It is natural for your horse to occasionally shake its head to ward off insects or because it is excited or tense. However, involuntary, persistent head tossing without any apparent cause is no longer natural. It is characteristic of headshaking syndrome. Unlike cribbing or weaving, headshaking syndrome is usually not a behavioral disorder, but a neurological condition that should be investigated by a veterinarian.
In most cases, the disease develops gradually and is therefore not always immediately recognized. It can begin with hypersensitivity in the head and nostril area, causing the animals to try to rub their head or nose against walls, the ground, or their front legs. Affected horses suddenly start to shake their heads jerkily beyond the normal range. The head movements can be horizontal, vertical, or circular. The symptoms vary greatly from horse to horse and can sometimes be so severe that normal riding is no longer possible. The horses are distracted and stressed by the head shaking and can endanger themselves, the rider, and the environment. Additional symptoms may include excessive sneezing, snorting, lethargy, nervousness, lack of concentration, and weight loss. The symptoms occur more frequently in spring and summer and can be triggered or exacerbated by sunlight (photosensitivity).
Not all causes of the condition have been fully researched. Head shaking syndrome is therefore divided into two forms. On the one hand, symptomatic head shaking refers to cases where there is an explainable cause. Around 70 underlying diseases or other causes are currently known that can lead to increased head shaking. These include dental problems, eye or ear diseases, changes in the nose or sinuses, infectious diseases, and back or riding problems. Stress, unsuitable bridles, or poor posture and feeding conditions can also lead to head shaking.
If no apparent cause can be identified, the condition is referred to as idiopathic headshaking. According to recent studies, this form could be compared to trigeminal neuralgia in humans. The trigeminal nerve is a cranial nerve that transmits pain signals to the brain. The nerve runs along the side of the horse's head and its three branches supply a large part of the entire head. It is thought that a blood vessel running close to the nerve causes irritation of the trigeminal nerve. The resulting hypersensitivity greatly reduces the stimulus threshold, meaning that even minimal stimuli that would not normally cause a reaction can cause extreme irritation of the nerve. This is then perceived by the brain as a pain signal.
Due to the variety of possible causes, a thorough veterinary examination is strongly recommended in all cases of head shaking.
In addition to a thorough general examination, the veterinarian will pay special attention to examining the head. A headshaker should always be given a complete blood count, including all possible tests for neurological infectious diseases such as herpes virus, Borna, or Lyme disease. Depending on the type and severity of the syndrome, an X-ray examination of the head and an endoscopic examination of the upper airways and air sacs may also be useful.
In many cases of idiopathic head shaking, no cause can be found despite intensive diagnostics. It is therefore extremely important that the veterinarian can better narrow down or rule out any triggers using this type of exclusion process. This thorough approach may therefore involve a variety of tests and examinations. Please always discuss the exact procedure in each individual case with your veterinarian.
Due to the wide variety of causes, which are not always easy to diagnose, treatment also depends heavily on the findings in each individual case. If symptomatic head shaking is caused by an underlying disease, this must of course be treated.
In the case of idiopathic head shaking, the symptom is treated first due to the lack of a cause. In mild cases, relief can be provided with the help of a fine-mesh net that is attached over the nostrils. The success of this treatment is explained by the constant mechanical irritation caused by the net, which shields the nerve from other stimuli and thus leads to a reduction in pain. Dark face masks help with head shaking that is strongly induced by light.
Medication with antispasmodic or antiallergic agents can be successful in some cases. However, these preparations are usually classified as doping-relevant drugs and are therefore not suitable for horses that participate in competitions.
Since about 90% of all headshakers suffer from hypersensitivity of the trigeminal nerve, various surgical and stimulation techniques have been developed as additional treatment methods for this neuralgia. However, there is currently no surgical method that promises satisfactory results without side effects, so the respective benefits and risks should be weighed up before deciding on surgery.
A combination of different treatment methods is often necessary to restore some quality of life to affected horses. Please discuss with your veterinarian exactly what treatment is best for your horse.
Horses with symptomatic head shaking can usually enjoy a symptom-free life after successful treatment of the underlying condition. The more accurate the diagnosis, the better the chances of recovery.
However, the chances of a horse diagnosed with idiopathic head shaking being able to be ridden again are significantly higher today than they were a few years ago. Even though the disease cannot be completely cured in many cases, it is now possible to reduce the symptoms to a tolerable level in many horses, allowing them to live a horse-friendly life.
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