Caudal Heel Pain or Navicular: What’s the Right Term?

Q. I’ve heard people use the terms “caudal heel pain,” “navicular disease,” and “navicular syndrome” when referring to a horse that has a lameness associated with the navicular bone and its related structures. Do all of these terms describe the same condition?

A. These terms are similar in meaning; however, technically, they are different.

Caudal heel pain is typically used to describe pain from the heel or back of the foot. A horse with caudal heal pain would respond positively to a palmar digital nerve block. The navicular structures are often included, but the horse could also have pain associated with other structures.

Navicular disease is usually used to describe disease that has caused radiographic changes to the navicular bone.

Navicular syndrome is more encompassing to describe lesions associated with the navicular soft-tissue structures and may not have radiographic abnormalities.

Having said this, all three terms are commonly used interchangeably depending on veterinarian preference.

About the Author

Josh Zacharias, DVM, MS, Dipl. ACVS, ACVSMR

Josh Zacharias, DVM, MS, Dipl. ACVS, ACVSMR, is an Iowa State University College of Veterinary Medicine graduate who practices at Countryside Large Animal Veterinary Services in Greeley, Colorado. His interests include equine lameness, surgery, and podiatry. In addition to working as a surgeon and sports medicine specialist, Zacharias is a farrier with nearly 15 years of experience in therapeutic shoeing applications. Much of his caseload includes Western performance horses.

Yes, Your Overweight Horse is at Risk for Laminitis

Yes, Your Overweight Horse is at Risk for Laminitis

Horses with body condition score of 7 or higher, generalized and/or regional adiposity, larger neck circumference, and decreased height (think pony) were at an increased odds of developing laminitis.

Photo: Michelle Coleman, DVM, PhD

Barn circles might banter about the chubby chestnut with the deep gutter down her back, or jest about the round roan who looks like he could foal any day now. But in a landmark observational case-control study in client-owned North American horses, scientists have demonstrated that these animals are more ticking time bombs than laughing matters—they are at risk for developing the painful and sometimes-fatal hoof disease laminitis. The good news is that many of the laminitis risk factors the researchers identified can be detected early and are modifiable.

“As we all know, laminitis is a disease of considerable importance to both horses and horse owners, with estimated incidence of 1.5% to 34% of horses affected annually, and 13% of horse operations,” said Michelle Coleman, DVM, PhD, assistant professor of Large Animal Internal Medicine at Texas A&M’s College of Veterinary Medicine & Biomedical Sciences, in College Station. “The lifetime risk of a horse developing laminitis is estimated at 15%. We all know that there’s a significant clinical and economic impact of this disease, especially in that there is no effective method or cure, and no effective method for prevention of disease.”

Coleman noted that this disease not only affects horses and horse owners but also veterinarians, who identified laminitis as the top priority for research funding in a 2009 American Association of Equine Practitioners (AAEP) survey of its membership. Coleman presented results from the pasture- and endocrinopathy-associated laminitis (PEAL) study at the 2016 AAEP Convention, held Dec. 3-7 in Orlando, Florida. She and her 15 co-authors in the Laminitis Research Working Group launched the research at the 2011 convention. And while she admitted many of the results were unsurprising, they confirm in no uncertain terms what veterinarians have believed for years and stress the importance of managing laminitis-prone horses very carefully.

Most existing research on laminitis has been conducted in experimentally induced laminitis cases. These approaches do predictably produce laminitis in study horses, but they aren’t an accurate representation of how natural disease occurs. Coleman said the group sought to study naturally occurring cases of disease. “Results of these epidemiologic studies are relevant to naturally occurring cases,” she said. “Our goal was to identify risk factors for development of disease.”

The researchers identified that the most common type of laminitis cases seen in private practice was PEAL, so they set out to investigate what AAEP members in North America were seeing in this type of case by recruiting cases via veterinarians and horse owners.

