Navicular Disease in Horses
- What is Navicular Disease in Horses?
- Supplements to Support Hoof Health and Circulation
- Diagnosing Navicular Disease
- Managing a Horse with Navicular
By: Dr. Lydia Gray | Updated March 11, 2025 by SmartPak Equine
What is Navicular Disease in Horses?
Navicular disease in horses generally refers to progressive degeneration of the navicular bone. This small bone in the hoof, also known as the distal sesamoid bone, is located behind the coffin bone or third phalanx.
Navicular syndrome is used to describe any condition causing pain in the area of a horse's navicular bone or the heel area, including the navicular bursa, deep digital flexor tendon, coffin joint, or any ligaments.
Video on Navicular Disease by Farrier Danvers Child
In this video, Danvers Child, CJF shows you the anatomy of the hoof and navicular bone, explains signs of navicular disease, and talks about how issues involving this area can affect soundness and overall health.
DANVERS CHILD: Hi, I'm Danvers. I'm the Hoof Health Consultant for SmartPak. And today we're going to talk about Navicular concerns.
The navicular bone is also known as the distal sesimoid bone, and it's nestled at the back side of the short pastern and the coffin bone. It's slung to form a false joint by the deep digital flexor tendon, that would be similar to our Achilles Tendon. It functions in the same way as the proximal sesimoid. So you have the distal sesimoid and the proximal sesimoid, and they both create false joints that allow for hyperflexion and attend to issues of hyperflexion.
As our diagnostic procedures have improved, our ability to understand that this is not a condition, but a myriad of conditions, has improved greatly. They would be a history of lameness, an intermittent lameness, a horse that when you block one leg and he goes sound on it but he goes lame on the opposing limb, lameness on tight circles, lameness on hard surfaces, and, of course, radiographic evidence. So, it's that preponderance or collection of concerns that comes up with the navicular syndrome issue.
Veterinary diagnostics have done wonders for our ability to address navicular concerns. So now you don't see so many references to navicular disease. In fact, we don't even see as many people talking about navicular syndrome. We talk about heel pain, caudal pain, and then we start isolating to very specific locations and looking at the issues in a more specific manner.
In terms of trimming and shoeing, the traditional approach has been to protect this area. You can see from the bottom, the navicular bone, and putting a bar across that bone to protect from concussion is a traditional approach. Using a heart bar shoe to not apply pressure, but apply protection to that area has been an approach. And of course, using pour-in pads and other materials to provide cushion and support in the caudal aspect of the hoof is a traditional approach.
Many of our approaches have involved wedging the foot and increasing the angle of the hoof. Dr. Bowker's recent research says that we need to re-examine that. Potentially, actually, go the other direction. So it's a wide open arena for further study and more involved research.
I think the most important thing you can do is to encourage good vascularity and circulation. Getting a good blood supply to this digit is never easy, but it's a key thing, and one of the best ways we can do that is to encourage activity. Don't let the horse stand idle, don't let him be static. Let him be dynamic, let him move and stimulate blood flow. In addition to that activity, we can encourage that with a good supplement. So a good supplement that supports vascularity is also a key element.
Issues related to the navicular bone, navicular disease, navicular syndrome, caudal heel issues are very complex. This is just the beginning. You'll definitely want to involve your health care professionals in any further discussions.
Stay with us at SmartPak for more issues related to hoof care.
Supplements to Support Hoof Health and Circulation
Prescription joint products such as Legend® and Adequan® are often administered to horses with navicular, and it may also be helpful to provide an oral joint supplement with similar active ingredients (i.e. glucosamine, chondroitin sulfate and hyaluronic acid).
Because a normal response to inflammation is key to keeping a horse comfortable and managing stressed tissues, ingredients such as MSM, omega 3 fatty acids, and herbs such as boswellia, turmeric, and yucca may be beneficial.
Agents that support proper blood flow (like arginine, niacinamide, and gingko biloba) may also be of use.
Prescription Medications Available
If a specific structure within the hoof can be identified as diseased or injured, anti-inflammatories such as corticosteroids or Hyaluronic Acid (Legend®) may be injected directly into the area. Prescription non-steroidal anti-inflammatories (NSAIDS) such as bute (phenylbutazone) and Banamine® (flunixin meglumine) are commonly used to relieve pain.
The human drug isoxsuprine, a vasodilator which increases blood flow, is often prescribed because one theory suggests the disease is caused by lack of blood flow to the bone.
Diagnosing Navicular Disease
It is usually not difficult to localize lameness in the horse’s heel with an examination by a veterinarian that includes applying a hoof tester, flexing the lower limb, standing the horse on wedges, and blocking local nerves.
However, determining exactly what structure within the hoof is causing the pain can be a challenge. X-rays have always been the basis of a navicular diagnosis, but methods such as x-rays with contrast dye, ultrasound, bone scan (nuclear scintigraphy) and especially MRI appear to be better at identifying which specific structures are involved.
Managing a Horse with Navicular
Corrective shoeing is a large component of the overall treatment plan for horses with navicular. Mild exercise to encourage vascularity and circulation is preferred over stall rest.
Extracorporeal shock wave therapy and desmotomy (cutting) of local ligaments are being explored as treatments. Cutting the nerves to the foot (palmar digital neurectomy) remains a last resort.
Video on Dealing with Navicular Issues
Dr. Gray answers a horse owner question on strategies for managing a horse with navicular syndrome, ingredients in supplements that may lend support, and specific diagnostics your veterinarian may use.
Questions to Ask Your Veterinarian
- Why did my horse develop navicular?
- How much longer will I be able to compete him?
- If he has the neurectomy, will he still be able to feel his foot and be safe to ride?