Headshaking after a sinus tumour?

Art Nouveau

Well-Known Member
Joined
27 September 2014
Messages
380
This is going to be a long and convoluted post as there's a lot of history and I don't want to miss anything important.
TL: DR could a sinus tumour (removed) cause headshaking/trigeminal nerve issues that are slightly alleviated with magnesium supplementation, but possibly not enough to remove all the pain? How would I find out?

I bought my mare in June 2015, she had just turn 7 and was sold as a green project who was beginning to show increasing problems under saddle - rushing in trot, wanting to break into canter, and rearing/head tossing if held back. She was vetted, and the vet agreed with the owner that the issues were just that she needed more work and training.

Over the next year her behaviour continues to be difficult, she was tense and anxious a lot. She would often stop to rub her head and she would flick her head trotting on the lunge or if trotting or cantering round in the field. In April 2016 after a recurring sinus infection we found a sinus tumour, an ossifiying fibroma, which was the size of an orange and was also beginning to distort her skull. This was removed, she came home, then the surgery site got infected but responded to antibiotics. Since this time, most of the work with my horse has been in a bitless bridle.

At the end of August 2016 we moved away, and my mare was moved to a friend's field with a companion pony. We had no facilities and the pony got stressed on his own so I was limited to riding only when someone could bring the pony too. My mare was still edgy but would happily follow the pony and if we had someone leading the pony who didn't mind running then we could do some trot work.

In May 2018 we moved to a livery yard. The pony had an accident in the field and was put to sleep. My mare became extremely herd bound and stressy. I would watch her running around the field flicking her head and remembered that I had previously pondered whether she was a headshaker. I spent the summer getting her confident leaving the field and being ok in the arena and for short walks out. I re-introduced magnesium as a calmer and she gradually improved in her behaviour and confidence. As she'd been out of any sensible amount of work for so long I wanted to build her up really slowly, so we stayed in walk when riding in the arena and avoided the deep corners, and built up her trotting in straight lines on the road.

Early 2019 we reintroduced trotting in the arena, which was to start with very rushed, high head carriage and hollow and some 'hopping' which we (me and my instructor) thought was probably just remembering the issues from her tumour and panicking. Over time she got more balanced and calm. However, we hadn't got very far when I got pregnant and I had a horrible pregnancy so my mare was on the back burner again. Baby was born in December, then in January this year my mare got an abscess which then recurred in February. That brings us to lockdown! So my instructor couldn't come over and I didn't have access to childcare from my family so haven't been able to do much with my mare since I have a baby in tow!

As my baby has got older it has been easier to leave her with my husband while he works from home and I rush up to work with my mare. I started longreining her out, which we'd made good progress with last year, but she got increasingly reluctant to go and panicky about one particular location that we have always struggled with. I decided to stop her hard feed 10 days ago, which she only has to carry the magnesium, to see whether she is reacting to something in that. She also doesn't tend to eat much of her feed in Spring and Summer once they're on the grass, so I figured she may not be getting enough magnesium to help anyway.

Since stopping the feed, I have led her out on a walk once when she was very stressy, but I put that down to her developing a fixation on a mare who is only in the herd for a few hours and then gets taken out to be on an area of hardstanding with hay and so thought perhaps this was restarting some herd bound issues. I then decided to focus on in-hand work and lunging in the arena while waiting to see what difference stopping the hard feed makes.

Day 1: in-hand work with a bitted bridle, my mare was tense and nervous of most of the arena! She was pushy with her shoulder and kept stopping to rub her head. I have only re-introduced the bit recently so I initially put this behaviour down to getting used to the bit again, or that I should get a bit-fit consultant out to find the best bit and bridle set-up for her.

Day 2: in-hand work and lunging in a rope halter. She was ok with the close in-hand work, although she persisted in finding a lot of the arena scary. She refused to lunge, displaying the behaviour she showed when I first had her, of either turning in to face me, grinding to a halt, or rushing into a trot with lot of head flicking

Day 3: this morning, lunging with a cavesson (rolled leather noseband). Continuing to refuse to lunge, or rushing into a trot and head flicking when I insist that she walks on rather than turning in.

