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An Effective Shoe for Navicular Disease
AN EFFECTIVE SHOE FOR NAVICULAR DISEASE
q'~ ,,.,.i[ Lore Robert M. Miller, DVM
Navicular disease is one of the most enigmatic and frustrating entities in horse practice. During the mid-eighties, I was attending a symposium on Navicular Disease at a veterinary meeting in Tennessee when a colleague sitting next to me sketched the shoe illustrated in Figures 1 and 2, and asked me if I had ever tried such a shoe. It looked to me as if the shoe was simply a rolled-toe shoe fitted with elongated caulks to raise the heel and I asked what the advantage would be over ordinary heel caulks, or a tapered shoe with the heels swelled, or an ordinary shoe with a wedge pad under it. He replied that he could not explain why, but that he had consistent success with the shoe. I am grateful to that unknown colleague. During the following year, I used the shoe as a last resort on patients who had failed to respond to conventional therapy (corrective shoeing and systemic medication). All diagnoses, of course, were made based upon clinical history, physical examination, radiographic confirmation, and diagnostic nerve blocking. To my surprise, all patients responded favorably, to a greater or lesser degree. Starting in 1986, I made the shoe my first therapeutic option. In a practice where several diagnoses of navicular disease per month were made, I continued to see consistently favor-
Volume 14, Number 6, 1994
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Figures 1. and 2. A factory "keg" shoe can be used to make the navicular shoe. Cut off the branches of a shoe of proper size, at an angle as shown above, and discard the toe of the shoe. The cut is made just anterior to the last nail hole. The cut-off branches are then welded to the bottom of an identical "keg" shoe, superimposing the last nail holes.
Figure3, Before the described navicular shoe became commercially available, we made this modification from the original design. The shoewas handmade and the heel "caulks", instead of being welded on as in the original factory made "keg" shoe, where turned under and forged. able responses to this shoe. One of the patients was a mare I owned, and my farrier (K. C. Angell, 4940 Huasna Townsite, Arroyo Grande, CA 93420) soon began making the shoes, forging them from bar stock, instead of weld-
Figure 4. G.E. Forge's current egg-bar "Tennessee" navicular shoe. This is what my mare has been wearing for the past year. ing them from factory-made shoes. (Fig. 3) Eventually we tried using an eggbar shoe with welded-on elongated heel caulks, and found that this was also effective, especially in those c a s e s where significant heel contraction had occurred. Ultimately, my farrier, together with a metallurgical company, (G.E.
295
Figure 5 , I found these similar shoes in a display of corrective shoes at the School of Veterinary Medicine at the University of Bern, Switzerland,
Forge & Tool, 959 Highland Way, Grover Beach, CA 93433) developed the egg-bar model for commercial use. The G.E. Forge shoe comes in only one heel height.(Fig. 4)
Two weeks prior to his untimely death, AAEP president Dan Evans telephoned me to say that he had been using the shoe ever since I had published a description of it in a lay horse magazine (The Tennessee Navicular Shoe, Western Horseman, June 1989, pp. 96-98). Dr. Evans said that every patient he had prescribed the shoe for had responded favorably, some slightly, and others dramatically. One of my former associates, Dr. Richard Stevens, of Conejo Valley Veterinary Clinic, Thousand Oaks, California, recently told me that all confirmed cases of navicular disease had, in his experience, responded favorably to this shoe. His opinion has been echoed by my long-time former partner, Dr. Larry Dresher, also of Conejo Valley Veterinary Clinic. Shortly after my article in Western Horseman was published, I received a
letter from a reader who resides in Switzerland. She told me that she had shown the article to her farrier, who told her that a similar shoe had been used in Switzerland for navieular disease for at least two centuries. In 1990, I lectured at the University of Bern in Switzerland and asked the faculty at the veterinary school about the shoe. Although it was not the shoe they were prescribing at that time for navicular disease, I did find a similar shoe in a display of modern and antique corrective horse-shoes at the school (Fig. 5). Why this shoe is so effective is a matter for conjecture, but since the anterior (cranial) edge of the caulk is placed under the navicular bone, I assume that the breakover occurring at the point (plus the slight additional breakover afforded by the rolled toe), must reduce the strain upon the na-
Photo by Debbie Miller
Figure 6. The author on one of his own Quarter Horse mares. This mare, aged 15 years at the time of this writing, was diagnosed with navicular disease 8 1/2 years ago. The only treatment of any kind that she has had has been corrective shoeing with various versions of the described shoe. Although she is not sound, she can be ridden and, as shown here, is used in the training of her own foals. The shoe has apparently greatly retarded the usual progress of the disease.
