In my experience, success depends on obtaining good lateral radiographs, gauging the severity of NPAS and applying an appropriate
trimming and shoeing strategy according to the severity of the disorder and the needs of the individual horse.
Photo 7: Grade IV forms of NPAS are complicated by flexor contracture, causing a "post-legged" appearance in which the pastern
is more vertical than normal and the fetlock angle is reduced.
If this condition is not treated appropriately, severe contracture of the heels can develop, followed by quarter cracks or
heel fractures, either of which makes the management of NPAS more complicated and delays the return to soundness. Suppurating
corns may also develop and can lead to proximal migration of the infection into the collateral cartilages and even the distal
NPAS is a treatable condition. Unfortunately, many affected horses that are not treated properly are retired, some after having
undergone neurectomies because nothing else has made them comfortable. But with a little know-how and some patience, you can
treat these cases and be rewarded for your efforts with a satisfied client and a happy horse.
Andrea E. Floyd, DVM, has specialized in equine podiatry for more than 25 years. She is the owner of Serenity Equine, Evington, Va., and the author
of Equine Podiatry. Dr. Floyd is a member of the American Veterinary Medical Association, American Association of Equine Practitioners and the
American Farriers Association.
1. Floyd AE. Use of a grading system to facilitate treatment and prognosis in horses with negative palmar angle syndrome (heel
collapse): 107 cases. J Equine Vet Sci 2010;30(11):[in press].