With hindsight, I can see that her behaviour is consistently worse in spring/summer. But then, I also tend to do less in winter as she's a very fair weather horse, but perhaps this is another symptom as she hates rain on her face so much? It could be allergies or sunlight if it's seasonal, but then it could also be that it's easier to get her to eat all her magnesium in autumn and winter. A quick google suggests that magnesium supplementation can help headshakers. Or it could be a permanent issue as a result of the tumour.

If it is headshaking, how would I know how much pain and discomfort it's causing her? She appears to be better on magnesium, based on her behaviour since being taken off it over the last 10 days, and also based on hazy recollections of her behaviour over the past few years. On the other hand, could it still just be that she needs consistent work which I haven't yet managed with her, and also the input of my instructor who has much better timing than I do with in-hand work, and corrects my balance when I'm riding?

On this website, https://www.an-eventful-life.com.au/eventing-news/horse-management/headshaking-horses the symptoms that she has shown at various times are:
  • Occasional head toss, episodes of intense head shaking or constant head shaking
  • Striking the air during trotting, getting very light in front (often seems to hop into trot, and sometimes chuck her head up and feel like she's going up slightly, but this improved over time. Then again, could have been as we were heading into winter again/getting more magnesium)
  • Rubbing the nose and muzzle on front leg, gates, walls and fences
  • Head may be moved up and down, side-to-side or even in a rotary fashion
  • May show pain when touched at the base of the ears (though sometimes she loves having her ears rubbed)
  • No head shaking, but getting angry and slinging the head
  • May get worse as exercise session progresses (worse when moving faster ie doesn't display issues when walking, but does when trotting either in the field, lunging or ridden)
  • May be seasonal
  • May occur only with poll flexion - not sure about this one, it's not something I've looked out for before

    I hope this makes sense, please do ask me questions for clarification. I've basically spent the last 4 years since the tumour removal flipping backwards and forwards between she just needs consistent, good work and being niggled that there's an issue. She's been treated for ulcers and hormonal issues with no effect, has had her ovaries scanned with no issues showing, no arthritis although now she's 12 maybe it's worth rechecking?
With hindsight, I can see that it's been spring and summer every year that I've been on the edge of getting the vet out for a vague, my horse isn't really in work but I think there may be something wrong check, and then it's been autumn and winter when I've been convinced it't just remembered pain and she'd settle and improve with consistent work.
 
Last edited:

ForeverBroke_

Well-Known Member
Joined
4 June 2008
Messages
10,366
Didn't want to read and run, but I know how frustrating head shaking and getting to the root of it can be, so my thoughts are with you all.

There are so many 10's of thousands of things it could be that's triggering the mis-fire (if it is head shaking) and it really is a mind field. With my limited experience, the horse had a CT scan and they kind of went from there. Sorry I can't be of any more help. The pony was retired and sent to a retirement home where he still is very happy.
 

Trouper

Well-Known Member
Joined
11 May 2015
Messages
1,544
Have a look at Tom Beech's FB page (The Osteopathic Vet) . He has had some success with head shaking cases and he would be my first call for an opinion. If he thinks it needs referral he will say so.
 

Art Nouveau

Well-Known Member
Joined
27 September 2014
Messages
380
Thanks Trouper, I'll have a look. I feel a bit lost as it can be so intermittent, and it's only just occurred to me that there might be a link with the magnesium so I haven't previously been looking for any relation between her behaviour and how much mag she'd had recently. I'm also concerned that a vet may just see a typical, uneducated thoroughbred mare. To be fair, that's all I see sometimes! But there's still a niggle at the back of my mind that crops up from time to time.

Snickett, yes I'm finding it difficult with all the potential causes! If hers is due to the tumour, it's distortion on the skull and removal then she's possibly going to be quite a unique case anyway. I'm concerned too that I won't know whether she's ever completely pain free if it is a nerve issue. Was the CT scan to diagnose headshaking, or to rule out something else?
 

