Trigeminal Nerve pain

[Breagha]

Hi all,

Has anyone dealt with this in their horses? My horse is currently under investigations for this. If she has it, then she is the 1% that is not seasonal.

She only seems to do it when bitted and a little in a hackamore.

We are ticking different boxes before I send her for more investigations.

Thanks
Jenna

 

[PinkvSantaboots]

I did a reply on your other thread I didn't see this one sorry, it may be of interest to you hopefully.

 

[Breagha]

I did a reply on your other thread I didn't see this one sorry, it may be of interest to you hopefully.

thank you. I replied.

I thought I would do a post with the name in the heading to see other peoples experience with it also. For tips etc.

 

[archiesmum]

My mare has been undergoing investigations to see if she has Trigeminal Nerve Pain - when she has a bit in and you pick up the reins her tongue almost trys to escape her mouth and falls out to the right hand side. Tried different types of bits and bridles but still the same. She has had a CT scan which showed nothing untoward and have just finished a 21 day trial of Gabapentin at 120 tablets a day to see if it is nerve pain. By the last day of the Gabapentin there was a good improvement so I am now waiting to see what the vets next steps are. She doesn't do it in a hackamore and has a lovely still mouth.
Good luck, it appears to be a rather long and winding road!

 

[Breagha]

My mare has been undergoing investigations to see if she has Trigeminal Nerve Pain - when she has a bit in and you pick up the reins her tongue almost trys to escape her mouth and falls out to the right hand side. Tried different types of bits and bridles but still the same. She has had a CT scan which showed nothing untoward and have just finished a 21 day trial of Gabapentin at 120 tablets a day to see if it is nerve pain. By the last day of the Gabapentin there was a good improvement so I am now waiting to see what the vets next steps are. She doesn't do it in a hackamore and has a lovely still mouth.
Good luck, it appears to be a rather long and winding road!

Good luck with your investigation with your mare.

So far, I have tried different bits, different bridles, high dose danilion to see if any better but wasn't, xray of her mouth. I have just switched her onto haylage and put her on anti histamines. Next thing would be nerve blocking but I am waiting for the vet to call me to discuss.

I have also found my mare is less happy getting her saddle on (she was never thrilled but will turn her head to me with ears back).

 

[webble]

Yes, tried a variety of bits, bitless and numerous medication including gabapentin with no success.
I did a lot of research into the pens treatment and discussed it with my vet and decided the success rate was too low and eventual recurrence rate too high to be worth putting the horse through it

 

[Breagha]

Yes, tried a variety of bits, bitless and numerous medication including gabapentin with no success.
I did a lot of research into the pens treatment and discussed it with my vet and decided the success rate was too low and eventual recurrence rate too high to be worth putting the horse through it

Did you end up retiring the horse?

I am not sure how much more I am willing to do with my mare as I have heard and been told by my own vet that alot of treatments are not 100%.

 

[SBJT]

A friend of mine has this problem with her horse. It’s pretty young still but from what we understand there isn’t much that can be done. She’s essentially semi retired at this point as it can flare up at any time and typically when she starts to get hot, or she’s been worked for a while. The vets investigations found nothing so it’s more that anything else has been ruled out at this point.

 

[Breagha]

A friend of mine has this problem with her horse. It’s pretty young still but from what we understand there isn’t much that can be done. She’s essentially semi retired at this point as it can flare up at any time and typically when she starts to get hot, or she’s been worked for a while. The vets investigations found nothing so it’s more that anything else has been ruled out at this point.

Yes, I found when my mare got warm/hot when ridden it got worse and she wanted to itch her face also. Which is apparently a sign.

 

[webble]

Did you end up retiring the horse?

I am not sure how much more I am willing to do with my mare as I have heard and been told by my own vet that alot of treatments are not 100%.

Yes. I actually had him PTS in the end because he was only 9 and having days when he was miserable just in the field

 

[nutjob]

Have you tried a nosenet? That was a massive help for my horse who was confirmed to have trigeminal neuralgia. The nerve block is not too expensive and at least it will help you make decisions about your mares future. If positive you may be able to work out what are the triggers for your horse and alter your management to help.

