Headshaking

EventingMum

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This is probably more veterinary but there's more traffic in here.

Long story short one of our horses was looking really miserable with half shut eyes and rubbing them, he was also tossing his head and resting his chin on the stable wall. The vet came and couldn't see anything in his eyes and flushed his tear ducts although only managed to flush one through.

Two days later he became very distressed so was referred to the vet school where his worst eye was nerve blocked and both eyes ultra sounded. Although not a completely normal presentation a diagnosis of posterior uveitis was made, his pupils dilated with atropine and steriod ointment prescribed. During his four days there he behaved impecably with no head tossing.

He was home three days when he started showing signs of distress again so was readmitted. The effects of the atropine had worn off, much sooner than expected and so he was kept in to allow more optical examinations. The following day I got a call to say he was head shaking so violently they had to sedate him to prevent him injuring himself or the staff. Having seen him as his normal well mannered self this was something of a shock to the vets and they said it's the worst case they have ever seen. The videos they showed me are awful, he was throwing himself about and rearing in the stable. They have scoped all his trachea, nasal passages, and guteral pouches and x rayed his head but have found nothing.

They suspect idiopathic headshaking but are sending him to Edinburgh on Monday for a head CT scan assuming he's settled enough to travel. If nothing is found then they suggest trying PENS Therapy with him, they have sent videos of him the the vet who pioneered this therapy and she thinks it's worth trying. I'm completely devastated, it's horrible seeing him so distressed and has come on so quickly, a couple of weeks ago nothing seemed wrong with him. I'm also aware that the long term sucess rate of PENS Therapy isn't that great. Does anyone have any experience of it? Any insights would be most welcome. TIA
 

teacups

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If you do a search for 'PENS therapy' on here there is a thread which contains a few personal experiences.

Will cross fingers for your horse, it sounds awful.
 

sidsmum

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I'm afraid I have no experience either. I'm sorry to read this it sounds very distressing for all involved. I sincerely hope they can get to the root of it and make him more comfortable.
 

baloo1

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Hi, my horse Dude is an idiopathic headshaker. My friend found your post and sent it on to me. He started headshaking 4 years ago and went through the same stages as your horse. Vets couldn't find anything, referred for CT scans, etc, and was diagnosed as an idiopathic headshaker. I presume the vet you've spoken too is Ronnie (Veronica Roberts) at Langford? Dude was part of one of her initial study trials 4 years ago and received the PENs therapy. She is utterly fantastic, I really couldn't recommend her or the treatment enough. Its a long story but he's been in remission for 3 years now and is back to work and competing fine. Yes we still have minor issues(very sensitive to flies, pollen, around his nose area) but all are workable around with fly masks, antihistamines, etc.

When he first started, I was left feeling just like you, completely helpless and hopeless as there just wasn't that much information available about the condition, and just watching him suffer made my heart break. I don't think people realise how bad it is. Dude was in agony and I couldn't do anything to help him. I only found Ronnie after loads of internet searching and it was complete luck. Due to this, and after Dude responded so well to the treatment, I set up a facebook help group called Headshaking UK. It's grown a little over the last six months but all the members are lovely and have shared their stories / advice / even just as a support network. Don't know if you're on facebook but I've added the link below for you. Also if you wanted to speak anymore on anything feel free to message me and I can hopefully help you x

https://www.facebook.com/groups/817340901700563/
 

EventingMum

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Thank you all so much. It is awful, to see such a loving, mannerly horse beside him self with pain is horrid.

Baloo1 it is Ronnie Roberts that the vets have spoken to and sent videos to. Glasgow is, I think, the only centre in Scotland doing PENS Therapy so if nothing is found on the CT scan that will be the next step.

The vets in Glasgow have been fantastic and they tell me Ronnie Roberts is developing a nutriceutical to treat headshaking so have expressed an interest in that with her. They have expressed concern at travelling him to Edinburgh on Monday morning in case he becomes distressed during the journey and we get stuck in rush hour traffic so Edinburgh have agree to admit him on Sunday afternoon so hopefully we'll have a smooth journey.

I will join the Facebook group, thank you for the link. I'll keep you up dated on what happens.
 

baloo1

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No worries at all. Ronnie is utterly fantastic and really cares about her horse patients. Honestly, I couldn't say enough nice things about her and the PENs therapy, she genuinely gave me back my horse and I'm eternally grateful. Don't know if you saw the series on BBC2 called Trust me I'm a vet? She was featured on that and Dude was featured as the 'happy ending'. It shows the PENs therapy treatment being carried out on another horse and would give you a little insight of what your horse would be going through. If you can't find it on youtube, I have the footage which I could send to you online if you drop me your email address. Might help put your mind at rest a bit. I saw the new treatment she is trialling the other day, I shared the article in the group.

Will have my fingers crossed for you both.
 

Bradsmum

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Couldn't read and run. Earlier this year my horse was diagnosed as a class 1 headshaker and there was talk of CT scan and possible referral for PENS treatment. Symptoms not as violent as those you are experiencing but I know how distressing it is to see them so uncomfortable and not being able to do anything for them. We managed to control Bs headshaking with antihistamines and Global Herbs Pollenex and he is now back in work. Don't give up hope because I really thought the worst for B and am v relieved that we have managed his symptoms for now. Good luck.
 

