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  Discussion on POSSIBLE HEAD SHAKER
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Member:
astbury

Posted on Sunday, Apr 26, 2009 - 4:43 pm:

Carry - my event ride - who has helped me through the last couple of weeks of sadness after losing my beloved Padraig - is behaving very strangely - and I suspect is demonstrating head shaker synDrOme - the aetiology of which I have no clue.

Pad died on 7 April and Carry has helped me through a very difficult time since. The only time I felt human was when I was on her. We have hacked out together for hours and really bonded.

I went for a lesson with a British Eventing trainer last week (needed to get my head back in gear) and Carry went really well. We decided best way forward for this young horse was to work in low outline currently (our dressage tests had said we were too deep previously) - to help her to build up "behind" following which we would gradually change the axis so she was working uphill.

A very inspiring lesson - and the next day I achieved the best work ever when working in the school.

Following day thought I would do just 10 minutes in the menage and then hack out quietly. Fine in walk but as soon as I tried to go into trot, Carry's ears went back and she refused to go forwards and threatened to rear.

Gave it best shortly afterwards thinking there was something amiss and next day worked her on lunge - fine. Day afterward rode her out on hack with friend - Fine on outward journey - although got the feeling she wasn't really forwards and happy, and on way back - crossing rape field - absolute nightmare - head throwing. Rubbing nose - I THINK mainly right nostril concern. Eventually got off Carry and as long as she kept her nose behind me seemed ok.

Since then I have ridden her in the school - once reasonably ok - but today - awful again and threatening behaviour immediately when trying to go into trot.

This evening, I lunged her - and she was fine when working simply off cavesson and lunge line - although at one point she snorted and loads of "gunk" came out of her nostril - and oddly her mouth - but when I put side reins on - fairly loosely - again exhibited same behaviour as when ridden: ears flat back and refusal to go forward.

I had ridden her out yesterday with nose net on - ok for a while, but once down at bottom of farm near stream - midges about and absolute nightmare - striking out with front legs and shaking head and trying to rub nose wherever she could.

Her owner rode her this morning, with similar result.

She is a lovely, lovely mare and at the back end of last season was really succesful with me at intro level eventing. Our last event was great - she was showing signs of being really brave and bold xc - very talented sj and with potential dressage.

My cranial osteopath is currently saying we need to get rid of lots of feedstuffs and under no circumstances should she be vaccinated again - since this is an auto-immune disorder precipitated by the vaccine. If this is the case then legally she will never be able to compete at British Eventing level again. On the other hand if we dont sort the headshaking problem, she couldn't compete anyway.

Not sure where to go from here. Any advice appreciated. This is a SO selfish thing to say, but I need this one like a hole in the head....

Isn't life like that though??
Member:
scooter

Posted on Sunday, Apr 26, 2009 - 6:04 pm:

Hi Jenny, two things come to mind, she may just be misbehaving because she thinks she is getting worked too hard or as you say something may be bothering her.

I just had a discussion about my horse..tho he is just a trail horse, he rubs his nose on everything and sneezes almost continuously...he does not refuse to go forward however.

I have been thinking it's alergies with him, and also midges. I was going to try a human substance on him but haven't been able to yet because of weather. In that thread tho someone mentioned vaseline on the nose. Here is the thread
https://www.horseadvice.com/horse/messages/4/311942.html
Moderator:
DrO

Posted on Monday, Apr 27, 2009 - 7:56 am:

Jenny the history does suggest that the horse either is overfaced with the new work or possibly finds it painful. Moving back to comfortable work then moving forward is one way to handle this. If you think there is a disease process the article associated with this discussion covers the possible causes and some way to differentiate them.
DrO
Member:
frances

Posted on Tuesday, Apr 28, 2009 - 7:11 am:

It sounds like two separate issues to me: perhaps some pain/discomfort from the increased work load (it's so easy to get over-enthusiastic when they go really well ) and a coincidental allergy problem.
Member:
astbury

Posted on Tuesday, Apr 28, 2009 - 4:16 pm:

Hi Dr O and everyone

Many thanks for your posts. (Am feeling very embarrassed - just notice the heading is in upper case again. I PROMISE that I will stick some tape over my "caps" key in future!

