🐴 Using Bisphosphonates to Treat Navicular Disease in Horses: 2025 Vet Guidance 💉🦴

By Dr Duncan Houston BVSc

Navicular disease—or what we now call heel pain syndrome—is a common cause of chronic front limb lameness in performance horses. From western disciplines to sport horses, navicular pain can limit performance and quality of life. In 2025, new tools like bisphosphonates, particularly Osphos, are offering hope where traditional treatments fall short. 🧠🐎

🧠 What Is Navicular Disease?

Navicular disease is more accurately termed “heel pain” because it may involve:

• 🦴 The navicular bone itself
• 🧵 Surrounding soft tissues like ligaments and the navicular bursa

It typically results in short, choppy strides, reluctance to work on hard ground, and front limb lameness that can shift between legs. 🐾

📋 Diagnosing Heel Pain

Proper diagnosis requires a full veterinary workup, including:

• 💉 Nerve blocks to isolate the pain to the heel
• 📸 Radiographs to evaluate navicular bone changes
• 🧲 MRI if soft tissue damage is suspected

Dr Duncan Houston emphasizes ruling out other causes of lameness before beginning bisphosphonate therapy. 🔍

💊 What Are Bisphosphonates?

Bisphosphonates are a class of drugs that inhibit bone resorption by inactivating osteoclasts—the cells that break down bone. In navicular syndrome, bone loss and inflammation can lead to pain. 🧬

By slowing bone breakdown, these drugs help preserve structure and reduce discomfort. 📉

✅ Osphos (Clodronate Disodium)

• 💉 Administered via intramuscular injection
• 📈 Improvement seen in up to 70% of horses based on clinical use
• 📅 Effects last several months in some horses

🔬 When Is Osphos Recommended?

Osphos is used in cases where:

• 📸 Radiographs show navicular bone changes
• 🩺 Pain has not improved with therapeutic shoeing or joint injections
• 🔁 The horse has chronic or recurrent heel pain

It is not appropriate for horses under 4 years old, pregnant mares, lactating mares, or breeding stock due to limited safety data. ⚠️

🧪 Administration and Monitoring

Administering Osphos includes:

• 💉 Intramuscular injection by a licensed veterinarian
• 🚫 Discontinuation of NSAIDs like Bute during administration
• 🚶 Light exercise post-injection to reduce mild colic risk

Horses may show mild signs of:

• 🤢 Colic (usually resolves with walking)
• 🥱 Lethargy
• 📉 Decreased appetite
• 📍 Injection site sensitivity

📊 Osphos vs Traditional Treatments

Dr. Steven Colburn, an equine vet with years of experience treating navicular disease, reports that he previously relied on:

• 👟 Therapeutic shoeing
• 💊 Isoxsuprine and aspirin
• 💉 Coffin joint injections

Now, he prefers Osphos in many cases, citing up to 70% success when bone involvement is confirmed. 💡

📆 What Happens After Injection?

Dr. Colburn recommends:

• 📉 Light work only for 1–2 weeks post-injection
• 🧠 Careful monitoring of gait and pain response
• 📞 Follow-up with your vet if lameness persists

Repeat injections may be considered every 4–6 months, depending on results. 📅

🛡️ Precautions and Contraindications

Because bisphosphonates affect kidney function, avoid combining Osphos with:

• 💊 NSAIDs like phenylbutazone (Bute)
• 🧪 Other nephrotoxic medications

Always ensure the horse is well hydrated, and discuss full health history with your vet before use. 🧠🩺

📲 Ask A Vet for Navicular Treatment Plans

If your horse has been diagnosed with heel pain or navicular syndrome and isn’t responding to traditional treatments, AskAVet.com or the Ask A Vet App can help guide your next steps. 📱🐴

Dr Duncan Houston and the team can review your horse’s radiographs, guide therapeutic shoeing, and evaluate whether Osphos or other therapies might help. 🧠💬

🏁 Final Thoughts

Navicular disease doesn’t have to mean the end of your horse’s athletic career. In 2025, Osphos and other bisphosphonates offer a powerful new option for reducing pain, preserving bone, and improving comfort. Used with good diagnostics and a tailored rehab plan, many horses return to work. 🐎❤️

Need expert navicular care? Visit AskAVet.com and find your horse’s path to comfort 🐴🦴