Friday, July 19, 2013

And the hits just keep on coming - Echo has been diagnosed with Headshaking Syndrome

I was planning for this post to be cute pictures of the kitties, with lots of happiness to counteract my earlier posts, but it's not to be. I don't know what I did to piss of the universe, but seriously, I'm at the end of my rope. To top off Oberon's death, trouble with all three of our vehicles (which resulted in the very untimely purchase of a new truck), and 7 chickens dying in last week's heat wave, Echo was diagnosed yesterday with Headshaking Syndrome.

Insert a whole lot of four-letter words here. And crying. Lots of crying.

Remember this post about Echo's ulcers, where I mentioned that he was flipping his head and not eating? I got a video of him doing it. (Note that the stuff on the ground that he's eating is soaked beet pulp, which he had just dumped out of his tub. The green bucket on the fence has 2 scoops of soaked Senior feed in it.)



At the time, I thought this behavior was ulcer-related - that is, he was flipping his head and not eating because his belly hurt him too much to eat. Turns out, it's not ulcer-related at all. Instead, it's a syndrome where the horse involuntarily flips or shakes his head in a vertical motion. The tell-tale action is the sudden jerk, like a bee flew up his nose. Horses also frantically rub their noses/faces on anything, often causing sores or cuts. It most commonly occurs in TB geldings between 7-9 years of age. It can be seasonal, with summer being the worst time. The initial trigger is unknown -there are over 60 proposed triggers, but the research shows nothing concrete.

What causes the sudden jerk is a response to neuropathic pain along the trigeminal nerves in the face. Vets think it's a sudden, sharp pain like the pain of a migraine headache in a human. Can you even imagine trying to eat your dinner, and every time you try, it feels like someone is stabbing you in the face? Or when we take a break during a ride, every time we stop, he insistently rubs his head/nose HARD on his LF leg. I thought it was a bad habit from the track, but it's a symptom of Headshaking Syndrome. In fact, he rubs so hard and so often on posts, trees, ANYTHING, that he's got cuts on his nose. My poor, poor Echo.

I've been wracking my brain as to when this started. I called Adopted Horse Mom yesterday (in tears, ugh), and we talked about if he'd done it during the month he was with her (Feb 20-March 15). He had not. I was not able to ride much the first month he was here (March 15-April 15) due to a bite to the saddle area and his mangled RF hoof, so I would not have had the opportunity to notice anything during that time. I remember my first few jumping lessons on Echo (April 15th-ish), he flipped his nose a few times when we were first warming up, and Paige commented about flies. In between May 19 and July 1, I did a number of dressage lessons where Echo snorted and sneezed when we started working, and Jeanne commented about allergies. The frantic rubbing of his face has been pretty consistent since I started dressage lessons (I remember commenting to JD during our first lesson on May 19 that it seemed to be a habit). Then somewhere between June 28 and June 30th he wouldn't eat his dinner, and that's when I really started to get worried.

Then I started trying to figure out if anything had changed. He's on a ton of supplements so it's possible that one of those was the trigger. My vet wants me to take him off everything and stop feeding him hard feed, and provide him with an all-alfalfa diet. I am really, really hesitant to do this for several reasons:

  • I've had a really hard time getting weight on him. He currently gets 15 lbs of Senior per day, including a bedtime snack. He got the same feed when he was at Adopted Horse Mom's and didn't show any symptoms, so I'm pretty sure it's not the feed. 
  • The ulcer meds (Zantac and Omeprazole) I've been giving him have helped TREMENDOUSLY - he's back to his snuggly self, and we even had a nice grooming session the other night where I got all his itchy spots and he made silly faces (as opposed to him pacing frantically, pawing, wringing his tail, and trying to kick while I groomed him just two weeks ago). He's halfway through a six-week course and I'm afraid that if we quit now, the ulcers are just going to come back worse than ever and he's going to be even more miserable. Also, he was exhibiting mild headshaking symptoms BEFORE I put him on Omeprazole the first time, so it's very unlikely that it's the trigger.
  • He doesn't eat alfalfa. I've tried pellets, cubes, flakes, and chopped. He won't touch pellets. The cubes he will eat if hand-fed as treats, but he won't touch them if they are soaked. He eats the leaves off the flakes and leaves everything else. He sort of eats chopped alfalfa, but only if it's mixed with Senior and only in small quantities. Also, for me to get 15 lbs of alfalfa down his throat every day, I would have to keep him in a stall during the day. He HATES being stall-kept, paces, and chews the walls, (even if I keep his BFF Cash with him) plus it's not good for his ulcers. I can't win.
I thought about when I'd seen him doing it, and figured out that he mostly won't eat his dinner. He generally polishes off his breakfast well enough, and his bedtime snack is no problem. I've seen him flip his head while eating hay too, during the day, but he seems to graze peacefully enough when he's out in the late evening. Many horses that are headshakers stop doing it when they are in a dark stall, because light exacerbates the problem. As a test, I went out this morning and fed a little earlier than usual, and left the barn lights off. Echo ate steadily, with no flipping or pausing - until the sun started to come up. I put his fly mask on in hopes that it would offer him a little protection, and after a bit of encouragement, he finished his breakfast, again with no symptoms. Last night I snuck out to the barn, again leaving the lights off, and watched him eat hay. No flipping or rubbing. Looking at my notes, his symptoms have also been markedly better during dinner time for the last several days, but we've had rain and it's been quite overcast. Given all these things together, I think his headshaking is caused by bright sunlight. I also think that since it started showing up in late spring/early summer, that it's seasonal. 

After reading everything I could about it last night, I'm pretty down. There are some treatments we can try, but most of them aren't very effective. Most horse owners seem to try a bunch of things and hope that one works. So here's the plan as of right now:
  • I've ordered him a Guardian Mask, which blocks 95% of UV rays. If I'm right and his is photic, this should work miracles. 
  • I've ordered him muzzle nets for riding. The constant contact of the net seems to help some horses - it's worth a try since I cannot ride him in a big mask at shows (assuming I have some hope of riding and showing him).
  • We're going to try a dex pulse - four days of high doses of dex, every 21 to 28 days. It helps some horses, not others. It would be nice if it worked for Echo.
  • Melatonin helps some horses, has low side effects, and I can get it OTC at Costco. However, it must be given at 5pm every day, year'round. It sort of fakes the horse out that it's always winter, so it can help horses that are seasonal headshakers.
  • Long-term nerve blocks (lasting 2-4 months) seem to work in about 70% of cases. On one hand, I really like this option, because it means that Echo would be pain-free. On the other hand, he won't be able to feel his face at all, and that seems like a bad thing. 
  • We may try cyproheptadine, which is an antihistamine and seratonin antagonist. It's definitely way down on my list of options, because side effects include colic and sedation. It's also a testable substance, and it sometimes work for a while and then stops..
So there you have it. I'd like the universe to please stop now. I'm usually really good at rolling with the punches, but I'm finding it really hard to cope. I am so physically and emotionally drained right now, I don't have anything left. In the grand scheme of world problems, I know this isn't that big of a thing, but right now it feels huge. I really hope that we're able to find a way to help Echo, and soon. It's hard to see him in pain.

40 comments:

  1. You know that I'm sorry :( I also think you can beat this, and know at least 1 horse that is a successful show hunter with headshaking syndrome as well. It'll be okay :)

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    1. Fingers crossed we can get it under control. There are people successfully showing horses with this problem, but I know it's hard to manage. Sigh.

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  2. I'm so sorry. It does seem like things tend to clump together, don't they? I really hope the issue is photic and the mask helps, even if it isn't a solution to showing, you should be able to ride out on the trail in it, right? If it does help, at least you know what the trigger is. Good luck and let us know if it works.

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    1. Karen, things definitely clump together. I'm hoping I've filled my quota of bad for then next 10 years or so, lol!