Coleman and colleagues asked veterinarians to report patients’ signalment (age, breed, sex, etc.), clinical signs, activity level, dietary status, and stable management practices in any case of laminitis within four weeks of onset of clinical signs with an Obel laminitis scale grade of 2 or higher. The scientists excluded horses with a history of laminitis due to toxic causes, grain overload, contralateral weight-bearing (such as in supporting-limb laminitis cases), and any other concurrent hoof disease.

Veterinarians in 32 states and three Canadian provinces responded, reflecting an 18% participation rate. The research team found 550 usable responses from submissions from 109 veterinarians. Ultimately, the study group included 199 cases, which Coleman and colleagues matched with 198 healthy controls, and 153 controls showing lameness (non-laminitic horses lame with a Grade of 3 to 5 lameness in one forelimb only). Some of the team’s key findings included:

  • The onset of clinical signs was greater in the spring and summer compared to the fall and winter;
  • Horses exposed to lush pastures were at an increased risk of developing laminitis;
  • Horses that had a recent stabling change or change in diet were at an increased risk of developing laminitis compared to horses with no recent change;
  • Horses with body condition score of 7 or higher (obese), generalized and/or regional adiposity (fat distribution all over or just in certain areas), larger neck circumference, and decreased height (think pony) were at an increased odds of developing laminitis;
  • Thoroughbreds and Warmbloods were at a decreased risk of developing disease and ponies and Minis were at an increased risk of developing disease
  • Horses that had endocrinopathic disease, such as equine metabolic syndrome or pituitary pars intermedia dysfunction (PPID, also known as equine Cushing’s disease) were at an increased risk of developing laminitis; and
  • Horses with recent glucocorticoid administration (such as dexamethasone or prednisolone) were at increased odds of developing disease though Coleman cautioned that researchers need more supportive evidence of this potential (only 6% of horses met this criteria).

Take-Home Message

Coleman scanned the audience, saying, “I see a lot of blank faces thinking, ‘Well, big surprise: Fat horses founder, steroids put horses at risk, endocrinopathic disease puts horses at risk of developing disease.”

However, she explained, this was the first observational study of only acute or incident cases of laminitis supporting a causal relationship of obesity and laminitis.

“Perhaps we need to think about laminitis in another way,” said Coleman. “What makes horses obese? Maybe obesity is a symptom of a much bigger problem. (We need to think) how can we reduce the burden of laminitis by reducing the burden of obesity? And while this distinction may be subtle, the impact may be profound.”

Similarly, she said, we might need to look at endocrinopathic disease in a new way–very few horses in this study had prior diagnosis of endocrinopathic disease, suggesting that laminitis was the first clinical sign these horses developed. If we can identify horses at risk of developing PPID or EMS early, then perhaps we can reduce the risk of laminitis, she added, suggesting dietary management practices for EMS horses, medical management for horses with PPID, and potential novel therapeutic agents.

The veterinary community’s potential for reducing the burden of laminitis also lies in client education and compliance, she said. “Until now, there has been limited evidence to support what we all think is true, that overweight horses founder and endocrinopathic disease results in laminitis. Now, with more supporting evidence I hope we can use this information to educate our clients.”

Still, in a 2010 study Coleman cited, only 1% of owners of geriatric horses perceived geriatric horse weight gain as an important health issue, so she emphasized that practitioners need to educate their owners early—early diagnosis, early intervention in these cases—to potentially reduce the burden of laminitis.

Coleman said this research was funded by the AAEP Foundation, with generous support from Boehringer Ingelheim.

About the Author

Stephanie L. Church, Editor-in-Chief

Stephanie L. Church, Editor-in-Chief, received a B.A. in Journalism and Equestrian Studies from Averett College in Danville, Virginia. A Pony Club and 4-H graduate, her background is in eventing, and she is schooling her recently retired Thoroughbred racehorse, Happy, toward a career in that discipline. She also enjoys traveling, photography, cycling, and cooking in her free time.