We had lots of rain yesterday and I rode Carry out with a friend in the evening and she showed no sign of headshaking - back to the mare I know and love. Did nap once when I was in front, but I growled at her and immediately pushed her forwards and she was fine. After about half an hour the sun appeared (early evening so low in the sky) and a few midges about - and still - no reaction. I suspect therefore it is an allergic reaction to either the rapeseed oil crop which is everywhere at the moment - or the tree pollen. The English press has commented on the number of people who are suffering hayfever this year already - who have shown no signs of it in the past - so I guess this impacts on our equines as well.

I have a McTimoney Chiropractor coming out tomorrow - haven't ridden Carry this evening - and will see what she says. I suspect - as you have all mentioned above - that perhaps the lesson overfaced her. I thought not initially - because we were working long and low - which she finds comfortable - but thinking about it - I felt her really working through from behind and it is possible that we overdid it. Normally, when I work her in the manage at home - I always do fifteen minutes in walk - long and low - to stretch her through her back before continuing into work - and never do more than 40 minutes in total - and we did do a full hour's lesson and Carry was pretty well sweated up - although it was warm. I also have to say that whilst she was working sweetly with me, the trainer did eventually get on her, and she reacted quite badly with her initially. Then when I got back on she was quite reluctant for the first few minutes. As I mentioned in earlier posts though - she did work very sweetly the next evening. I think she is quite a sensitive mare.

Her teeth were done a week before the problem started. The dentist (who is qualified)said she did have a problem on the left side of her mouth and did quite a lot of work. I had told him I thought she was reluctant to take contact that side. Presumably teeth fine but again, maybe something to check in case work on her teeth has caused an irritation?

My priority is obviously to get Carry working with me so that she can shine! I just hate to see a horse with its ears back when I'm on board.

A question for Dr O now - sorry for long post (seems to be my style). I used to work in the pharmaceutical industry for a Company called Fisons - whose major product was sodium cromoglycate (previously known as disodium cromoglycate). A subsequent formulation was successfully used in horses for COPD (or heaves) - called "Cromovet". I have noticed that in a December 2008 article in the "Horse and Hound" magazine, there has been a study by Cambridge University using sodium cromoglycate as an eye formulation (product I used to know it as was "Opticrom" - for humans) which is showing some success in allergic or photophobic head shaking reactions in horses. I think Opticrom is now manufactured by Sanofi Aventis (previously Rhone Poulenc), but whilst it used to be a Prescription Only medicine, I have noticed that it can be ordered on the internet - so guess it has been downgraded to an Over The Counter product.

I am wondering whether to ask my vet to talk to Cambridge University to check the formulation which they used in their trial (I wonder whether an OTC product might be a different lesser formulation)and if problems start again once the weather improve at the weekend, whether we should give it a try?

I do wonder also whether the stress levels and subsequent reluctance to work have made the challenge of a high pollen count less acceptable - and more likely to create a reaction - to Carry than would have been the case if she was her usual happy laid back self.

Thanks again for your help.
Moderator:
DrO

Posted on Wednesday, Apr 29, 2009 - 5:41 am:

First I am uncertain why you have ruled out photic head shaking which is a different disease than say a allergic rhinitis. Your last post seems more consistent than inconsistent with the observation that during lower light situations the horse improved.

If the problem is eye irritation causing the head shaking, corticosteroids might be more effective than the mast cell stabilizer cromoglycate as it covers a much wider variety of reactions, including those ameliorated with cromoglycate. But to the degree that mast cells are involved it may help, we just don't have enough information to say.
DrO
Member:
astbury

Posted on Wednesday, Apr 29, 2009 - 12:46 pm:

Sorry Dr O - I was confused for a moment but see what you mean - my reference to the sun being fairly low in the sky - the sun was in fact very bright and dazzling when it appeared - and made me squint - which is why I tended to rule it out. But I guess we will have to see how she reacts when we have a sunny day and the sun is at its height.

The information on the study by University of Cambridge referred to headshaking caused by seasonal allergy or light stimulation i.e. (December 08 - Horse & Hound Magazine):

"Cambridge University vets have recently reported another therapy: sodium cromoglygate eye DrOps.


