What the Horse Can't Feel

There is a rule in the FEI's veterinary regulations that says a horse which has undergone a neurectomy may not compete in international competition. The rule has been on the books for years. According to the FEI's own veterinary department, it is also one of the most frequently queried regulations in their entire framework -- in part because it is, by their own admission, difficult to understand. In March 2026, at the FEI Sports Forum in Lausanne, Dr. Caterina Termine, the federation's Senior Veterinary Advisor, laid out the plan to fix that. The proposals heading to the November General Assembly for a vote include a possible explicit prohibition of all forms of neurectomy, a targeted ban on palmar digital neurectomy specifically, and a requirement that any neurectomy be compulsorily registered in the horse's passport and the FEI's digital identification system, Equipass. The sport is being asked to decide, in plain language, what it thinks about a surgery that removes a horse's ability to feel its own foot.

What the cut does -- and what it cannot

Palmar digital neurectomy is the surgical severing of the palmar digital nerves at the back of the pastern, removing sensation from the heel and the navicular region of the foot. It is not a cure for anything. The underlying pathology -- typically navicular syndrome, the cluster of degenerative changes in and around the navicular bone -- continues uninterrupted beneath the skin. What changes is the signal. The horse stops reporting pain. In clinical terms, it goes sound. According to the Merck Veterinary Manual, navicular syndrome accounts for approximately one-third of all chronic forelimb lameness in horses. It is most commonly diagnosed between the ages of seven and fourteen, and the breeds most frequently affected are Thoroughbreds, American Quarter Horses, and warmbloods -- the population, in other words, that fills the hunter ring, the jumper ring, and this readership's barns.

The procedure exists as a last resort for horses that have failed to respond to conservative treatment -- corrective shoeing, joint injections, bisphosphonates -- and would otherwise face retirement or continued work through unmanaged pain. A multicentre study led by Dr. Santiago Gutierrez-Nibeyro at the University of Illinois, published in the Equine Veterinary Journal in 2015, examined fifty horses that underwent palmar or plantar digital neurectomy after MRI-guided diagnosis. Forty-six of fifty -- ninety-two per cent -- responded positively to the surgery. Forty horses, eighty per cent, returned to their previous level of athletic use for a median of twenty months. A separate 2020 study from Ghent University, led by Dr. Maarten Oosterlinck and published in Equine Veterinary Education, compared surgical techniques in forty horses and found comparable outcomes regardless of method.

The numbers read well until you reach the complications. In the Illinois study, eighteen of fifty horses -- thirty-six per cent -- developed post-operative complications, including painful neuromas, residual lameness, and early recurrence of symptoms. Horses with pre-existing core or linear lesions of the deep digital flexor tendon had significantly shorter periods of soundness, a finding that makes MRI screening before surgery not optional but essential. The more serious risks are rarer but catastrophic: rupture of the deep digital flexor tendon, luxation of the coffin joint. When a horse cannot feel its own foot, it cannot adjust its loading to protect a weakening structure. The failure, when it comes, is sudden.

The navicular problem is the warmblood problem

Navicular syndrome is not a disease of neglect or overwork alone. It is a disease of biomechanics and, increasingly, of documented genetics. Dutch researchers studying 746 normal and 174 clinically affected Dutch Warmbloods between the ages of three and nineteen found a significant, age-independent association between the shape of the navicular bone's proximal articular border and the likelihood of developing the disease. Bones with a convex proximal border carried a higher risk. The finding underscores what the warmblood breeder and buyer would rather not hear: the predisposition is heritable, it clusters in the breeds selected for the modern sport horse's scope and movement, and it announces itself in the middle of the horse's competitive prime. The horse your trainer found with the textbook jump does not come with a guarantee that its feet will hold.