Mine was worse in rain or bright sunlight, particularly when the sun was low in the evening and lots of flies about, he was better in the morning. Also affected when the light level changed suddenly like coming out of a wood. Basically normal in an indoor school. He also had allergies so it might be worth stripping back the diet to the very basics and see if this helps, it takes at least a couple of weeks to see the affect.

It's worth keeping a diary of when your horse is OK and when she is worse. Note down what tack you are using, what the weather is doing, what sort of work you are doing etc and if she is symptomatic in the field.

This is useful http://www.newmarketequinehospital.com/headshaking-in-horses/ it looks like things have moved on a bit since my horse was diagnosed and it doesn't look like they are recommending nerve block so much now and there are some additional treatments to try. Good luck it's a complex problem.

 

[Breagha]

Have you tried a nosenet? That was a massive help for my horse who was confirmed to have trigeminal neuralgia. The nerve block is not too expensive and at least it will help you make decisions about your mares future. If positive you may be able to work out what are the triggers for your horse and alter your management to help.

Mine was worse in rain or bright sunlight, particularly when the sun was low in the evening and lots of flies about, he was better in the morning. Also affected when the light level changed suddenly like coming out of a wood. Basically normal in an indoor school. He also had allergies so it might be worth stripping back the diet to the very basics and see if this helps, it takes at least a couple of weeks to see the affect.

It's worth keeping a diary of when your horse is OK and when she is worse. Note down what tack you are using, what the weather is doing, what sort of work you are doing etc and if she is symptomatic in the field.

This is useful http://www.newmarketequinehospital.com/headshaking-in-horses/ it looks like things have moved on a bit since my horse was diagnosed and it doesn't look like they are recommending nerve block so much now and there are some additional treatments to try. Good luck it's a complex problem.

Yes, I tried a nose net and it didn't make any different. Her trigger is having a bit in her mouth and pressure on her face.

I spoke with a vet from lanark tonight and they have advised CT then possible PENS treatment but it is not 100% guaranteed x

 

[Fellewell]

https://research-information.bris.ac.uk/ws/portalfiles/portal/185830125/Roberts_VMRR.pdf

This is an interesting article. I lost my gelding 8 years ago, he became unrideable and after 18 mths of retirement he was 'twitching' in his field. I had to let him go.

 

[Breagha]

https://research-information.bris.ac.uk/ws/portalfiles/portal/185830125/Roberts_VMRR.pdf

This is an interesting article. I lost my gelding 8 years ago, he became unrideable and after 18 mths of retirement he was 'twitching' in his field. I had to let him go.

I will give it a read. I haven't seen my mare twitching in the field but I am very aware it can get worse and she could do this.

I am still trying to decide whether I send her down to the dick vets for CT scan and possible PENS treatment but haven't read alot of successful stories yet. X

 

[Fellewell]

I will give it a read. I haven't seen my mare twitching in the field but I am very aware it can get worse and she could do this.

I am still trying to decide whether I send her down to the dick vets for CT scan and possible PENS treatment but haven't read alot of successful stories yet. X

I tried everything available at the time, hopefully they've made some progress now.

 

[Breagha]

I tried everything available at the time, hopefully they've made some progress now.

I have read the PENS treatment is only 38% successful but timeline of remission is unknown. X

 

[webble]

I read a few vet websites that had wording such as good success rate re PENS but no actual figures. The two sites I found with actual data didn't fill me with confidence with regards to long term out come. As you say around 38% effective but that could be for as little as 3 months

https://www.dovepress.com/trigemina...nd-manage-peer-reviewed-fulltext-article-VMRR

http://www.newmarketequinehospital.com/headshaking-in-horses/

 

[Flowerofthefen]

.y now retired 26yo wb was a terrible headshaker. I had to ride early morning before the pollen got bad. He was terrible the field. Funny enough he was fine at competitions. I think it gave him sometelse to think about. He fully retired about 5/6 years ago and hasn't been anywhere near as bad since retiring. It really is a horrible distressing thing to see.

