Navicular Syndrome - What's the current thinking?
Species
Equine
Contact Hours
3 Hours - RACE Accredited
Language
English
Discipline
Anaesthesia & Pain Management
Diagnostic Imaging
Orthopaedics
Sports Medicine
Toxicology & Pharmacology
Veterinary Partner
Equine
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Recorded: 30th July 2024
Panelists:
Simon Curtis FWCF, BSc (hons), PhD, HonAssocRCVS - Consultant, UK
Meghann Lustgarten DVM, DACVR, DACVR-EDI, DACVSMR - Consultant, USA
Tim Ober DVM - John R. Steele & Associates, USA
Moderator:
Michael Schramme DVM, CertEO, PhD, DECVS, DACVS, DECVSMR, Associate LA-ECVDI - VetArgo Sup, France
PANEL DISCUSSION DESCRIPTION
Navicular syndrome (or palmar foot pain) remains the most common cause of performance-limiting lameness in many equestrian disciplines. Instead of routinely diagnosing ‘navicular disease’, we now know that different osseous and soft tissue injuries may result in a set of associated symptoms that we have collectively named ‘navicular syndrome’. The different sub-categories of this syndrome, however, may present with slightly different clinical characteristics and generally require very different treatment approaches. It is true that improved diagnostic abilities have not always been met by progress in treatment success. The discussion will review the current thinking regarding the limitations of the clinical examination, the role of advanced imaging and the best choice of treatment strategies for the successful management of a sports horse with navicular syndrome.
Controversial Discussion Points:
- Specific Clinical Tests: can hoof tester application, toe and heel elevation tests, flexion tests and circling help in the differentiation of foot pain?
- Intrasynovial Diagnostic Anesthesia: can it help in the differentiation of foot pain?
- Advanced vs. Conventional Imaging: a critical appraisal of different imaging modalities
- Critical review of the latest shoeing and rehabilitation strategies
- Physical Therapies: keeping an affected horse performing
- Evidence for the use of shockwave, LASER, TECAR, or other physical therapy techniques?
- Local and Systemic Medicinal Therapies: can they be helpful in managing a performance horse with navicular syndrome?
- Surgical Interventions: the role of navicular bursoscopy and osteostixis in the management of navicular syndrome?
Simon Curtis is a farrier, author, lecturer and horse hoof-care expert with a PhD in Equine Physiology and Biomechanics (2017). He is a 4th generation farrier; his family have been farriers and blacksmiths in the Newmarket area for at least 150 years. In over 45 years working as a farrier, he has lectured and demonstrated in more than 30 countries including the USA, Australia, India, Russia, and Brazil.
Simon is internationally renowned in the hoof-care world for his remedial farriery textbooks and lectures. He has authored several books on farriery and has been published in numerous journals. Among other roles, Simon is a Past Master of the Worshipful Company of Farriers, was made a member of the International Horseshoeing Hall of Fame in 2005, and is the only farrier to have been awarded an Honorary Associateship of the Royal College of Veterinary Surgeons (2002).
He was awarded the Sir Colin Spedding Award in 2018, presented by HRH Princess Anne to an exceptional hero of the equestrian world. Other honours include entry to the International Horseshoeing Hall of Fame at the Kentucky Derby Museum (2005).
More InfoDr. Meghann Lustgarten earned her bachelor’s degree from the University of Nebraska at Omaha in 2004 and graduated from Kansas State University College of Veterinary Medicine in 2008. She then completed a one-year orthopedic/ambulatory internship at Ocala Equine Hospital, followed by a one-year diagnostic-imaging internship at Gulf Coast Veterinary Specialists. She was accepted to and successfully completed a three-year residency program in veterinary diagnostic imaging at North Carolina State University College of Veterinary Medicine. She earned board certification from the American College of Veterinary Radiologists (ACVR) in 2013. During her time in the university, she authored and co-authored several publications regarding equine musculoskeletal imaging. Dr. Meghann Lustgarten is one of few veterinary radiologists with a special interest in equine imaging. Given her strong interest in equine performance, she went on to earn additional board certification from the American College of Veterinary Sports Medicine and Rehabilitation (ACVSMR) in 2018. Dr. Lustgarten enjoys volunteering her time and expertise at the North Carolina Zoo, and to the examination committees of the ACVR-Equine Diagnostic Imaging subspecialty and the ACVSMR.
More InfoDr. Tim Ober earned his veterinary degree from Tufts University in 1990 and completed a one-year internship at New Jersey Equine Clinic with Dr Scott Palmer, before staying on an additional three years focusing on Standardbred racetrack practice. He joined Dr Dan Flynn in Charlottesville, VA in 1994 and made the change to sport horse practice. He has practiced with John R Steele & Associates since 2001 and served as the US showjumping team veterinarian from 1999 until 2022. Tim’s practice is focused on the disciplines of jumping, dressage, and eventing, and is based in Gordonsville, Virginia and Wellington, Florida. He served on the FEI Commission for Clean Sport and the first FEI List Group in 2009, and is the Charter President of International Sport Horse Veterinarian’s Association.
More InfoMichael Schramme qualified as a veterinarian from the University of Gent, Belgium, in 1985. He has since worked as a resident, lecturer, senior lecturer or associate professor in equine surgery at the University of Ghent, the Royal Veterinary College (London), the Animal Health Trust (Newmarket), Cornell University (New York) and North Carolina State University (USA). In 2011, Dr. Schramme was appointed Professor in Equine Surgery and Orthopaedics at the Ecole Nationale Vétérinaire de Lyon, VetAgro Sup in France. He holds the Certificate in Equine Orthopaedics, the Diploma of the European College of Veterinary Surgeons, the Diploma of the American College of Veterinary Surgeons, the Diploma of the European College of Veterinary Sports Medicine and Rehabilitation and Associate Diplomate status of the European College of Veterinary Diagnostic Imaging. He has a PhD in equine rheumatology. Dr. Schramme is President of the European College of Veterinary Surgeons and ex-President of the European Society of Veterinary Orthopaedics and Traumatology. He has an interest in all aspects of large animal surgery, lameness and diagnostic imaging with special emphasis on MRI and regenerative medicine.
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