Neurologic head shaking syndrome

[Trekkie]

Sadly, my super sweet, super talented young gelding seems to have acquired this. It has been about two weeks he has been exhibiting symptoms with a very sudden onset. He is otherwise in very good health and was doing well with his training. Regular dental and vet checks, chiro, etc. Not related to light but symptoms appear with exercise with and without tack. He is fine standing in the field or in his stall. Symptoms include vertical head flipping, snorting, rubbing his nose on his leg or trying to rub it on objects and occasionally striking into the air with a foreleg. No coughing or nasal discharge, no watery eyes. A nose net appeared to make him more irritated. No recent change in diet or routine. We are trying Zyrtec next on vet recommendation, but I am not optimistic. He is pretty unrideable and it also is suggested that it is quite painful when it is triggered so then it seems the exercise also is not just irritating but painful. I am looking for reasons to be optimistic as I am feeling pretty pessimistic just about now. Any success stories or info on vets doing good research on this?

Link to article that describes syndrome.

Trigeminal-mediated headshaking in horses: prevalence, impact, and management...

[No1]

Is he wearing his halter when he is exercising without tack? Have spoken to your vet about allergy testing (and possibly shots), head xrays, or cyproheptadine (the most commonly used antihistamine for headshakers)? Have you tried to rub a decent amount of vasaline in his nostrils? There is also a regime of spirulina and magnesium available that I have seen have some success.

It’s frustrating, because the same thing doesn’t work for every horse. That said, I’ve never seen one remain unrideable due to headshaking. Including the one mare I knew who violently banged her head on stall walls until her allergies were under control. I even know of one person who had contacts made for their photic headshaker.

[Martina]

You are not alone, and I think this is more common than people think. Lots of horses can be managed with meds and/or supplements but unfortunately there are often a lot of diagnostics and trial and error.

There is a group on Facebook called Equine Headshaking Syndrome with thousands of members worldwide. As you can imagine with groups like this, there are all sorts of posts with good recommendations and bad. And a lot of people posting frustrations–just understand that there are lots of success stories. You just need to sift through all of it.

A video was posted which has some good information. It is long: https://www.youtube.com/watch?v=yhuSAblzISU&list=LL&index=1&t=2402s

A vet, last name Madigan, who has done a lot of research. You can search for that on the internet.

There is another allergy med that has been successful for some. Its called cyproheptadine. And supplements of B vitamins and magnesium. Some have found melatonin to be helpful.

Good luck!

[beowulf]

Try cyproheptadine and 24/7 turnout with a Guardian/UV flymask during the day.

[islgrl]

I’ve been through it. Same ting where he was fine except when he was working. I can tell you everything I tried if you want to message me. My story doesn’t have a happy ending regarding his ability to stay in work however.

[leesa1]

I’m sorry to hear it, I wouldn’t wish headshaking syndrome on anyone.

My last horse became a headshaker and I tried various things for almost 10 years.
His had no relevance to seasons, pollen, daylight/nightime, humidity or anything like that. I tried chiros, physios, saddle fitters, nose nets, many vets, xrays, scopes, ultrasounds, blood tests, steroid courses, herbalists, dentists, neck injections, probiotics, professional riders, acupuncturists, supplements, indoor/outdoor/stabled, steamed hay incase of mould/dust, nebulised drugs, experimental drugs from the vet, probably a bunch of other stuff that I’ve forgotten but you name it I tried it, even had his nasal mucosa biopsied. moved him to 4 different locations incase it was some sort of allergen around my city.

It was suspected from one vet that my horse had paresthesia as when the vet tried acupuncture on him, he got very itchy in places that horses apparently tolerate needles quite well.

There was one thing that I found would help my horse enough to keep him in light work. He had some other conditions so it was vet’s advice to keep him in light work if possible. What worked was a full head bonnet, a nose net and then a second nose net flipped upside down to cover the underside of the jaw. It took me a long time to realise that my horse mostly objected to sand that got flicked up by his front legs in the arena. He’d start to relax and lower his head but then he’d throw his head up and shake, lather/rinse/repeat. You couldn’t ever really pick up a contact with him as he’d gob himself in the bit when he’d shake and then he’d get unhappy about that too. On grass he was better, but walk him through a cloud of midge flies and he’d shake, so covering his entire head was the answer for him.