What the FEI is actually proposing

The proposals debated at the March Sports Forum fall into two tiers. The first is regulatory clarity: a rewritten rule that explicitly prohibits either all forms of neurectomy or, at minimum, palmar digital neurectomy -- the specific procedure that desensitises the navicular region. If the broader prohibition does not find a majority at the General Assembly, the targeted palmar ban stands as the fallback. The second tier is traceability: a requirement that any neurectomy, wherever performed, be registered in the horse's passport and in the Equipass system. If a horse has been denerved, the record will follow it across borders and between owners.

The neurectomy overhaul sits inside a broader revision of the FEI's veterinary regulations -- the most comprehensive in the current revision cycle. Among the other proposals heading to the November vote: a streamlined therapeutic use exemption for pergolide, the standard medication for equine pituitary pars intermedia dysfunction, more commonly known as Cushing's disease. Under the current rules, horses on pergolide must withdraw from the drug around competition dates -- a disruption that can worsen the condition. The proposed change would allow a TUE to be requested so that treatment continues uninterrupted through competition. For the estimated fifteen to twenty-five per cent of horses over fifteen that carry PPID, according to prevalence data from the UC Davis Center for Equine Health, this is not a bureaucratic adjustment but a meaningful shift in how a common condition is managed on the circuit. Additional proposals address the removal of non-emergency treatments by injection during competition, stricter limitations on the possession of medications at show venues, and updated body condition scoring using the Henneke Scale.

The case for keeping the nerve

The case for prohibiting neurectomy in competition rests on a clean and persuasive logic: a horse that cannot feel its own foot cannot signal that its foot is failing, and a sport that presents itself as a partnership between horse and rider has a public obligation to ensure the horse has not been surgically silenced. The FEI's veterinary department is right that the current rule is opaque, and right that the sport's credibility depends on the public believing that welfare comes before results. All of that is true.

But the case for keeping the procedure legal -- or at least for leaving the decision in the hands of the veterinarian and the owner rather than the rulebook -- is not frivolous, and it deserves more than a paragraph before being dismissed.

Without neurectomy, a horse with advanced navicular syndrome has two options: retire or continue in pain. The sport talks about welfare as though it flows in only one direction, as though the most harmful outcome is always the procedure and never the alternative. A well-screened horse -- imaged before and after surgery, monitored by a veterinarian who knows the case -- can compete comfortably and safely for years. The Illinois study's median of twenty months of athletic use is not a loophole. It is a functional, productive life that was not available any other way. The complication rate is real, and it matters; but MRI screening before surgery materially reduces the risk, and the study's own authors identified the horses most likely to fail: those with pre-existing deep digital flexor tendon lesions that should not have been candidates in the first place.

A ban, if it passes, will also create a regulatory split. The FEI governs international competition; it does not govern the hunter ring at a domestic A-rated show. A horse that can no longer compete at a CSI can still compete under national federation rules. The passport registration requirement may erode that gap over time -- it is difficult to imagine USEF and USHJA ignoring a flag in the system -- but in the near term, the effect is to penalise the horse that has reached the international level while leaving the domestic competitor untouched. Whether that distinction reflects a genuine difference in welfare risk, or simply the difference in regulatory ambition, is a question the sport has not answered.

What November decides

The vote at the FEI General Assembly will land in one of three places: a full ban on all forms of neurectomy, a targeted prohibition of palmar digital neurectomy with other forms permitted, or a failure to pass either proposal -- in which case the current opaque rule survives another cycle. Whatever the outcome, the passport registration requirement is likely to carry on its own merits, which means the infrastructure for tracking neurectomised horses will exist even if the competition ban remains muddled.

For the owner at a domestic show, the immediate practical effect may be small. For the owner of a warmblood that has just been diagnosed with navicular syndrome at age nine -- which is the phone call this readership dreads, and the diagnosis that accounts for a meaningful share of pre-purchase failures in the sport-horse market -- the question is whether the international regulatory direction will eventually arrive at the national level, and whether the conversation with the veterinarian about treatment options will narrow before it should. The FEI's instinct to clarify a rule that its own department calls unenforceable is right. The instinct to ban a procedure that gives horses years of comfortable athletic life, rather than regulate it into transparency, is worth the argument the November vote will force.