EventingMum

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Couldn't read and run. Earlier this year my horse was diagnosed as a class 1 headshaker and there was talk of CT scan and possible referral for PENS treatment. Symptoms not as violent as those you are experiencing but I know how distressing it is to see them so uncomfortable and not being able to do anything for them. We managed to control Bs headshaking with antihistamines and Global Herbs Pollenex and he is now back in work. Don't give up hope because I really thought the worst for B and am v relieved that we have managed his symptoms for now. Good luck.

Unfortunately when we tried antihistamines we didn't see any difference in his symptoms.

He had his CT this morning and all went well in so far as he kept still for it. An initial look at the scan didn't show anything but the images still have to be analysed properly. He's back at Glasgow Vet School now and once the reports on the scan are back a plan will be made as to where we go from here. My gut feeling is the Gabapentin and ACP are having an effect just now but who knows for sure?
 

EventingMum

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Scan results are back and didn't show anything. So the plan is to keep him on the Gabapentin and start PENS treatment tomorrow, after three treatments he'll be weaned off the Gabapentin. Fingers crossed he's one of the lucky 25% who gains long term benefit from it.
 

EventingMum

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He had his PENS treatment yesterday and tolerated it well so I brought him home today. A short while ago he started head shaking again so I phoned the vet school and was told to give him some ACP and I'm now waiting to see if it helps. I've to call them if he doesn't settle or gets worse anytime, even through the night and they'll phone me in the morning if they don't hear from me. Devastated doesn't begin to describe it :(
 

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I'm so sorry for you, I can totally sympathise - Headshaking is a truly heartbreaking condition (I speak from personal experience)...
I really hope you can help your boy....
 

teacups

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Can't believe it, poor boy is looking miserable with his head squashed againist the wall and the ocassional head shake, really hoping it doesn't escalateand he has to be sedated again :(

Oh no - it must be so hard to watch him like that.
How did it go, and how is he today?
 

EventingMum

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We managed just to keep an eye on him and by 11 pm he was fine. He's started again this evening so I thought perhaps it was following on from getting his eye drops in but then he doesn't react the same way to getting them in each morning so it's probably not that. Another theory is that it could be coming in to a darker stable from outside - I really don't know. He certainly wasn't like this before his PENS treatment so it seems to have stimulated thingsat present. He's due his next treatment on Tuesday but I'll obviously speak to the vets beforehand.
 

Pearlsasinger

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Does he only do it in the stable?

Could it be a reaction to something in the stable? Disinfectant? Bedding? Paint on walls?

I remember years ago, there was a particular clothes shop that I couldn't go in because my eyes started streaming as soon as I stepped through the door - it was a reaction to their carpet cleaner.
 

kate2323

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My pony had everything - veterinary and natural therapies - drugs you name it - including Pens and nothing worked so sad but only resort now is to pts as seems no cure for him
 

EventingMum

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UPDATE: Not good I'm afraid, we managed to have him turned out happily for two days but still had issues at night, however yesterday morning he wasn't good and when turned out he tried to rest his face on another horse and then started galloping about madly. We brought him in and he was really distressed so ended up with the vet sedating him again, once that wore off he was still having tics etc. Today, after speaking to the vets at Glasgow we orally sedated him and took him back up there. They've put a catheter in so they can sedate easily and are putting him back on steroids and probably some pain relief too. They say he could be in up to two weeks and a decision will be made as to when to do his next PENS treatment depending on how he is. It's utterly heart breaking to see such a lovely horse like this and not know what the prognosis is.
 

redapple

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So sorry to hear this EM. At least you know you are doing absolutely everything you can for him and have him at the best place possible.
 

GirlFriday

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Really sorry to hear this.

Idiopathic headshaking isn't really a diagnosis. It is a description of a symptom they don't know the cause of. On the face of it it seems to me that
- horse had minor eye infection
- horse partially treated
- eyes get worse
- horse goes to vet school
- horse comes home
- horse headshakes in stable at home
- horse headshakes in stable at vet school

In your situation I'd go for as many diagnostics as my wallet/insurance allowed along side the PENS (and whatever other pain relief etc you find helps) and get him out 24/7 and off the original eye-related treatments asap.

As per a poster above undoing any management changes at all (new batch of forage when stabled to add to the list of possible allergens etc, etc) and keeping him away from environments that seem to trigger it may be as good a bet as anything else you've got left after PENS.

Good luck.
 

Clare85

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How terrible for you op, I'm so sorry. I have a headshaker who was diagnosed as trigeminal mediated by Veronica Roberts earlier this year. We tried EquiPENS with only limited success unfortunately. They fully expect the headshaking to return after the first two treatments, as each horse needs at least three treatments for it to have any long term effects.

I really hope you can get your boy's condition under control. It is the most horrendous condition, I know exactly how heart breaking and stressful it is to see and deal with.

Your boy's case sound particularly distressing. Our girl is currently fine in the field, luckily, as it only affects her significantly under saddle or on the lunge. She is about to take part in a new clinical trial for a new treatment, so it will be interesting to see how that pans out.

I will keep everything crossed that you begin to see improvement in your boy. Wishing you all the best x
 

EventingMum

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Thanks everyone,

I've racked my brains, as has everyone else on the yard, and we cannot come up with anything that has changed recently. The horse has been in the same stable for six years, we haven't change any feeding, forage or bedding lately plus he has displayed the same behaviour at the vet school. I'm not sure we have much left in the way of diagnostics as he's been x-rayed, had a CT scan. As far as putting him out 24/7 it's not really safe, when turned out yesterday he galloped about manically head shaking and wasn't far off going through a fence.
 
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