296
Figure 7. This is 17-year-old Thoroughbred gelding "Pepper" owned by Sasha Richardson of Woodland Hills, California. Wearing G.E. Forge & Tools "Tennessee" Navicular Shoe, he is able to perform in Dressage. The shoe was prescribed for his navicular disease by Dr. Richard Stevens of Thousand Oaks, California.
JOURNAL OF EQUINE VETERINARY SCIENCE
own experience in practice, plus the experience of the esteemed colleagues I have named, I decided to publish this report in a professional journal. Navicular disease is such an insidious problem, and the prognosis so traditionally dismal, if this shoe can slow the progress of the disease and postpone the ultimate demise of the patient, it is well worth trying. Below is my mare "Holly" who has been wearing the shoe for almost nine years and is doing great in them. This is the G. E. Forge shoe, but for most of the nine years, we have been hand-making the shoes. No more!
Figure 8. This is Joann Wiiliamson's Paint "Country Banditt." The G.E. "Tennessee" Navicular Shoe has been very successful in relieving his navicular disease symptoms. The horse presently is being shown and is winning. vicular apparatus and actually assume some of its function in the progression of the horse. When I was practicing, I only prescribed the shoe for palliative measures. I warned my clients that the shoe had an unnatural contact surface with the ground, and that I, therefore, did not recommend it for riding purposes,
except, perhaps, for slow work as in the case of my own mare. It has been reported to me, however, some patients with confirmed navicular disease are performing competitively. (Figs. 7, 8) That the shoe is radical in appearance is obvious to me. In my experience, some farriers have refused to use the shoe. However, based upon my
Figure 10. (below) The G. E. Forge factory-made egg bar "Tennessee" Navicular Shoe as designed by me and farrier, K.C. Angell
Figure 11. (above) Fitting the shoe.
Figure 9. (above) Old shoes pulled (at 6 weeks) and feet trimmed.
Volume 14, Number 6, 1994
297
Figure 12, Shaping the shoe Figure13. (right) Shaped and ready to fit. Incidently, I receive no royalties or financial rewards of any kind from G. E. Forge. My motivation in publishing this information is in helping the navicular horse.
Figure 14. Newly shod, front view.
298
Figure 15.
Rear view.
Figure 16. (below) Side view - looks awkward, but they work. Great reduction in lameness; great improvement in stride and movement at all gaits; no stumbling or loss of agility.
JOURNAL OF EQUINE VETERINARY SCIENCE
q'~ ,,.,.i[ Lore Robert M. Miller, DVM
Navicular disease is one of the most enigmatic and frustrating entities in horse practice. During the mid-eighties, I was attending a symposium on Navicular Disease at a veterinary meeting in Tennessee when a colleague sitting next to me sketched the shoe illustrated in Figures 1 and 2, and asked me if I had ever tried such a shoe. It looked to me as if the shoe was simply a rolled-toe shoe fitted with elongated caulks to raise the heel and I asked what the advantage would be over ordinary heel caulks, or a tapered shoe with the heels swelled, or an ordinary shoe with a wedge pad under it. He replied that he could not explain why, but that he had consistent success with the shoe. I am grateful to that unknown colleague. During the following year, I used the shoe as a last resort on patients who had failed to respond to conventional therapy (corrective shoeing and systemic medication). All diagnoses, of course, were made based upon clinical history, physical examination, radiographic confirmation, and diagnostic nerve blocking. To my surprise, all patients responded favorably, to a greater or lesser degree. Starting in 1986, I made the shoe my first therapeutic option. In a practice where several diagnoses of navicular disease per month were made, I continued to see consistently favor-
Volume 14, Number 6, 1994
J~"
hi
J
,,
O~k,v=~ ~ \
t
!, ;'
• / J
Figures 1. and 2. A factory "keg" shoe can be used to make the navicular shoe. Cut off the branches of a shoe of proper size, at an angle as shown above, and discard the toe of the shoe. The cut is made just anterior to the last nail hole. The cut-off branches are then welded to the bottom of an identical "keg" shoe, superimposing the last nail holes.
Figure3, Before the described navicular shoe became commercially available, we made this modification from the original design. The shoewas handmade and the heel "caulks", instead of being welded on as in the original factory made "keg" shoe, where turned under and forged. able responses to this shoe. One of the patients was a mare I owned, and my farrier (K. C. Angell, 4940 Huasna Townsite, Arroyo Grande, CA 93420) soon began making the shoes, forging them from bar stock, instead of weld-
Figure 4. G.E. Forge's current egg-bar "Tennessee" navicular shoe. This is what my mare has been wearing for the past year. ing them from factory-made shoes. (Fig. 3) Eventually we tried using an eggbar shoe with welded-on elongated heel caulks, and found that this was also effective, especially in those c a s e s where significant heel contraction had occurred. Ultimately, my farrier, together with a metallurgical company, (G.E.
