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Neurectomy/De-nerving/Osphos
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The1CowgirlsEnvy
Reg. Aug 2011
Posted 2016-06-06 2:40 PM (#7274674)
Subject: Neurectomy/De-nerving/Osphos



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I have a wicked little 2D mare, 10 years old that was just off a bit, not limping or painful but something just didn't feel right. Rads show navicular. Scale of 1 to 10, 10 being the worse, vet says she's a 7. Career over.

This is my "heart horse" and after reading some info online have seen some people had very good outcomes and even NFR horses that were de-nerved. I'm curious to hear from someone who hasn't had a good outcome from doing the procedure.

I'm realize that this is a morally and ethically charged topic and I'm not trying to start a debate. I'm trying to be logical and weigh the pros and cons.

From what I have been able to find, it appears that there is several type of ways to do this. If you have had it done, what procedure did you have done. What was the recovery time? Did a local vet do it or did you go to a surgeon?

Has anyone tried the new Osphos? I'm trying to be rational about my options. Shes bred out the wazoo, won me a small fortune, and I want to do right by her. I was planning on running her the next 5 years and then retiring her at 15 to be a broodie. I'm just really overwhelmed and not sure what I can or should do for her.


Edited by The1CowgirlsEnvy 2016-06-06 2:48 PM
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FLITASTIC
Reg. Jun 2012
Posted 2016-06-06 3:21 PM (#7274690 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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The1CowgirlsEnvy - 2016-06-06 12:40 PM

I have a wicked little 2D mare, 10 years old that was just off a bit, not limping or painful but something just didn't feel right. Rads show navicular. Scale of 1 to 10, 10 being the worse, vet says she's a 7. Career over.

This is my "heart horse" and after reading some info online have seen some people had very good outcomes and even NFR horses that were de-nerved. I'm curious to hear from someone who hasn't had a good outcome from doing the procedure.

I'm realize that this is a morally and ethically charged topic and I'm not trying to start a debate. I'm trying to be logical and weigh the pros and cons.

From what I have been able to find, it appears that there is several type of ways to do this. If you have had it done, what procedure did you have done. What was the recovery time? Did a local vet do it or did you go to a surgeon?

Has anyone tried the new Osphos? I'm trying to be rational about my options. Shes bred out the wazoo, won me a small fortune, and I want to do right by her. I was planning on running her the next 5 years and then retiring her at 15 to be a broodie. I'm just really overwhelmed and not sure what I can or should do for her.

Lots of reading on here about Osphos. I use it and it has worked wonders for the horses that needed it. I would start there first before denerving.
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MPoloncic
Reg. Mar 2013
Posted 2016-06-06 3:29 PM (#7274693 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos


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I had a nice nice rodeo horse diagnosed with "navicular". I did extensive research and talked to several people including 6 vets, equine nutritionists, and natural hoof care advocates. It ended up not evening being navicular, but just chronic heel bulb pain; nothing concerning the joint(s) at all. He is sound sound sound, barefoot and running consistent 17.0-17.2s on a standard pattern.

I understand that news can be devastating, especially with a horse with so much talent. I advise that you do your research and talk to as many vets and experts as you can! Especially with the uncertainty surrounding navicular to begin with, it's imperative to find out the actual source of pain.

On the topic of Osphos, I believe it to be great stuff and have seen significant improvement in a horse of mine that was inject with it. Seems like something you may want to try before de-nerving one.

Edited by MPoloncic 2016-06-06 3:31 PM
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RunNitroRun
Reg. Oct 2011
Posted 2016-06-06 3:31 PM (#7274696 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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I personally haven't used it but a Vet we use is thrilled with Osphos and the results he's witnessed. He said a client of his has a horse that was 4/5 on lameness scale who is now competing again after being treated with Osphos.

