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Navicular disease, a common cause of heel pain in horses, can be extremely challenging to manage because the underlying problem is often difficult to identify. In fact, “navicular disease” is frequently used as a catch-all phrase describing any horse with pain and lameness stemming from the caudal (back) aspect of the hooves. Bisphosphonate drugs were approved by the Food and Drug Administration (FDA) for navicular disease, giving hope to many horse owners.

“Bisphosphonate drugs, including tiludronate and clodronate, reportedly improve lameness in horses with navicular disease. Both drugs purportedly decrease bone resorption, while clodronate also has pain-relieving effects, according to the studies used to achieve FDA approval,” explained Laura Petroski, B.V.M.S., staff veterinarian for Kentucky Equine Research.

A recent study revealed that neither tiludronate nor clodronate appeared to impact bone remodeling in young horses treated with these medications for 60 days. These findings prompted the researchers to conclude that they were “unsure if clinical improvement in lameness is due to effects on bone remodeling or the analgesic effect of clodronate or other effects secondary to bisphosphonate administration in the horse. More studies are warranted to further explore these negative findings, including the investigation of clinically diseased horses.”

“It should also be noted that the use of bisphosphonates is still highly debated and should not be used in young horses. Tiludronate, for example, is licensed for use in navicular disease in horses that are at least four years old. Bisphosphonates are not recommended for use in any other disease process, and the long-term risks of using this class of drug remain unknown,” emphasized Petroski.

While horsemen continue to discuss the use of bisphosphonate, owners should also consider other tools for maintaining comfort in horses with navicular disease. This includes nonsteroidal anti-inflammatory drugs, rest, physical therapy, and nutritional supplements that support bone health.

Kentucky Equine Research offers two unique supplements designed for optimal bone health. First, Triacton supports bone health and bone density in addition to protecting the gastrointestinal tract from gastric ulceration and hindgut acidosis,” Petroski explained. “Another product, DuraPlex, provides protein, minerals, and vitamins required for bone growth as well as minimizing bone resorption for horses at rest.”

As with any medical condition, be certain to have your horse examined by a veterinarian to rule out other causes of lameness, caudal heel pain, or neurological conditions that can present as lameness.

*Richbourg, H.A., C.F. Mitchell, A.N. Gillett, et al. 2018. Tiludronate and clodronate do not affect bone structure or remodeling kinetics over a 60 day randomized trial. BMC Veterinary Research 14(1):105.

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