associated with navicular disease. The shape of the navicular bone in the offspring was on average the same as the sire, indicating an hereditary element in navicular bone shape.     

Effects of warfarin on blood rheology in navicular disease

A preliminary investigation has been undertaken of blood rheology in horses and ponies, its variation in navicular disease and the changes following treatment with warfarin. Erythrocyte flexibility, measured by a centrifuge packing technique, is higher in horses (30 per cent min-1) than in ponies (23.8 per cent min-1). There are corresponding differences in blood viscosity. The high erythrocyte flexibility in horses is caused by an unknown factor present in plasma. The erythrocyte flexibility in horses with navicular disease is even higher, at 38.5 per cent min-1. Treatment with warfarin reduces the flexibility to just below the normal value. A significant fall in plasma viscosity and erythrocyte flexibility was found after treatment of four ponies with 6 mg warfarin daily for one week.     

Relationships of age and shape of the navicular bone to the development of navicular disease: a radiological study

Estimating the shape of the proximal articular border of the navicular bone and grading the radiological navicular bone condition (grades 3 and 4 representing the most severe changes), the aim of this study was to assess potential age-related implications of the previously reported shape predisposition to navicular disease in 746 normal and 174 clinically affected Dutch Warmbloods age 3-19 years. A significant, age-independent, shape-grade association found in normal and affected horses emphasises the fundamental character of the shape predisposition to navicular disease. A significant age-related increase of the least susceptible shape prevalence was found in elderly normal horses. A shape-independent low grades 3 and 4 prevalence (mean 15%) was found in normal horses, vs. a high grades 3 and 4 prevalence (mean 85%) in the affected horses. Therefore, the clinical manifestation of the disease is grade-rather than shape-dependent. A significant age-related appearance of inverted flask-shaped channels and enthesophytes was found in the clinically affected horses. However, considering the significant shape-radiological features association previously reported in 3-year-old normal horses, this association may be shape- rather than age-dependent.     

Shoeing principles for the management of navicular disease in horses

Navicular disease was diagnosed in 36 horses. Each horse was treated, using shoeing as the only major means of treatment. Phenylbutazone was used initially for 10 days after shoeing. Shoeing was designed to correct preexisting problems, enhance physiologic function of the foot, and ease breakover of the foot. The horses were evaluated over a period ranging from 12 to 54 months. The lameness improved in all horses. Thirty-one of the 36 horses treated were not lame when last evaluated. Shoeing was most effective when performed within 8 months of the first signs of lameness. Also, horses used for show ring performance classes had a better response to treatment than did horses used for gaming or jumping.     

The force and contact stress on the navicular bone during trot locomotion in sound horses and horses with navicular disease

Mechanical overload due to poor conformation or shoeing has been suggested to contribute to the development of navicular disease. While studies have determined the compressive force exerted on the navicular bone in normal horses, this has not been reported for horses with navicular disease. Also, the force has not been converted to stress by correction for contact area. In this study we developed a technique for the determination of the contact area between the deep digital flexor tendon and the navicular bone in vivo, and used a forceplate system to determine the force and stress on the bone at trot in 6 normal and eight diseased horses. The mean +/- s.d. peak force and peak stress were 5.62+/-1.45 N/kg and 2.74+/-0.76 MPa for the normal group and 6.97+/-1.50 N/kg and 3.07+/-0.55 MPa for the navicular disease group. The peak force and peak stress were similar for both groups but the force and stress in the horses with navicular disease were approximately double control group values early in the stance phase. This was due to a higher force in the deep digital flexor tendon, which was attributed to a contraction of the deep digital flexor muscle in early stance in an attempt to unload the heels.