ForeverBroke_

Well-Known Member
Joined
4 June 2008
Messages
10,366
Thanks Trouper, I'll have a look. I feel a bit lost as it can be so intermittent, and it's only just occurred to me that there might be a link with the magnesium so I haven't previously been looking for any relation between her behaviour and how much mag she'd had recently. I'm also concerned that a vet may just see a typical, uneducated thoroughbred mare. To be fair, that's all I see sometimes! But there's still a niggle at the back of my mind that crops up from time to time.

Snickett, yes I'm finding it difficult with all the potential causes! If hers is due to the tumour, it's distortion on the skull and removal then she's possibly going to be quite a unique case anyway. I'm concerned too that I won't know whether she's ever completely pain free if it is a nerve issue. Was the CT scan to diagnose headshaking, or to rule out something else?
I believe it was just an investigation tool that they use to look into it further / rule things in or out.
 

TreeDog

Well-Known Member
Joined
31 May 2017
Messages
159
My gelding has a similar sounding tumour in his nasal cavity. In his case surgery would be invasive and not recommended by vet so I just have to monitor him and hope it doesn't get worse.
Behaviour wise, he does rub his nose a lot, I don't know much about head shaking but this spring/summer I suspect he is head shaking a bit. He's not tossing or jerking his head, just light shaking like flies are bothering his ears but he's doing it sometimes when there's no flies about. Of course, it is easy to blame this on the tumor but could be a number of other causes too. To ride and handle he is generally very sweet, not especially stressy/tense/spooky as you describe with your mare.

If you would like op I can pm you, I can share my CT images if you are interested too.
 

BBP

Well-Known Member
Joined
17 July 2008
Messages
5,181
Mine is a seasonal headshaker, I had a head CT done as his behaviour had become so erratic that we thought he had a brain tumour and nothing unusual was found. I looked back and realised that over time there was a pattern, that he would be ok over winter but it would start as early as February and last into October. He would flick his head if raindrops or insects hit his nose and would strike out sometimes with his front legs. He was incredibly sharp and hypersensitive to noise and touch and became dangerous to ride. His eyes go very ‘pain face’ with downwards pointing eyelashes and wrinkles around the eyes and nostrils like his whole face is tense. He gets big hard temporalis muscles (forehead) like he is tensing his jaw all the time (people dismissed those muscles as an issue, but when he was at his happiest they flattened and smoothed right out to a flatter forehead). I always say it’s like he had a massive headache all the time, and then I would ask him to work and he couldn’t cope.

I had him scoped for ulcers in Oct/Nov I think and he had smallish ones near the pylorus. So I spend months treating those and his behaviour and movement improved so much, I was super happy. But this was in the winter. Then March came around and the flicking and anxiousness etc came back. So the vets agreed that we could try antihistamines. I use cetirizine, which vets can’t prescribe as it isn’t approved for horses. I’ve had great results. He will still flick in bright sunshine if bugs hit his face, and he still has bad days when I can see by his eyes and don't ask him to work, but he is so much happier. This year has been the best year for him as for the first time none of the local farmers have rape crops on the rotation nearby. Other pollen gets him too, but not having rape has been a big help. I also get best results if I start the antihistamines right at the start of the pollen season, in Feb. If I wait til later on, he has already started to develop the response to it.

He is ridden bitless with a nose net as that’s what we prefer, but if he is feeling hypersensitised then I figure the extra nose pressure may not be nice, so I ride him using a neck rope mostly.

Sadly with headshaking it can be a number of causes. I hope you get to the bottom of hers.
 

Art Nouveau

Well-Known Member
Joined
27 September 2014
Messages
380
To update this, my horse is going in to the clinic for x-rays on Friday. The vet came out to look at her and thought that should be the next step. He agreed she is in pain and said he thought her head carriage was odd even when she wasn't shaking it.
Two days ago she was apparently rearing vertical in the field after she was turned out, fell over, got up and carried on rearing.

In light of this, if we don't find anything on Friday I don't know what to do. She's never been quite right and she's not insured, so there's a limited budget for extensive investigations. The current threads on rearing have got me thinking too that it possibly isn't safe to ride her again even if we think we've found a cause and treated it.
 
Top