Santa Anita Daily Results and Activity

Early Entries

Friday, January 13 Overnight
Race# Race Type Purse
Race 1 Claiming – $20,000 $25,000
Race 2 Claiming – $16,000 $20,000
Race 3 Maiden Claiming – $50,000 $29,000
Race 4 Claiming – $25,000 $23,000
Race 5 Allowance Optional Claiming – $40,000 $56,000
Race 6 Maiden Special Weight $54,000
Race 7 Allowance Optional Claiming – $75,000 $56,000
Race 8 Maiden Claiming – $20,000 $18,000
Saturday, January 14 Overnight
Race# Race Type Purse
Race 1 Allowance Optional Claiming – $40,000 $56,000
Race 2 Starter Allowance – $16,000 $28,000
Race 3 Claiming – $8,000 $16,000
Race 4 Claiming – $12,500 $20,000
Race 5 La Canada S. $200,000
Race 6 Maiden Special Weight $54,000
Race 7 Maiden Special Weight $54,000
Race 8 Claiming – $50,000 $43,000
Race 9 Maiden Claiming – $30,000 $21,000

Final Entries

Thursday, January 12
Race# Race Type Purse
Race 1 Claiming – $16,000 $22,000
Race 2 Starter Allowance – $40,000 $30,000
Race 3 Claiming – $20,000 $25,000
Race 4 Maiden Claiming – $75,000 $33,000
Race 5 Maiden Claiming – $20,000 $18,000
Race 6 Claiming – $12,500 $16,000
Race 7 Claiming – $32,000 $33,000
Race 8 Maiden Claiming – $50,000 $29,000

Turf Paradise Daily Results and Activity


Wednesday, January 11
Race# Race Type Purse
Race 1 Claiming – $3,000 $7,000 Overnight Overnight Overnight
Race 2 Claiming – $5,000 $8,500 Overnight Overnight Overnight
Race 3 Claiming – $3,000 $7,000 Overnight Overnight Overnight
Race 4 Maiden Claiming – $5,000 $6,300 Overnight Overnight Overnight
Race 5 Claiming – $3,500 $7,000 Overnight Overnight Overnight
Race 6 Claiming – $3,500 $7,000 Overnight Overnight Overnight
Race 7 Claiming – $3,500 $7,000 Overnight Overnight Overnight
Race 8 Maiden Claiming – $5,000 $6,300 Overnight Overnight Overnight

Early Entries

Monday, January 16 Overnight
Race# Race Type Purse
Race 1 Maiden Claiming – $5,000 $3,700
Race 2 Stakes $8,000
Race 3 Allowance $15,000
Race 4 Claiming – $8,500 $8,000
Race 5 Allowance $16,000
Race 6 Starter Allowance – $3,500 $8,200
Race 7 Claiming – $20,000 $15,000
Race 8 Claiming – $8,500 $8,500

Final Entries

Sunday, January 15
Race# Race Type Purse
Race 1 Trials $3,000
Race 2 Trials $3,000
Race 3 Maiden Optional Claiming – $30,000 $12,500
Race 4 Claiming – $8,500 $8,500
Race 5 Claiming – $3,200 $7,200
Race 6 Maiden Optional Claiming – $30,000 $12,500
Race 7 Claiming – $6,250 $9,000
Race 8 Claiming – $3,500 $7,000