If it was me I'd try the Osphos first and if that doesn't work consider the neurectomy.
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barrelchasinmonki
Reg. Oct 2003
Posted 2016-06-07 4:56 AM (#7274797 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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 Go to a Good facility. I would try osphos or Tildren first. Tildren is very expensive unless you can get it done as a regional limb profusion...yes it does work this way and is about a tenth the cost. Had a gelding that was crippled to the point of being put down and in less than a week he was 80 percent better.   I have a really nice 1d/2d mare that I ended up having nerved, she did great and went back to winning. What you have to remember is though you can only nerve once maybe twice then a lot of times that's it you can't do it anymore and if they get sore again they are done. They can also become sore to the neuromas that form. I would exhaust every other option first and foremost I'd get a extremely good farrier under her. My farrier has saved me a lot as far as my horses health goes
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cj jet
Reg. Apr 2009
Posted 2016-06-07 8:59 AM (#7274847 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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I did neurectomy on my gelding but only after a MRI and all other avenues were exhausted (injections, shockwave, tildren, etc). Navicular is often misdiagnosed so I would get 2nd opinion and make sure you have a very good farrier.
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Whiteboy
Reg. Jul 2012
Posted 2016-06-07 10:00 AM (#7274871 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos


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I had one denerved and didn't have any problems.  This was before the days of osphos and Tildren were available.  I would try them first, if they didn't work, then I'd denerve.   
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Bear
Reg. Dec 2007
Posted 2016-06-07 10:44 AM (#7274892 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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I'm willing to bet that a ton of navicular horses have been "cured" with a good balanced trim. That might be the best, cheapest thing to try first, followed by the meds like Tildren and de-nerving by a good vet surgeon with a good reputation.
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Herbie
Reg. Oct 2003
Posted 2016-06-07 11:46 AM (#7274922 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos


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As Bear said, find someone who can do a good, balanced, barefoot trim and get the foot pulled up under the horse first and foremost.  I totally agree with him in that this alone will go a very long way in getting your horse comfortable.  Problem is, there are very few farriers who can and do trim this way effectively.  Before I nerved a horse or used Osphos or other similar medications, I would get with Dr. Schell at Nouvelle Research and start her on either the EQ Pure or the EQ Total Support along with the EQ Nourish.  The boney change and arthritis cannot be reversed, however further change can be slowed down through inflammation management, and therefore also greatly reducing pain.  I would give Dr. Schell and the Cur-OST products 60 days before I would use Osphos or explore a neurectomy.   

My concern with the medications such as Osphos is that it affects the ability of the bone to remodel in the long term.  Bones are constantly changing and building, so by affecting the ability of the bone to remodel, we are therefore increasing the risk of fracture.  So whilethe medication is effective in managing pain short term, the long term effects could have a big impact on the bone integrity.  That's just not a risk i'm willing to take with my own safety considering what I ask my horse to do physically in competition.  This article will explain more about the risks of Osphos and similar medications and the reason they aren't prescribed as much as they used to be in human medicine. 
https://www.grayson-jockeyclub.org/resources/bones.pdf

Edited by Herbie 2016-06-07 11:49 AM
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ccarpe18
Reg. Jun 2014
Posted 2016-06-07 11:55 AM (#7274933 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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There's a great group on FB (if you have FB) that is all about natural/barefoot trimming. They are amazing & helped me a TON. I understand parts of the hoof now that most farriers don't even seem to know about. I trim & or touch up my horses myself now & I've seen much better results. It's called ABC Hoof Care-natural hooves. Just fair warning, they really DON'T like the idea of shoes lol.

I also agree with others stating navilcular is misdiagnosed most of the time.


 
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casualdust07
Reg. Mar 2005
Posted 2016-06-07 12:08 PM (#7274937 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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If you have the rads and can send them I would love to see them. Sometimes based on the rads you can guide your treatment one way or the other. Meaning, if she looks like she has a lot of flexor cortical erosion, she is not a good candidate for a neurectomy because there's a high coincidence of DDFT involvement when they also show the erosion on the bone there.

The pros for the neurectomy are- they temporarily don't feel pain in the heel region. Temporary meaning, you will have to redo it at some point because the nerves do grow back. You may get a few years of benefit from it.

The cons are: it does not stop the disease from progressing, and they lose sensation to a lot of their foot so it would be unwise to turn her out in a pasture for days-weeks at a time where you aren't there to check her feet daily. Abscesses can go unnoticed because they don't feel them, as well as puncture wounds into the coffin joint, and you can end up having to euthanize because of something like that, not the navicular.

As far as bisphosphonates, it is worth a try. I would definitely try them over a neurectomy at this point.