 

[mavandkaz]

Can't really add too much, just to say I hope you find something to help.
My boy is a head shaker, I tell people it's seasonal/pollen allergies but I've never really got to the bottom of it. Weather certainly has an affect, especially wind. He is a sensitive horse to touch, and things such as clipping really affect him (even other horses being clipped).
When it's bad, he will stand in his field/ stable flicking his nose. You can see it's where the nerve is firing as it's a real jolt. At its worst he can't eat as the touch of grass or hay against his nose triggers it luckily this is quite rare. I can tell when he's struggling as his ears go flat out sideways.
What I do find interesting is the he finds a firm pressure on his muzzle quite soothing. If he's having a bad day he will bury his muzzle in-between my arm and side as he's being led, and he loves me scratching his muzzle, or even just resting my hand on it.
Luckily he is better being ridden then at rest. He seems to cope better if he his distracted and having to think. I use a nose net, and he will quite often play with it and hold the edge of it in his mouth whilst being ridden. My instructor has mentioned that he knows of similar horses who have improved when ridden in bits with a curb as they find it comforting.
I did look into electro acupuncture but never got round to trying in.
Good luck.

 

[nutjob]

OP, your horse sounds a bit different than a classic case of trigeminal neuralgia possibly a good thing. A CT might show up something which can be treated, like a tooth root or sinus problem. Depending on cost I would be inclined to go for this and it also gives you another vets opinion which could be useful. If you haven't already, it's also worth getting the vet to have a good look inside the ears while sedated. I know of one who started headshaking when the ears were clipped and the hair went in them.

 

[spotty_pony]

Yes. My old boy who I sadly lost last year (not due To the head shaking but something else) Randomly started headshaking but only in the stable luckily At his worst, he could even eat. I found that a nosenet helped him which he had to wear in the stable, on a leather headcollar as for a while this was the only way he could eat. He went to Rossdales for investigations and they said it was nothing like they’d ever seen before. He had a CT scan and everything was normal, We tried steroids, soaking hay in case it was a dust allergy, he was scoped, we had ears, eyes, nose and teeth looked at in detail and then we have the nerve blocks done To see whether it was trigeminal neuralgia. The nerve blocks were negative and so we didn’t go forward with the Pens treatment. I wasn’t sure about him having that anyway as a success level isn’t that high and it is quite an invasive procedure and one that would need redoing regularly and would be very expensive once the insurance had run out. I controlled it just by him wearing a nose now as luckily that stopped him from doing it. He had a swollen lymph node and his jaw at the time which the vet said was unrelated to the head shaking. Then one day it became burning hot and abscessed and Vet took a biopsy from it and it turned out to be some really rare bacteria. It took two lots of antibiotics to get rid of this and one of the side-effects for this not being treated early enough is nerve damage. So we now believe the abscess was related to the head shaking. He still headshook in the stable and had to wear a nose net a lot of the time but would go months towards the end without having to wear one and then occasionally sometimes need to but apparently with headshaking they can go into stages of remission where it starts and stops. It doesn’t sound like your boy has the same thing as mine but if there’s anything you want to know about trigeminal neuralgia then feel free to message me as I’m like a walking encyclopaedia for it as I spent a lot of time studying it when I was looking for answers with my boy.

 

[Breagha]

I read a few vet websites that had wording such as good success rate re PENS but no actual figures. The two sites I found with actual data didn't fill me with confidence with regards to long term out come. As you say around 38% effective but that could be for as little as 3 months

https://www.dovepress.com/trigemina...nd-manage-peer-reviewed-fulltext-article-VMRR

http://www.newmarketequinehospital.com/headshaking-in-horses/

I had a quick read of the above links, I think I have read them but I have read so much it all blurs into one.

My mare has been referred to the Dick vets for a CT scan so I am just waiting for a phonecall with a date.

.y now retired 26yo wb was a terrible headshaker. I had to ride early morning before the pollen got bad. He was terrible the field. Funny enough he was fine at competitions. I think it gave him sometelse to think about. He fully retired about 5/6 years ago and hasn't been anywhere near as bad since retiring. It really is a horrible distressing thing to see.

She didnt start getting bad until August and has continued to get bad so I don't think her trigger will be pollen for her headshaking. Another horse on the yard is affected by pollen and is always ridden in a nose net plus on anti histamines in the summer.