16-Apr BRIGHOUSE BELLE 3+ F&M 6.5F $50,000
30-Apr BC CUP DOGWOOD 3F 6.5F $50,000
30-Apr BC CUP STELLAR JAY 3 6.5F $50,000
6-May VANCOUVER SUN 3+ F&M 6.5F $50,000
7-May GEORGE ROYAL 3+ 6.5F $50,000
22-May JIM COLEMAN PROVINCE 3 6.5F $50,000
22-May ROSS MCLEOD 3F 6.5F $50,000
3-Jun STRAWBERRY MORN 3+ F&M 8.5F $50,000
4-Jun JOHN LONGDEN 6000 3+ 8.5F $50,000
24-Jun RIVER ROCK CASINO 3 6.5F $50,000
25-Jun EMERALD DOWNS 3F 6.5F $50,000
1-Jul LT. GOVERNOR 3+ 8.5F $75,000
2-Jul MONASHEE 3+ F&M 8.5F $75,000
15-Jul SUPERNATURAL 3F 8.5F $50,000
16-Jul CHRIS LOSETH 3 8.5F $50,000
16-Jul SPAGHETTI MOUSE 2 6F $50,000
7-Aug PCB CLASSIC 3+ 9F $75,000
7-Aug PCB DISTAFF 3+ F&M 8.5F $75,000
7-Aug NEW WESTMINSTER 2 6.5F $50,000
7-Aug HARD ROCK CASINO 2F 6.5F $50,000
7-Aug SIR WINSTON CHURCHILL 3 8.5F $50,000
7-Aug HONG KONG JOCKEY CLUB 3F 8.5F $50,000
7-Aug BC CUP MARATHON 3+ 9F $20,000
21-Aug CTHS SALES STAKE 2 C&G 6.5F $50,000
21-Aug CTHS SALES STAKE 2F 6.5F $50,000
25-Aug CTHS SALES STAKE 3 & 4 YR OLDS 3&4 8.5F $50,000
25-Aug CTHS SALES STAKE 3 & 4 YR OLDS 3&4F 8.5F $50,000
9-Sep BC DERBY G3 3 9F $150,000
9-Sep BC OAKS 3F 9F $100,000
9-Sep S W RANDALL PLATE 9F $75,000
9-Sep DELTA COLLEEN 9F $75,000
9-Sep JACK DIAMOND FUTURITY 2 C&G 6.5F $100,000
30-Sep FANTASY 2F 8.5F $100,000
1-Oct ASCOT GRADUATION 2 8.5F $100,000
8-Oct BALLERINA G3 3+ F&M 9F $100,000
9-Oct BC PREMIERS G3 3+ 11F $100,000
22-Oct BC CUP DISTAFF 3+ F&M 9F $50,000
22-Oct BC CUP CLASSIC 3+ 9F $50,000
22-Oct BC CUP NURSERY 2 6.5F $50,000
22-Oct BC CUP DEBUTANTE 2F 6.5F $50,000

Local Trainers and Horses out of Town

Sandi Gann
January 14Turf Paradise
Dear Lilly Race 2 Allowance Optional Claiming $20,000
Steve Henson
January 11 – Turf Paradise
Get Aboard Race 6 Claiming $3,500

January 10 – Turf Paradise
Gold Treasure finished 5th beaten 9 1/2 lengths Race 7 View Chart    
Cindy Krasner
January 11 – Turf Paradise
Scarpetta Veloce Race 5 Claiming $3,500
Crystalngold Race 5 Claiming $3,500
January 14 – Turf Paradise
Bixley Race 3 Claiming $3,000
Ronda Rocks Race 4 Glendale H.
Tizagogo Race 5 Allowance


Mario Gutierrez
January 13Santa Anita
Lady Tapit Wgt-122 Race 5 Allowance Optional Claiming $40,000
Mind Reader Wgt-122 Race 6 Maiden Special Weight
Sandy’s Surprise Wgt-122 Race 7 Allowance Optional Claiming $75,000
Mario Gutierrez
January 13Santa Anita
Lady Tapit Wgt-122 Race 5 Allowance Optional Claiming $40,000
Mind Reader Wgt-122 Race 6 Maiden Special Weight
Sandy’s Surprise Wgt-122 Race 7 Allowance Optional Claiming $75,000


LEXINGTON, KY (Jan. 10, 2017) – Oussama Aboughazale’s International Equities Holding led buyers at the Keeneland January Horses of All Ages Sale for the second consecutive day on Tuesday by spending $1,080,000 for four horses, including $575,000 for session-topper Joyfully, in foal to 2015 Triple Crown winner American Pharoah.

