Posterior Digital Neurectomy & Equine Navicular

Equine Posterior Digital Neurectomy

The surgical option in treating navicular in horses is Posterior Digital Neurectomy

If your vet or farrier recommends surgery then Digital Neurectomy may be the only option for your horse especially if it has long-standing navicular syndrome and other alternatives have not alleviated your horses pain.

A small piece of the two nerves that penetrate the navicular area is cut below the fetlock. This numbs the entire foot.

Problems resulting from this surgery involve stumbling as your horse will lose sensation in the foot and won’t know where it has been placed.

Most equine health problems involve the horses hoof or foot and your horse will lack sensation in its foot following posterior digital neurectomy.

Horses that have undergone neurectomy should be closely monitored for hoof and leg problems.

Sometimes, the severed nerve may grow back, but it can be cut as many times as necessary to keep the horse pain-free.

A new surgical treatment that involves cutting the navicular suspensory ligament may result in long-term improvement for some horses.

For horses with advanced long-term navicular syndrome, retirement may be the only option. This should include daily turnout to ensure regular blood flow is maintained and to promote healthy hoof growth.

The following is an extract from, ‘A Farrier’s Point of View’ © J. Scott Simpson

An Alternative to Pain …

If vet and farrier techniques have not proven successful within one year from constant toe pointing, serious consideration should be given to humanely alleviating the pain.

Farrier procedures are obviously not doing the job and Posterior digital neurectomy seems to be the only answer at this time other than constant medication.

I am not qualified to scientifically discuss the long-term effects of the drugs currently in use. I do know that some of them are not good for the horse as a steady diet, especially in the quantities needed for relief from the pain these animals suffer. I will believe in Warfarin and Isoxsuprine therapy the first time I see them reverse a chronic case of heel lameness.

Drastic Treatment …
Neurectomy is a drastic treatment usually reserved for long-term cases of navicular disease.

In this day and age, we should rationally be able to talk about neurectomy as an alternative to unrelenting distress for chronic heel lameness.

Logical, honest assessment of the problem should reveal that when everything else has failed, beginning the cycle all over again isn’t going to give the horse any relief.

What does the animal really deserve? To be killed? To be jacked around for another couple of years? Or a chance to extend its service in what we humans call "a better quality of life".

Are The Complications In PDN Frequent? …

There are few proponents of Posterior Digital Neurectomy. Most farriers and vets have succumbed to the horror story syndrome associated with it.

Most can quote from a long list of bad things they have heard can happen to the nerved horse. Many freely admit that they haven’t actually seen most of these things themselves.

The chance of painful neuroma formation is the most frequently cited excuse for not doing the procedure.

It is the most logical one in terms of actuality. This is the one thing that seems to determine the longevity factor of a successful neurectomy. Although the condition can occur, how much worse off is the horse for having experienced some period of respite from constant pain?

A very prominent equine practitioner told me that fewer than 5% of his patients returned because of neuromas. Given a factor of another 5% going elsewhere for treatment, another 5% that got lost in the shuffle, and another 5% that were put down when the condition occurred, the odds still look pretty favorable to me.There also remains the option of operating again on the horse that may develop neuromas.

Loss of the hoof wall and rupture of the deep flexor tendon are weak arguments against the procedure. None of the dozens of horse doctors I have interviewed have seen hoof loss and only one a rupture of the DFT, and that was at the insertion into P3. (His own rope Horse.)

Nail punctures and heel abscesses are possibilities which may occur, but they often go unnoticed in non-nerved horses. Every horseshoer has removed nails which the owners did not know were in their horse’s feet. Ask the horse whether to take the chance of dealing with these remote problems. I think you could surmise the answer if you yourself suffered chronic heel pain.

Degeneration of the articular cartilages in the joints of the lower limb has been observed in young neurectomized horses. I don’t feel competent to address this issue other than to think that very young animals are not good candidates for the procedure.