First things first- I would be shoeing her differently, injecting the coffin joints, trying bisphosphonates (but don't do them at the same time as injections because some vets believe the steroids damper the effects of the Osphos or tildren, so get your money's worth and do that first then go back for joint injections later). See how long you can go that way before you have to nerve her. How long have you been having issues with her soundness?
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casualdust07
Reg. Mar 2005
Posted 2016-06-07 12:12 PM (#7274939 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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Navicular is a pain to diagnose because there's so many structures that can be causing pain. In fact, the trend is to call it "caudal heel syndrome" as an umbrella that covers all the many potential causes of it. The other trend now is if there's signs of navicular disease in the bone itself, to describe that as navicular bone degeneration. Horses can have soft tissue damage in that area in the hoof and they will block out and hoof test like they are navicular.. A horse like that would benefit from time off and rehab like its a soft tissue injury.. a horse with actual boney change is one you would be more inclined to medically manage with IA steroids and oral NSAIDs..

MRI has been very good for horses with lameness that block to an abaxial or PD because they can visualize everything in the foot and give you a better idea of exactly what structure is involved. But, it's anywhere from 1000-2000 to get it done, and it doesn't fix anything, just shows you exactly what's wrong. Then you have to decide what to do on top of that.
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Bear
Reg. Dec 2007
Posted 2016-06-07 12:26 PM (#7274953 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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I'd say listen to casualdust07. Very sensible advice. I hope you never change, Lauren. You're going to me a hell of a good vet!
Bottom line for me is to remind myself that "navicular" is a wastebasket diagnosis that is all too often thrown at horses with sore feet and "lollipops" in the cortex of the navicular bone.
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casualdust07
Reg. Mar 2005
Posted 2016-06-07 12:40 PM (#7274970 - in reply to #7274953)
Subject: RE: Neurectomy/De-nerving/Osphos



You get what you give


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Bear - 2016-06-07 12:26 PM

I'd say listen to casualdust07. Very sensible advice. I hope you never change, Lauren. You're going to me a hell of a good vet!
Bottom line for me is to remind myself that "navicular" is a wastebasket diagnosis that is all too often thrown at horses with sore feet and "lollipops" in the cortex of the navicular bone.

Thanks :)

Almost there!
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The1CowgirlsEnvy
Reg. Aug 2011
Posted 2016-06-07 3:02 PM (#7275022 - in reply to #7274937)
Subject: RE: Neurectomy/De-nerving/Osphos



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Thank you Casualdust, this is the info I'm really looking for. She was examined, blocked, and radio-graphed at MU Equine Hospital. She has not only the top farrier in Missouri under her but one of the top farriers in Kentucky when she is at home. This isn't just some run of the mill backyard barrel horse lol I'd sell everything I own to make sure she has the best care possible so if this means hauling her to Texas or California for a surgery I just need to know where to go.

As far as her lameness, she has never been lame, even now she is running and bucking in her paddock. I did not notice anything until this weekend. She wasn't limping but something in my mind just said, she isn't right. She wasn't working this past weekend like she always had in her 7 years with me. She is the most rock solid mare and has the biggest work ethic, she never complains, and this weekend she thought about running up the wall on second which she has never in her life done and that's when I knew there was something seriously wrong.

I have sent her rads to a few other lameness vets to see what they think, and honestly the more opinions I get the better. So sorry this is a bit of a picture overload. I am a breeder by profession so I can read an ultrasound no problem but I am really really lost when it comes to looks at rads. I have worried she would not be a candidate for a neurectomy due to issues with the DDFT but I'm not trained enough to see really what is going on in these pics.

The vet was shocked that she is not lame and that she was also running and placed in the 2D against big name races with 300+ runners. Guess that's why my world is pretty shattered right now because I've owned this mare since she was 3.

What I would like to do long term is be able to run her another 5 years and then retire her to the broodmare band.
In your professional opinion what do you think my odds might me to accomplish that?

She doesn't currently have shoes because she pulled one this weekend and so I went ahead and just pulled the other, but normally she is shod with aluminum and shockwave pads. Not because she's ever been sore but they were free and I figure if they help her with as much time as we spend down the road why not. They certainly weren't hurting her.

