Tildren is a medical option for treating horses as the drug is approved for equine use. Tildren can treat their navicular disease. In navicular disease, the navicular bone is only one of the structures that can lead to lameness in the back of the horse's foot. Consequently, it is important to get an accurate diagnosis before using Tildren because it only is effective in treating bone disease when it inhibits bone resorption. If structures other than the navicular bone are involved and causing pain, Tildren will have no effect and should not be used.

To determine which structures are actually causing pain, x-rays, ultrasound, and possibly even an MRI may be required. Once a diagnosis is made and the navicular bone is thought to be involved, Tildren can be used as it inhibits bone resorption, which is considered to occur in some cases of navicular disease.

This drug is also used in humans with osteoporosis and is currently being investigated for use in navicular disease. Dr. Britt Conklin indicates in Remuda magazine that Tildren is believed to help with pain by reducing absorption of bone, and some believe it may also have some anti-inflammatory action. The drug's duration of action is weeks to months as it is slowly eliminated from bone. The drug is usually administered intravenously over a period of 30 minutes and a short-term low-calcium concentration can occur in the blood but has not been noted to be a serious problem. Dr. Conklin also indicates that when giving the drug, horses should be held off feed and given an injection of flunixin to help prevent colic.