Joyfully, a 5-year-old daughter of Mineshaft out of the Forestry mare Rejoicing, is a half-sister to Grade 3 winners Divine Oath and Auntie Joy and from the family of Grade 1 winners Miner’s Mark, Traditionally and My Flag. Her third dam is Racing Hall of Famer Personal Ensign.

Aboughazale, who races under Sumaya Stables, said both Joyfully and Delightful Joy, his $700,000 purchase on Monday, would be bred to leading sire War Front.

“(Joyfully) is lovely and (her) foal sold very well just before her. I think it’s a good buy, I hope,” said Aboughazale, who purchased seven horses for $1,171,000 on Monday. “I just bought my farm here (in Bourbon County, Kentucky), and we have to stock it up with nice mares. We want to start well; that’s why we are buying nice mares. There will be a few more (mares to buy) today and that’s it. I think we are very satisfied and have bought very well. We want to breed to sell and breed to race.”

Joyfully was the fourth horse to sell Tuesday. The horse preceding her in the ring was her first foal, a yearling colt by Uncle Mo, sold to Key Palm Stable for $370,000.

Joyfully and her yearling colt both were consigned by Paramount Sales, agent, the session’s leading consignor, who sold 38 horses for $1,732,400. Paramount’s Pat Costello was pleased with the results from the pair.

“It was on the upper side (of what I expected); it was a great price for both mare and foal,” Costello said. “They were two lovely horses. (The Uncle Mo colt is) a beautiful, big-walking horse and so he deserved to bring that money. He was a good colt and the mare was absolutely beautiful. When they produce that kind of foal, you know they are a good mare. I think that particular package was a beautiful package and it probably stood out in the sale.”

On Tuesday, Keeneland sold 221 horses for $11,059,600 for an average of $50,043 and a median of $25,000. The gross declined 15.06 percent from the corresponding session last year when 193 horses sold for $13,020,400. The average was down 25.82 percent from $67,463 in 2016, and the median was 28.57 percent lower than $35,000 last year.

“Today’s session started off exceptionally well,” Keeneland Director of Sales Operations Geoffrey Russell said. “Mixed sales are hard to compare year-to-year and even session-to-session. There was a better buzz today. Again, anything with perceived quality sold really well.

“Yearlings sold exceptionally well both to end-users and pinhookers. We look forward to seeing some of them back here in (the) September (Yearling Sale),” he said. “And it is good to see the number of breeders investing in mares for their newly retired stallions.”

Cumulatively, 384 horses have sold for $21,573,600, down 19.05 percent from $26,651,600 for 375 horses sold last year. The average of $56,181 is 20.95 percent lower than $71,071 in 2016, and the median of $30,000 is 14.29 percent below $35,000 last year.

Springhouse Farm paid $460,000, the day’s second-highest price, for Chocolate Pop, dam of Grade 2 winner Airoforce, in foal to Bernardini. Four Stars Sales, agent, consigned Chocolate Pop, an 11-year-old daughter of Cuvee out of the With Approval mare White Chocolate. She is from the family of Grade 1 winner Sea Cadet and Grade 2 winner On Target.

“It was a fair price,” Four Stars Managing Partner Kerry Cauthen said. “Everybody should be happy with that. She is the kind that you could (make money) with her first foal (for her new owner). She is very attractive and to have that kind of production with her first foal (Airoforce), she is the right kind.”

At $385,000, the session’s top-priced yearling was a son of Uncle Mo sold to Ellen M. Charles’ Hillwood Stable of Maryland. Warrendale Sales, agent, consigned the colt, who is out of the Salt Lake mare Gone to Utah and is a half-brother to stakes winner Away We Go. He is from the family of Grade 1 winner Ogygian.

“He’s just a really beautiful colt,” said Charles, accompanied by her trainer, Rodney Jenkins. “Rodney Jenkins trains for me and trained (Gone to Utah and Away We Go), so I know all of the family. I’ve wanted an Uncle Mo and he seemed like the right one, so we’ll see.

“We don’t usually (come to the January Sale), but this colt was here so we thought we’d come to see him. We came to buy something and there he was, and we got him.”