Edited by The1CowgirlsEnvy 2016-06-07 3:15 PM




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casualdust07
Reg. Mar 2005
Posted 2016-06-07 3:21 PM (#7275033 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



You get what you give


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the skyline of her left front foot looks worse than the right front, but the right front skyline looks like theres motion artifact in the picture, as well as the lateral. also she's got a lot of dirt still on her foot that muddies up her pictures (not that it matters but its a pet peeve; we pack ours with play dough to prevent that)

So, she has navicular changes. Is she lame today? How lame is she? And, how long has she been lame? what have you tried so far?

The skyline view of her left front is concerning because that's the area I was talking about, the flexor cortical erosion. But you can't make a judgement call on just one thing. Honestly, if you are wanting to eventually put her in your broodmare band I would be even less inclined to do a neurectomy, if she's going to be turned out on pasture.
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The1CowgirlsEnvy
Reg. Aug 2011
Posted 2016-06-08 8:22 AM (#7275182 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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I bought her as a 3 year old, when I did the trainer told me she had thin soles and would get sore if she was barefoot. I took that as true and have kept shoes on her ever since. On the occasion that she lost or pulled one she would walk very tenderly around. Other than that she has never had an abscess or taken a lame step in the 7 years I've had her. The only reason I thought there was something wrong was because at the last race she just was not striding out like she always has and was kind of taking a choppy stride, but she still did her job.

That night she pulled a shoe so I went ahead and pulled the other. (She only wears fronts) She was a 3 outta 5 lame that next day on the front left. Vet blocked her and she suddenly became a 3 outta 5 lame on the right. Blocked that and she was sound so we took rads. She is running and bucking out in the field, when she's brought into the dry lot at night she's got a definite head bob trotting. She is not pointing any of her feet while standing.

Farrier is coming out today to put 3 degree wedge, egg bar shoe, and equipak.


Edited by The1CowgirlsEnvy 2016-06-08 8:24 AM
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Macy922
Reg. Jun 2015
Posted 2019-03-08 11:58 AM (#7424551 - in reply to #7274922)
Subject: RE: Neurectomy/De-nerving/Osphos


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The bone fracture only applies to nitrogenous bisphosphonates, not non-nitrogenous like Tildren or Osphos. Nitrogenous ones are 10,000x more potent than nitrogenous and used  in human medicine for severe osteperoisis 

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Liana D
Reg. Sep 2008
Posted 2019-03-08 4:32 PM (#7424585 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos


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The1CowgirlsEnvy - 2016-06-06 2:40 PM I have a wicked little 2D mare, 10 years old that was just off a bit, not limping or painful but something just didn't feel right. Rads show navicular. Scale of 1 to 10, 10 being the worse, vet says she's a 7. Career over. This is my "heart horse" and after reading some info online have seen some people had very good outcomes and even NFR horses that were de-nerved. I'm curious to hear from someone who hasn't had a good outcome from doing the procedure. I'm realize that this is a morally and ethically charged topic and I'm not trying to start a debate. I'm trying to be logical and weigh the pros and cons. From what I have been able to find, it appears that there is several type of ways to do this. If you have had it done, what procedure did you have done. What was the recovery time? Did a local vet do it or did you go to a surgeon? Has anyone tried the new Osphos? I'm trying to be rational about my options. Shes bred out the wazoo, won me a small fortune, and I want to do right by her. I was planning on running her the next 5 years and then retiring her at 15 to be a broodie. I'm just really overwhelmed and not sure what I can or should do for her.


So if she’s not lame why are we talking about nerving ?

Hoof testers will tell you more than X-rays. If she was sore across the heel and frog I it would most likely be Navicular syndrome.   I wouldn’t consider Osphos or nerving until you had a definite diagnosis. Looks like she could benefit from a good, balanced shoe job, probably a wide web shoe, like a PLR  and a coffin joint injection. Even though I’ve ridden a lot of nerves horses, I would try Osphos first if the above suggestions didn’t help, possibly an MRI before you do anything invasive. 

 

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Keepkick'n
Reg. Nov 2007
Posted 2019-03-10 11:18 AM (#7424632 - in reply to #7274674)
Subject: RE: Neurectomy/De-nerving/Osphos



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Just want to share this video about OsPhos. 

https://m.facebook.com/story.php?story_fbid=10204674142051307&id=1768536670

I hope this attaches.  If not, Google OsPhos and Rood & Riddle.  Very informative.  

 

 

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