Can't really add too much, just to say I hope you find something to help.
My boy is a head shaker, I tell people it's seasonal/pollen allergies but I've never really got to the bottom of it. Weather certainly has an affect, especially wind. He is a sensitive horse to touch, and things such as clipping really affect him (even other horses being clipped).
When it's bad, he will stand in his field/ stable flicking his nose. You can see it's where the nerve is firing as it's a real jolt. At its worst he can't eat as the touch of grass or hay against his nose triggers it luckily this is quite rare. I can tell when he's struggling as his ears go flat out sideways.
What I do find interesting is the he finds a firm pressure on his muzzle quite soothing. If he's having a bad day he will bury his muzzle in-between my arm and side as he's being led, and he loves me scratching his muzzle, or even just resting my hand on it.
Luckily he is better being ridden then at rest. He seems to cope better if he his distracted and having to think. I use a nose net, and he will quite often play with it and hold the edge of it in his mouth whilst being ridden. My instructor has mentioned that he knows of similar horses who have improved when ridden in bits with a curb as they find it comforting.
I did look into electro acupuncture but never got round to trying in.
Good luck.

I have never noticed her doing it in the field yet but before it wasnt something I would be looking for. When my mare started she was being ridden in a pelham with a chain so not sure if this makes a difference as when we did the danilion course I tried riding her in both her pelham and snaffle and neither were any better or worse.

I am waiting for the Dick vets to phone me to make an appointment for a CT scan.

OP, your horse sounds a bit different than a classic case of trigeminal neuralgia possibly a good thing. A CT might show up something which can be treated, like a tooth root or sinus problem. Depending on cost I would be inclined to go for this and it also gives you another vets opinion which could be useful. If you haven't already, it's also worth getting the vet to have a good look inside the ears while sedated. I know of one who started headshaking when the ears were clipped and the hair went in them.

Hi, I am currently waiting for the Dick vets to get in touch for a date for the CT head. Will take it one step at a time at the moment. That is one thing I have never seen the vet do is check her ears so worth an ask next time they are out or they could do it when she gets her scan.

Yes. My old boy who I sadly lost last year (not due To the head shaking but something else) Randomly started headshaking but only in the stable luckily At his worst, he could even eat. I found that a nosenet helped him which he had to wear in the stable, on a leather headcollar as for a while this was the only way he could eat. He went to Rossdales for investigations and they said it was nothing like they’d ever seen before. He had a CT scan and everything was normal, We tried steroids, soaking hay in case it was a dust allergy, he was scoped, we had ears, eyes, nose and teeth looked at in detail and then we have the nerve blocks done To see whether it was trigeminal neuralgia. The nerve blocks were negative and so we didn’t go forward with the Pens treatment. I wasn’t sure about him having that anyway as a success level isn’t that high and it is quite an invasive procedure and one that would need redoing regularly and would be very expensive once the insurance had run out. I controlled it just by him wearing a nose now as luckily that stopped him from doing it. He had a swollen lymph node and his jaw at the time which the vet said was unrelated to the head shaking. Then one day it became burning hot and abscessed and Vet took a biopsy from it and it turned out to be some really rare bacteria. It took two lots of antibiotics to get rid of this and one of the side-effects for this not being treated early enough is nerve damage. So we now believe the abscess was related to the head shaking. He still headshook in the stable and had to wear a nose net a lot of the time but would go months towards the end without having to wear one and then occasionally sometimes need to but apparently with headshaking they can go into stages of remission where it starts and stops. It doesn’t sound like your boy has the same thing as mine but if there’s anything you want to know about trigeminal neuralgia then feel free to message me as I’m like a walking encyclopaedia for it as I spent a lot of time studying it when I was looking for answers with my boy.

Thanks - the nose net didnt make a difference to my mare at this time but hoping once we get a CT scan we can decide what to do from there. I am on the fence with the PENS treatment due to the low success rate but part of me is thinking she is only 10, maybe I should try it but I am not going to set anymore decisions in stone until we get the results of the scan.

 

[ycbm]

It's worth keeping a diary of when your horse is OK and when she is worse. Note down what tack you are using, what the weather is doing, what sort of work you are doing etc and if she is symptomatic in the field.