The nose nets had to be a specific type with mesh tight enough that sand or midges couldn’t get through. Not an equilibrium nose net, the holes are too big. If you can see through the net easily, the holes are too big.
I got two of them, sewed a strip of velcro around the long edge of each so that one would go on the top of his face and the other would go under his jaw, and then the masks would velcro together around his lips, creating a sort of barrier around his entire nose a bit like a dog muzzle. And it had to be about an inch or so longer so there was an airgap between it and his lips, so that he couldnt feel sand hitting the mask either. Yes he looked ridiculous, but he was happy enough to work for the first time in several years.

I wish I’d gotten a picture but unfortunately I didn’t.
What I used was a snuggy hood itch mask but with the eye strips cut off:

Then the bridle on top of that, then the nosenet muzzle attached to the bridle noseband. The bit rings would sit outside of the net, if that makes. Getting it on was a struggle as my horse hated his face being touched, but we came to an understanding provided a treat was involved immediately afterwards.

Edit: I also had some luck with an unjointed kimblewick bit but I didn’t try it long enough to really test it. But I believe one of the trigeminal nerve branches extends to the underside of the jaw so perhaps the mild pressure from the bit/chain was enough to calm the nerve, who knows?

[MrsFitzDarcy_amp_Feliks]

In the 90s my OTTB, Lorenzo, developed head shaking syndrome at 12 years old. At first, I thought it might be due to the mushroom farms in the area, but the head shaking continued when we moved out of the area. Sometimes it was pretty extreme, the tossing, pawing, and itching. At first we rode him with a hairnet over his nose, but then that was not enough. Then we rode him with a stocking over his nose. It worked, and he continued to show in the hunters. My trainer would ask the steward to ask the judge if we could show with the stocking. Many did. For those that wouldn’t, we slipped the stocking off right before we went in the ring. It didn’t bother him so much when we were jumping, for some reason. After I sold him to a barnmate, he had continued success in the a/a hunters and eq. When he got older, the dentist found a tooth abcess. They don’t know how long he had had it, but I wonder if it could have had an effect on his head tossing. He was a great horse.! Don’t have a picture available with his stocking.

image|635x500

[frugalannie]

@Trekkie, I don’t know where you are located. I’ll describe my experience but it may not be applicable. My 12 yo OTTB mare, about to move up to prelim eventing started head shaking out of the blue one day. She was unrideable, even in the indoor/ low light. We went through the diagnostics as you have with no findings of significance. For some reason I asked the vet to pull blood and hold it. A week later, after all the scoping, teeth check, chiro, acupuncture with no improvement, but a clear understanding that it was trigeminal neuritis, I asked the vet to run a Lyme titer on that blood. It came back sky high.

Mare was allergic to IV oxytetracycline, so I had to give her liquid oral doxy plus rifampin (an antibiotic which will cross the blood brain barrier). The former is bright yellow, the latter bright red. I was stained with both everyday for weeks. But her head shaking stopped while she was being treated.

Her head shaking would resume a few weeks later if it was summer, and pretty much go away in the winter. The pattern became seasonal: she would become miserable in about late May and stay that way til September. Sometimes she’d have a bout in the middle of winter. At times I considered euthanasia, but I had her at home so board wasn’t an issue.

About 4 years into this( maybe more) I got a bright idea. I was taking CBD oil for nerve pain in my back. So I gave her some. A daily dose of 10 mgs squirted into her mouth for four days in a row resulted in an almost complete cessation of her symptoms for the season. She might’ve snorted a little, or rubbed her head on a day or two but that was probably within normal limits for any horse.

I did ride her again ( not competing) and bred her, and she died a year ago due to unrelated causes.