In a number of horses, seasonal and light-stimulated head-shaking was either cured or significantly improved by daily usage. "

For some reason I hadn't read it that the seasonal allergy referred specifically to eye irritation - but of course I guess it does. Um - would the eye DrOps have a purely local or possibly systemic effect - ie also benefiting irritation in the nose? or I suppose, if the eys are irritated that could cause nose irritation too. Her nose certainly does run and is irritated. - although I would say the greater irritation is in the right nostril - which is what she tends to rub.

I'll let you all know once the vet has talked with the university.

The McTimoney Chiropractor came out at lunch time and she said that the mare was assymetrical behind which resulted in soreness both behind and in the saddle area - which she said was sufficiently bad to cause her to back off when asked to work forward into trot in an outline. Following treatment, she said she was much straighter when walked and trotted up and I have to give her the day off today, hack out for gentle walk exercise tomorrow and Friday, do a little walk and trot on Saturday and if all goes well, begin to work again on Sunday. Taking it slowly.
Moderator:
DrO

Posted on Thursday, Apr 30, 2009 - 5:59 am:

I have read about the study but have not been able to find any published results. So I would be interested in what they found. I am uncertain about the logic if it is not too relieve eye irritation due to histamine release from mast cells.
DrO
Member:
astbury

Posted on Friday, May 1, 2009 - 6:33 pm:

Hi Dr O

Will try and get vet to delve out published results on the SCG trials and keep you posted.

Rode Carry out tonight on my own - very sunny evening - dry, some flies about and no problems at all.

Tomorrow have arranged to ride out with friend at 1000 hours - weather predicted to be warm and sunny so will see how things go.

Thanks again for your help.

Jenny
Member:
astbury

Posted on Saturday, May 2, 2009 - 8:59 am:

Rode out with friend this morning and before we had gone 100 yards over fields (same route as yesterday evening), Carry became distressed, throwing head, snorting, desperately trying to rub her head on my friends horse. Awful. After she went so well yesterday evening, guess this is fairly conclusive proof that there is an allergy somewhere. Was bright sunlight, warm, loads of oil seed rape everywhere.

Walked on for a while but she became much worse. Nose running a lot - when she shook her head I got wet. Decided there was no point in continuing and took her home. When I got off noticed that there was a thin white discharge in left nostril and right eye running.

Haven't got hold of the vet yet, Dr O - will probably be Monday now - but saw this article with a further google search - which gives reference to an article in Vet Record magazine - not sure if you can access that on line? If not I will try and get hold of a copy and scan it:

Not only is headshaking an irritating and frustrating problem for the rider, it is an indication that the horse is suffering pain and discomfort.

The problem is often worse in the summer. Numerous causes have been identified, making it a challenging condition to investigate.

Occasionally a physical abnormality affecting the sinuses, teeth or ears may be detected. Often no physical abnormality can be found. Many cases are thought to be the result of pain in the trigeminal nerve that innervates the nose and face.

Various treatment strategies have been used, with inconsistent results. A novel treatment suggests that, at least in some cases, an allergic condition is involved. A report, by Dr Catherine Stalin and others in the Veterinary Record, describes three cases of seasonal headshaking that responded to treatment with sodium cromoglycate DrOps.

The three horses were so severely affected that they could not be ridden. Headshaking started, or grew worse, when the horses brought in to the light from a dark stable. All horses showed signs of excessive tear production and photophobia.

Sodium cromoglycate eye DrOps were successful in relieving the condition, where previous treatments including corticosteroids (dexamethasone) had not.

One horse had suffered seasonal headshaking for the previous two years. Within a few minutes of starting treatment with sodium cromoglycate eye DrOps it stopped headshaking and could be ridden.

Sodium cromoglycate acts by stabilising mast cells, preventing them releasing histamine as part of the allergic response.

The response to treatment suggests that in these cases the cause of the headshaking was an allergic conjunctivitis. It was, however, interesting that there had been no response to dexamethasone which might have been expected to relieve signs of allergy. Perhaps, the authors suggested, this was more than a purely allergic condition, or maybe cromoglycate has other modes of action that are not yet understood.

