Injection of corticosteroids, hyaluronate, and amikacin into the navicular bursa in horses with signs of navicular area pain unresponsive to other treatments: 25 cases (1999-2002).
OBJECTIVE
To determine history, clinical and radiographic abnormalities, and outcome in horses with signs of navicular area pain unresponsive to corrective shoeing and systemic nonsteroidal anti-inflammatory drug administration that were treated with an injection of corticosteroids, sodium hyaluronate, and amikacin into the navicular bursa.


METHODS
Retrospective study.


METHODS
25 horses.


METHODS
Data collected from the medical records included signalment, history, horse use, severity and duration of lameness, shoeing regimen, results of diagnostic anesthesia, radiographic abnormalities, and outcome.


RESULTS
17 horses had bilateral forelimb lameness, 7 had unilateral forelimb lameness, and 1 had unilateral hind limb lameness. Mean duration of lameness was 9.2 months. All horses had been treated with corrective shoeing and nonsteroidal anti-inflammatory drugs for at least 6 months; 18 had previously been treated by injection of corticosteroids and sodium hyaluronate into the distal interphalangeal joint. Fourteen horses had mismatched front feet, and 21 horses had signs of pain in response to application of pressure over the central aspect of the frog. Palmar digital nerve anesthesia resulted in substantial improvement in or resolution of the lameness in all horses. Twenty horses (80%) were sound and returned to intended activities 2 weeks after navicular bursa treatment; mean duration of soundness was 4.6 months. Two horses that received numerous navicular bursa injections had a rupture of the deep digital flexor tendon at the level of the pastern region.


CONCLUSIONS
Results suggest that navicular bursa treatment may provide temporary improvement in horses with signs of chronic navicular area pain that fail to respond to other treatments.
Dabareiner
Robin M
RM
Department of Large Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843, USA.
Carter
G Kent
GK
Honnas
Clifford M
CM
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000583:Amikacin / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002061:Bursa, Synovial; D005260:Female; D005552:Forelimb; D006614:Hindlimb; D006724:Hoof and Claw / Q000002:abnormalities; D006734:Horse Diseases / Q000188:drug therapy*; D006736:Horses; D006820:Hyaluronic Acid / Q000627:therapeutic use; D007270:Injections, Intra-Articular / Q000662:veterinary; D007794:Lameness, Animal / Q000188:drug therapy*; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000662:veterinary*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000583:Amikacin; D006820:Hyaluronic Acid