Bisphosphonates Ban: Keeneland, Fasig-Tipton and Ocala Breeders’ Sales Ban Off-Label Use of Popular Navicular Disease Medication in Young Thoroughbreds

Bisphosphonates are a type of medication used to treat osteoporosis in humans. They have been approved by the US Food and Drug Administration since 2014 for treatment of navicular disease in horses older than four. Research in Europe, conducted by Professor Jean-Marie Denoix and others, has also investigated the possible expanded use of one bisphosphonate, tiludronate (Tildren) for other lameness problems, such as bone spavin and osteoarthritic lesions of the thoracolumbar vertebral column. Professor Denoix also led the initial research on Tildren for navicular disease in older horses.

Beyond Navicular Disease: Racing Commissioners Call for Regulation of Bisphosphonates in Sale Horses

Portions of the following information is edited from a press release:

The Association of Racing Commissioners International (ARCI) is formally calling for the independent regulation of the breeding and sales industries, including regulation of the class of drugs known as bisphosphonates, which are approved by the US Food and Drug Administration (FDA) for the treatment of navicular disease.

Springs in the Bluegrass; Fine-tuning a Thoroughbred Yearling's Hooves 30 Days Before the Sale

A funny thing happened on the way to the airport.

I had a chance to look over the shoulder of Dr Scott Morrison of Rood and Riddle Equine Hospital's Podiatry Clinic, and who would turn that down? The patient was a perfectly healthy yearling colt being prepared for an August sale. But with 30 days left until the sale, the growing colt was showing a slight tendency to be "a bit upright" and some finetuning was in order.

Make no mistake: this colt’s hoof conformation wouldn’t be of much, if any, concern other than the fact that he’d be under the microscope at the sale and every detail has to be considered. Every detail, after all, can make the difference in a bidder's enthusiasm for a horse and where the colt would be ranked on a bidder's wish list. In the end, it comes down to dollars and cents but in the climate of recent yearling sales, it could be the difference between a sale and no sale.

Dr. Morrison’s solution to this horse’s problem was at once right out of the textbook and equally unorthodox in that it might have come out of two different textbooks. He arrived with two spring shoes, which would be on the menu of recommended shoes for a case like this. But the shoes for this horse were made of two different materials.

The solution to working on two front feet with different levels of contraction? 
Spring shoes made of two materials, one more flexible than the other. The aluminum 
shoe also had a hinge in the toe to open the right front more.

On the left front, which had the least amount of deviation, the horse now wears a Burns Polyflex shoe, into which Rood and Riddle added a spring wire, which is a v-shaped wire roughly the size and shape of the frog. The wire, however, does not touch the frog.

Polyflex spring shoe glued on, before cutting the horizontal keeper wire and adding
Equipak to fill the sole. The spring (frog-shaped wire) does not touch the frog.

The Polyflex shoe is made for glueing; it is composed of nearly-transparent polyurethane with a wire spine inside. The shoe was glued on with Equilox  hoof adhesive and then the sole was filled with Vettec’s Equipak, a clear cushioning urethane. Before pouring in the liquid padding, Morrison clipped the temporary horizontal keeper wire to release the spring action of the wire.

The Polyflex shoe did not have a hinge, but the spring action of the wire and the forgiving material of the shoe would help keep the foot open, Morrison believes.

Completed left front foot with polyurethane shoe after Equipak is solidified. Just to clarify: soft urethane-based Equipak fills and cushions the sole and frog; harder PMMA epoxy-type adhesive Equilox glues on the shoe.

On the right front, which was slightly more problematic, Rood and Riddle’s shoe fabrication specialist Manuel Cruz created an aluminum hinged shoe with a spring wire. The hinge was in the center of the toe, as typically described for hinge shoes to relieve club feet and contracted heels in more advanced cases. Equilox, the clipping of the horizontal keeper wire, and Equipak again followed.

Shoe fabrication specialist Manuel Cruz fabricates a vast repertoire 
of shoes and devices for the vets and farriers at Rood and Riddle.

Aluminum hinge shoe fabricated back at Rood and Riddle by Manuel Cruz. 
The spring is the same as in the Polyflex shoe, but the shoe has a 
hinge in the toe to open the foot. 

I asked Manuel about the discrepancy in thickness between the two shoes but he said that it was an illusion and that they were almost the same.

Morrison and McAninch tackled the application of these results-oriented horseshoes to the colt's front feet as if it was routine; with yearling sales season approaching, that may be the case. The organization at the clinic to prepare what's needed for supplies and to fabricate shoess must be impressive when you see how easily the work gets done without searching for things.

The case itself was intriguing but equally interesting was the process, especially the speed and efficiency with which Morrison and his technician Loryn McAninch completed the job. I know from my travels that this would have been a half-day job at most clinics but the feet had been traced and trimmed in advance, the shoes fabricated to the tracings, and the adhesive and support materials were ready to go.

Another good point about the way this case was handled, from an outside observation, was that the young horse had to stand for a minimal amount of time since the measuring, tracing and trimming had already been done. The unorthodox unmatching spring shoes may have been an insurance policy on this horse's value. We'll never know what his feet might have looked like without this intervention but prospective owners will appreciate the picture-perfect feet that they will see on this horse at the sale.

Thanks to Dr Morrison, Loryn, Manuel and the farm staff for allowing me to observe this procedure and photograph it. Good luck to the colt!

To learn more: A valuable detailed reference paper by Dr. Morrison, Foal Foot Care, is available for download from the Proceedings of the 2009 CanWest Veterinary Conference.

All photos © Fran Jurga | Hoofcare Publishing.

Fran Jurga's Hoof Blog at Hoofcare.com
© Fran Jurga and Hoofcare Publishing


Please, no use without permission. You only need to ask. Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.