For more details see:

Treatment of seasonal headshaking in three horses with sodium cromoglycate eye DrOps.
CE Stalin, IP Boydell, RE Pike.
Veterinary Record (2008) 163, 305 -306
Moderator:
DrO

Posted on Sunday, May 3, 2009 - 5:42 am:

Thanks Jenny, thats the most detailed report I have yet of the paper and better explains the situation and why they considered conjunctivitis. Here the horses had clear signs of eye irritation: fear of bright light and tearing. Does your horse display these two symptoms?
DrO
Member:
astbury

Posted on Sunday, May 3, 2009 - 7:53 am:

No Dr O - Only one: Both of Carry's eyes were running on return to the stable - right more than left but there was no indication of fear of bright light. When I first left the stable, I mounted with no problem and the mare moved off quite happily. It was only after 5 minutes when we were moving across the field that the headshaking started. I don't think the sun was full on in her face then but I guess it is something to check out next time.

I have noticed on a couple of occasions though that the corners of Carry's eyes are redder than usual.

Today is a mixed bag weather-wise - cloudy but interspersed with periods of bright sunlight. Haven't ridden yet - not sure it would be wise at present - will probably lunge the mare later on with nose net on to at least get her used to that. I've talked to people with headshakers, and many say that with a nose net on they can generally ride the horses through it - I may be being over sensitive but my feeling on Carry when she really starts, is that she is completely absorbed with trying to deal with whatever is irritating her - and if I try to influence her she just gets more agitated.I certainly wouldn't want to be riding her on the road if it started (although I guess less likely than on fields - if indeed a pollen or whatever allergy is the cause).

Sodium cromoglycate is also formulated (or was) as a hayfever or allergic rhinitis prophylactic product - Rynacrom - as well as "Intal" for asthma and "Cromovet" an equine formulation for COPD sufferers.

I would be surprised if Rynacrom hadn't been tried in horses with seasonal allergies - but can't find any mention of it. Maybe I should do another Google search.

Thanks for your help.
Member:
astbury

Posted on Tuesday, May 12, 2009 - 6:10 pm:

Brief update on Carry. Definitely not Photic headshaking. Have ridden her out in very bright sunlight at lunch time on several occasions on windy days and after rainfall with no headshaking at all. Soon as wind DrOps though or dry conditions, is an issue UNLESS I ride her with nose net on in which case much improved.

Had session with trainer in manege few days ago when conditions were right for problems to occur - dry, humid, lots of flies with oil seed rape full out - had nose net on and as long as I kept her fully occupied, apart from a few headshakes and snorts initially she was fine.

So come to conclusion is definitely an allergy to either tree pollen or rape.

The behavioural problem was interesting. My trainer rode Carry and had a fairly difficult time for 15 minutes when she bucked, ears flat back and lots of tail swishing, but suddenly, the ears back and tail swishing stopped and she went forward sweetly. I rode her later and as long as I kept her forward into a contact she was fine.

Maybe lack of positive riding on my part?

Chiropractor out today - and says C. is working much straighter. So maybe a combination of factors.

I think there is definitely an allergy problem - and wonder if there is any management which I can undertake to lessen this.

There was also a training issue - where I think the mare discovered a weakness in me at that time and challenged me.

Still trying to talk to owner's vet about Rynacrom. Will update Dr O once succeeded. Vet has been away for a couple of weeks- on holiday I think.
Member:
mrose

Posted on Tuesday, May 12, 2009 - 6:59 pm:

It does sound like allergy is part of her problem, doesn't it? I'm so glad you are figuring it out. It will be so nice for you to have a good reliable mount to compete on again.

I have a stallion that is very allergic fly sprays, and in the past has broken out in severe hives due to a combination of things. It seems once his system is activated, it becomes sensitive to a lot of things, including some of our local weeds. The only thing that helps him is steroid shots. If I don't use the offending sly sprays on him, it seems like he has no problems. Before we figured out his problem, we tried antihistamines on him and they didn't help at all.

Are you allowed to show with the mask on? If so, it might be the easiest method of dealing with her problem.
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