Warrendale owner Kitty Taylor said the colt “is from a small breeder (Carolyn Beverly) who had only one horse to sell this year. I said, ‘Let’s come here instead of (Keeneland) September when there are a ton of horses.’ I am really glad to do this for someone like that.”

Hillwood bought three weanlings Tuesday, including a colt by Flatter for $220,000. Consigned by Mulholland Springs, agent, he is out of the El Corredor mare Dulce Periculum, a half-sister to Grade 2 winner Indian Firewater.

Hunter Valley Farm paid $280,000 to acquire the session’s highest-priced yearling filly, a daughter of Shanghai Bobby consigned by Mulholland Springs, agent. The filly is out of the Giant’s Causeway mare Saravati and is a half-sister to Japanese Group 3 winner Mask Zoro. Saravati is a half-sister to multiple Grade 1 winner You.

“She was by far the best (yearling) offered today,” Hunter Valley co-owner Fergus Galvin said. “The sire (Shanghai Bobby) we are huge fans of; we think he is going to be one of the top freshman sires for this year. I’d say she will be re-offered, we are not sure yet. At that sort of (price), it’s a bit more than you would like, but she’s just the real deal. Quality is shining through. Anything that especially looks like her is going to be at the top end of the market, and you have to be prepared to pay for it.”

“She is almost black, has a beautiful head and walk,” Martha Jane Mulholland of Mullholland Springs said. “Her body is so mature that she looks like she will be a grand yearling. She had it all. We knew she would sell well. A lot of people were very interested in her.”

Not This Time/A. F. S. paid $270,000 for Dream Your Dreams, a 4-year-old daughter of Tapit cataloged as a racing and broodmare prospect, and $235,000 for the stakes-winning Street Boss mare On the Backstreets, in foal to Into Mischief.

Lane’s End, agent, consigned Dream Your Dreams, a daughter of the Gone West mare Takesmybreathaway who is a half-sister to Grade 1 winner Frost Giant. Mulholland Springs, agent, consigned On the Backstreets, who is out of the Mutakddim mare Mutakaway, by Mutakddim.

Mulholland and partners purchased On the Backstreets for $65,000 at Keeneland’s 2015 November Breeding Stock Sale.

“Every year we try to buy good prospects either off the track or at the sales and breed them to hot sires,” she said. “That is where we make a lot of our income.”

Tizsomthingspecial, a 4-year-old daughter of Tiznow cataloged as a racing or broodmare prospect, sold for $240,000 to Mayday B. Branham. Gainesway, agent, consigned the filly, a half-sister to Grade 3 winner Bitumen and stakes winner Meshell. Her dam, the Tale of the Cat mare Kobla Kat, is a half-sister to Grade 1 winner and sire Quality Road.

Nancy From Nairobi (GB), winner of the 2016 Royal Heroine (G2) at Santa Anita, sold for $210,000 to BBA Ireland. Cataloged as a racing or broodmare prospect, the 6-year-old daughter of Sixties Icon (GB) is out of the Hawk Wing mare Madame Hoi. She was consigned by Lane’s End, agent.

“She is going to Japan,” Michael Donohoe of BBA Ireland said about Nancy From Nairobi, who last raced in the Matriarch (G1) on Dec. 4 at Del Mar. “She is going to ship out as soon as possible to Japan. There is obvious interest in the pedigree. It is quite good (and has) a Japanese horse (Group 3 winner Sweet Salsa). (Nancy From Nairobi) is a graded stakes winner, a very good-looking filly. She fit the program in Japan.”

Also bringing $210,000 was the stakes-winning Yes It’s True mare Yes She’s a Lady, in foal to Hard Spun. Richard Hogan, agent, purchased the 11-year-old mare, who is from the family of Grade 1 winner Pure Clan and Grade 2 winner Greater Good. She was consigned by Brookdale Sales, agent.

The January Sale continues through Friday. Sessions begin daily at 10 a.m. ET. The entire sale is streamed live at