CAT - Evidence for bisphosphonates in navicular syndrome

Navicular disease is a complex degenerative condition of the navicular bone that may occur in isolation but more commonly occurs in combination with concurrent soft tissue injury (navicular syndrome) to the podotrochlear apparatus. A combination of diagnostic anaesthesia, radiography and magnetic resonance imaging (MRI) are required to assess all components of the syndrome before the most suitable/ affective treatment options can be considered [1]. Broadly, bisphosphonates can be divided into non-nitrogen and nitrogen containing bisphosphonates. In human medicine there has been a move away from non-nitrogen containing bisphosphonates due to their relative low affinity for bone, relative low efficacy at bone resorption prevention and short dosing interval (daily) resulting in noncompliance in human patients [2]. Third-generation nitrogen-containing bisphosphonates, supported by pharmacokinetic and pharmacodynamic studies, are used in single dose treatments regimes in humans and there is a report of their use in horses (not currently licensed) ...