Dental x-rays vs. dental exam outcomes? - with preamble

[LilyandBaron]

My Standardbred has now had two years where he’s been in enough work for me to notice an issue that is apparently seasonal. It’s not THAT cold here yet, though we’ve had some cold weather (SW Ohio), but undersaddle (really noticeable) and some on the ground (stall/crossties/pasture), he will turn his entire head to the right, to where the jaw is parallel to the ground, and fuss with his tongue as his neck is snaked that direction. Last year, I did vet exam, saddle fitting, chiro, and myofascial massage. Nothing connected to it - no TMJ stuff, nothing dental, no weird body pain. And it resolved in spring/summer.

He’s always been weird about his mouth - I’ve done bitless and bitting clinics and dentals - but I’ve not done dental x-rays, just exams. With the behavior being seasonal, I feel like it’s triggered by something. This year, my footing has been fine, so his work load really isn’t different, so I don’t think it’s due to less work/turnout in the winter, as those are about the same so far this year.

I’m in a FB group for STBs and one noted that many of these horses develop these weird mouth/head issues on the track to express themselves because in the shafts of the carts, it’s about the only option. So that’s one possible explanation, but doesn’t really explain the seasonal presentation.

I still hate to rule out pain for things like this - things that pop up and don’t seem in response to a specific training thing. I don’t think horses do this for fun - it’s normally for some reason. So, I may yet try acupuncture as a diagnostic and possible treatment, but also considering dental x-rays.

Wondering if anyone had horses not present anything in a dental exam, including no pain response to palpation and massage around the jaw/head, but actually did show something in a dental x-ray that was missed? I had my vet and massage therapist out last year specifically for this behavior, so they really did explore the area, and nothing. My vet mentioned x-rays but also noted it could just be behavioral…

Thoughts/advice from any similar experiences appreciated! For now, I’m wiggling the reins softly, using leg and carrying on, and he can get normal work done, but having the moments where he’s going around like a possessed camel isn’t really fun.

[IPEsq]

X-ray might be helpful. At least it could rule something out. My friend’s horse had weird almost headshaking behavior but was fussy in the mouth generally, more one side than the other. Also worse seasonally. Turns out he has some airway stuff going on, but he also had a cavity (rare) that was missed by 3 vets (2 sports vets and 1 dental specialist) before being found by another dental specialist. The infection had been going on long enough it had killed off at least 2 nerve roots in that tooth and had infected the bone. Wound up needing a CT in that case to determine the extent of the damage and inflammation whether normal extraction would work. I think they shot Xrays also but cavity was confirmed by the fact the dentist could stick a probe way up into the tooth.

Given cold weather connection in your case, I wonder if it could also be this horse’s back, and this is how he’s expressing having a cold/tight back. May not be an actual injury, but some horses are just more sensitive to the cold in that way. My guy prefers to be blanketed heavily or else he’s quite cold backed and stressed out in winter.

Last thing is possibly cold weather airway issue that is mild so not causing a cough but could maybe cause this expressive behavior.

[LilyandBaron]

I use BoT sheets and pads, and do blanket him - he really doesn’t get a good winter coat at all. Chiro, vet, and saddle fitters didn’t find major back issues last year. The airway thing is actually interesting - he coughs at the beginning of exercise, year-round thing. And a lot of horses do that, but he is dramatic. It doesn’t persist, though. I wonder if there could be underlying/old airway damage that is worse in cooler weather??? I did have his sinuses examined in the past as he also develops a lot of tears. So it may be something anatomical triggering it - I guess that leads me to wonder if it’s fixable or how else I could manage. Hmm. Worth exploring; thank you!

[IPEsq]

Depends on what it is and what is triggering it. Horse with tooth issue I mentioned has some significant asthma and also an abnormality where the adenoid cartilages periodically collapse during exercise. Unlike other types or upper airway things, that is not fixable with surgery. My horse with asthma does a lot of weird posture and contact things as well, but his triggers are mostly in the summer (he’s also cold backed in winter as I mentioned, but different symptoms).

With my horse and friend’s horse, we did upper airway scope standing. Then dynamic scope (ridden). Then because they found the upper airway thing with the other horse, they stopped there initially. Until he became totally unrideable again the next summer after seeming to manage the upper airway thing through the spring (his usual worst season). My horse was clear to this point, so we did a BAL which diagnosed the asthma. I did take him to another climate for several months, and he had no major issues, so seasonality triggers can vary based on what they are. Friend’s horse did a BAL this year, and it showed some significant issues in his airway, and he had to do a course of steroids for a while. So, other horse had tooth, upper airway, and lung issues going on.

I will say that my horse VERY RARELY coughs in the warmup, and that was one of the first signs of his asthma. Although usually he’d cough only once. After being somewhere else with minimal issues, coming back to land of dry and thin air, he started coughing in warmup again immediately. Just once. But not normal for him at all. And so we started treating his asthma directly with nebulizer and allergy meds (based on the type of asthma he has, identified by the BAL).