I highly recommend this, and add blink rate and whether she has a visible fan of tense muscle on her cheek, almost like a hand print.

In my horse, who I had put down at 7 after drugs failed to help him, both of those correlated strongly with wind and sun.
.

 

[Breagha]

I highly recommend this, and add blink rate and whether she has a visible fan of tense muscle on her cheek, almost like a hand print.

In my horse, who I had put down at 7 after drugs failed to help him, both of those correlated strongly with wind and sun.
.

Thanks - she is at her worst when being ridden. Really bad when in a bit. She is much better in a hackamore but once she heats up herself, she will start headshaking again but not to the same extent as when bitted.

When we were at Blair last year it was roasting when we were in our class but obviously has been colder when trailing different things at home.

I am going to get the CT head in the first instance now. I am not going to ride until we have more answers as she is obviously in some form of discomfort.

I would need to clip her face to see anything on it at the moment as she is a hairy bear. lol

 

[pastit]

I had a non seasonal headshaker - worse in bright sunlight because I think he had a permanent headache. I recommend you get a lameness workup or visit Tom Beech's clinics.
I know that my horse had an arthritic neck joint as a 5yr old and poor conformation in front which eventually resulted in coffin joint arthritis. But I swear it was all linked to the head shaking. It could result in extreme behaviour, so we managed it and kept him very fit and as comfortable as possible. Regular physio always found a locked jaw and poll tightness. Head, bitting and teeth problems are often linked to the back end or poor gait and my horse was pretty lame on the left fore on a 10m circle on hard, but sound on other surfaces. The headshaking was always worse at the end of a long hack, or when he'd had a hooley on rough ground. Towards the end (he was 17) he liked flat ground, and flat bedding - he couldn't bear shavings, so we put him on straw. A nose net was essential piece of kit. Hope this helps and that you find your answers.

 

[Breagha]

I had a non seasonal headshaker - worse in bright sunlight because I think he had a permanent headache. I recommend you get a lameness workup or visit Tom Beech's clinics.
I know that my horse had an arthritic neck joint as a 5yr old and poor conformation in front which eventually resulted in coffin joint arthritis. But I swear it was all linked to the head shaking. It could result in extreme behaviour, so we managed it and kept him very fit and as comfortable as possible. Regular physio always found a locked jaw and poll tightness. Head, bitting and teeth problems are often linked to the back end or poor gait and my horse was pretty lame on the left fore on a 10m circle on hard, but sound on other surfaces. The headshaking was always worse at the end of a long hack, or when he'd had a hooley on rough ground. Towards the end (he was 17) he liked flat ground, and flat bedding - he couldn't bear shavings, so we put him on straw. A nose net was essential piece of kit. Hope this helps and that you find your answers.

Hi,

Thanks for your reply. Apart from the head shaking my mare is completely sound as that has already been checked by my vet. She is now booked in for a head CT on the 2nd Feb at the Dick Vets in Edinburgh.

 

[Breagha]

Update:

Breagha was down at the Dick vets in Edinburgh yesterday and the did a full examination on her, checked teeth again (all ok), she was scoped (all clear) and CT head (again all clear) so she has now been given the diagnosis of trigeminal neuralgia. So I have decided to retire her as she is only triggered when ridden and is comfortable in the field. Spoke with vet about possibly having a foal and they were happy for her to do so. So I think this is my new plan.

I am gutted!

 

[PinkvSantaboots]

Update:

Breagha was down at the Dick vets in Edinburgh yesterday and the did a full examination on her, checked teeth again (all ok), she was scoped (all clear) and CT head (again all clear) so she has now been given the diagnosis of trigeminal neuralgia. So I have decided to retire her as she is only triggered when ridden and is comfortable in the field. Spoke with vet about possibly having a foal and they were happy for her to do so. So I think this is my new plan.

I am gutted!

Sorry to hear that I would be gutted as well.

 

[Breagha]

Sorry to hear that I would be gutted as well.

Thanks - she still has a home for life with me. So maybe she can give me my next horse instead.

 

[nutjob]

Very sorry I was hoping you would have a better outcome. Well done for doing the best for your horse.