295
Figure 5 , I found these similar shoes in a display of corrective shoes at the School of Veterinary Medicine at the University of Bern, Switzerland,
Forge & Tool, 959 Highland Way, Grover Beach, CA 93433) developed the egg-bar model for commercial use. The G.E. Forge shoe comes in only one heel height.(Fig. 4)
Two weeks prior to his untimely death, AAEP president Dan Evans telephoned me to say that he had been using the shoe ever since I had published a description of it in a lay horse magazine (The Tennessee Navicular Shoe, Western Horseman, June 1989, pp. 96-98). Dr. Evans said that every patient he had prescribed the shoe for had responded favorably, some slightly, and others dramatically. One of my former associates, Dr. Richard Stevens, of Conejo Valley Veterinary Clinic, Thousand Oaks, California, recently told me that all confirmed cases of navicular disease had, in his experience, responded favorably to this shoe. His opinion has been echoed by my long-time former partner, Dr. Larry Dresher, also of Conejo Valley Veterinary Clinic. Shortly after my article in Western Horseman was published, I received a
letter from a reader who resides in Switzerland. She told me that she had shown the article to her farrier, who told her that a similar shoe had been used in Switzerland for navieular disease for at least two centuries. In 1990, I lectured at the University of Bern in Switzerland and asked the faculty at the veterinary school about the shoe. Although it was not the shoe they were prescribing at that time for navicular disease, I did find a similar shoe in a display of modern and antique corrective horse-shoes at the school (Fig. 5). Why this shoe is so effective is a matter for conjecture, but since the anterior (cranial) edge of the caulk is placed under the navicular bone, I assume that the breakover occurring at the point (plus the slight additional breakover afforded by the rolled toe), must reduce the strain upon the na-
Photo by Debbie Miller
Figure 6. The author on one of his own Quarter Horse mares. This mare, aged 15 years at the time of this writing, was diagnosed with navicular disease 8 1/2 years ago. The only treatment of any kind that she has had has been corrective shoeing with various versions of the described shoe. Although she is not sound, she can be ridden and, as shown here, is used in the training of her own foals. The shoe has apparently greatly retarded the usual progress of the disease.
296
Figure 7. This is 17-year-old Thoroughbred gelding "Pepper" owned by Sasha Richardson of Woodland Hills, California. Wearing G.E. Forge & Tools "Tennessee" Navicular Shoe, he is able to perform in Dressage. The shoe was prescribed for his navicular disease by Dr. Richard Stevens of Thousand Oaks, California.
JOURNAL OF EQUINE VETERINARY SCIENCE
own experience in practice, plus the experience of the esteemed colleagues I have named, I decided to publish this report in a professional journal. Navicular disease is such an insidious problem, and the prognosis so traditionally dismal, if this shoe can slow the progress of the disease and postpone the ultimate demise of the patient, it is well worth trying. Below is my mare "Holly" who has been wearing the shoe for almost nine years and is doing great in them. This is the G. E. Forge shoe, but for most of the nine years, we have been hand-making the shoes. No more!
Figure 8. This is Joann Wiiliamson's Paint "Country Banditt." The G.E. "Tennessee" Navicular Shoe has been very successful in relieving his navicular disease symptoms. The horse presently is being shown and is winning. vicular apparatus and actually assume some of its function in the progression of the horse. When I was practicing, I only prescribed the shoe for palliative measures. I warned my clients that the shoe had an unnatural contact surface with the ground, and that I, therefore, did not recommend it for riding purposes,
except, perhaps, for slow work as in the case of my own mare. It has been reported to me, however, some patients with confirmed navicular disease are performing competitively. (Figs. 7, 8) That the shoe is radical in appearance is obvious to me. In my experience, some farriers have refused to use the shoe. However, based upon my
Figure 10. (below) The G. E. Forge factory-made egg bar "Tennessee" Navicular Shoe as designed by me and farrier, K.C. Angell
Figure 11. (above) Fitting the shoe.
Figure 9. (above) Old shoes pulled (at 6 weeks) and feet trimmed.
Volume 14, Number 6, 1994
297
Figure 12, Shaping the shoe Figure13. (right) Shaped and ready to fit. Incidently, I receive no royalties or financial rewards of any kind from G. E. Forge. My motivation in publishing this information is in helping the navicular horse.
Figure 14. Newly shod, front view.
298
Figure 15.
Rear view.
Figure 16. (below) Side view - looks awkward, but they work. Great reduction in lameness; great improvement in stride and movement at all gaits; no stumbling or loss of agility.
JOURNAL OF EQUINE VETERINARY SCIENCE