It might be worthwhile talking with your vet about this. The conclusion my vets came to was that neurologic Lyme caused the initial trigeminal neuritis. In my mares case, CBD helped. It might not work for any other horse but it’s relatively inexpensive, pretty harmless and might be worth a try. Just get the good stuff, not the stuff they sell in gas stations.

Best of luck. It’s heartbreaking I know.

[Moneypitt]

Have you tried the Equimax protocol? It targets the juvenile Onchocerca parasites carried by the no see um gnats aka midges. Amazing results on some horses.

There is a FB page for the Equimax protocol. For some reason cannot share.

[Trekkie]

Thank you so much for the video link. This was super up to date and informative. Worth the two hour watch for sure.

[J-Lu]

My current horse is a headshaker.

Knock on wood, lucky for us he responds well to a nose net (I use a fitted nose net that always “bounces” with a wee bit of pressure on his nose). I keep it on year round because frankly I’m too lazy to take it off and see how he does.

Last year, he became unrideable in the spring because I waited to treat him. I tracked his pattern with grass pollen. But he did respond well once I started cyproheptadine. This year, I started the cyproheptadine when I first noticed symptoms and we haven’t missed a ride. Exercise can enhance the symptoms (says my vet).

He becomes symptomatic in the spring (1-2 months) and sometimes in the fall (1 month) and it seems to track with pollen. There is a county website that lists all of the various pollen counts and I check that with his symptoms.

I know he misfires around the nostrils because when I groom and he is symptomatic, he’ll gently press his nostrils into the fence or into me when misfirings occur. I used to let him stop mid-ride to press his nose on his knee until I figured out Mr. Smartypants was doing that to mostly get out of work.

He’s on pasture 24/7 and constant grazing stimulates his nasal trigeminal endings. But when the pollen is high he’ll toss his head walking up to me.

Luckily (knock on wood) HSS is well managed in him and his training progresses as normal. Try experimenting with the fit of the nose net and the brand (the shape). I have also sewn metal washers into the nosenet before I tried drugs. The washers flapped when he trotted and cantered and provided periodic stimulus on his nasal nerve endings. It worked quite well. I didn’t care how it looked!

Don’t be pessimistic just yet!!! Try cyproheptadine, be observant, track pollen, adjust your nose net and be creative (like I was with washers and I even started with panty hose rather than a nose net), and next year start cyproheptadine right when you see the start of symptoms. My horse is a success story!

[CalPal]

Can you share the brand of fitted nose net? Thanks!

[J-Lu]

Sure.

I believe I purchased and equilibrium nose net:

Amazon.com : Equilibrium Net Relief Muzzle Net - Cob/Horse Black : Pet Supplies

you can see ho fitted it is over the nose. Even as it comes off my horse’s nose the constant bouncing on his nerve endings seems to help.

Tha cashel isn’t so fitted. In retrospect it might work if fitted differently than the picture:

Amazon.com: Cashel Quiet Ride Nose Net - SMALL: Sports & Outdoors

MY horse needs pressure to activate the nerve endings around his hose to prevent misfiring. I figured this out by watching his behavior and because he’s really smart. And not stoic. He doesn’t tolerate discomfort well and seeks solutions. Whether bad or good! If your horse is stoic, you’ll have to be creative to figure out what works and doesn’t work.

[Wyndwolfe]

My gelding developed a head shake when he was about 15. Started suddenly, and was rather unpredictable as far as how violent it could be. Was not photosensitive. After doing some research, I suspected that he had developed an allergy to soy. I changed his diet to minimize soy, and added Spirulina (an algae). I saw a change pretty quickly.

[Trekkie]

Anyone here done the EquiPENS treatment? Experience? Anyone doing it in the eastern US? The academic centers I have contacted so far are not.

[Moneypitt]

It’s not available in USA. It is in the UK. Unfortunately, doesn’t help them all and is not permanent from what I gather.

Have you tried the Equimax protocol yet?

There is a page on FB that explains it.

Cured one of ours that was severely effected. Three annual treatments. Definitely worth trying.