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  3. That is such a tough diagnosis to deal with--one of those things where there's no "Here's the cure! Yay!" fixes. Hugs to you, and I hope the bad news ends with this.

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    1. Carly, it IS a tough diagnosis. We know so little about it. I'm going to contact some of the research programs and send them my notes and timelines... maybe if enough people do this, vets will be able to connect the dots eventually and figure out a way to treat it.

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  4. Back off universe and give Jen a break!

    I hope the dex works. That is Harley's backup plan if he has trouble despite his immunotherapy shots, which I give him every 21 days. It helps his cough. I hope it helps Echo, too.

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    1. Val, some folks have had luck with allergy shots for headshaking too, but not many. We might try that if other things don't work. Thanks for the good thoughts!

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  5. Oh wow... Whoah! My 11y/o TB did this same motion for weeks in spring this year. I couldn't figure it out, he would be happily eating and then look like he got stung or bitten on the face. It seemed too early for flies but I put his mask on anyway. The whole time I was trying to find a pattern and almost calling the vet about it but held back because I assumed it was bugs and it didn't stop my horse from eating like Echo. He would eat, just twitch-ily extend his head and neck regularly.

    I wondered if it was a neuro problem until it sort of disappeared. My horse likes to scratch his head US too, but he also gets very salty skin on the face in summer. He does 1 or two cough expels at the beginning of every ride but we are very dusty.

    So while I think I have an "explanation" for our similar symptoms, this will be very helpful if the behavior returns. I did not know about HeadShaking Symdrome!

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    1. Oh my, I'm sorry to hear about your horse. I'm glad it went away quickly though - maybe it was triggered by an allergy in the spring? Impossible to know. I really hope it was a once-in-a-lifetime thing and it never, ever comes back!

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  6. When it rains it pours.... The positive thing about alfalfa is that it might help buffer the stomach if you can get him to eat enough of it. The high calcium in alfalfa is actually very helpful for "digestively challenged" ponies. I have one of those.

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    1. B, I would LOVE LOVE LOVE it if he'd eat alfalfa. But he won't, not like a normal horse. Red would be THRILLED if I gave him nothing but alfalfa... of course, he'd probably weigh 2000 lbs too. I'm glad that your horse does well on it though! Maybe someday Echo will develop a taste for it?

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  7. Geez :( You just can't catch a break over there. I'm so sorry. This is such a mysterious syndrome that we know so little about. How frustrating.

    This post is also making me paranoid...

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    1. Dom, sorry about the paranoia. I didn't mean to!

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  8. :( Hugs!! It's about time some awesome things happen for you!

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    1. Karely, it sure would be nice. I hope the universe hears you!

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  9. I feel for you Jen. You've had (more than) your share of heartbreak lately. :(

    You're obviously doing everything you can for Echo, and it sounds like you've researched the daylights out of this bizarre situation. Hope you can make him comfortable and get his mealtimes sorted out. Thinking positive thoughts for you and your pony... (((♡♡♡)))

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    1. CFS, there's actually not much to research. It's quite surprising, really, but they really don't know much about it at all. There are several vets compiling info on it, and I'll send Echo's case to them in hopes it will help.

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  10. So sorry you're having a tough time. I hope everything gets much better for you.

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  11. :( Hugs to you, yet again. I hope you find something that works for all of you.

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    1. I hope we find something that works too, SB. Thanks for the hugs.

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  12. Oh Jen, I'm so sorry, it seems like nothing is going right for you. I hope that you catch a break soon and that you figure out something to manage Echo's head shaking.

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    1. TBA, thanks. We started the dex pulse today and the melatonin yesterday - hope for miracles!

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  13. I am so, so sorry to hear this. You just don't deserve so much grief. You obviously do a GREAT job taking care of your critters. I know that Linda, who has, or had a blog called "Beautiful Mustang" had a horse with this problem. I believe she managed it somewhat by keeping the horse out of bright sunlight, but I don't know much more. Sending you many wishes for good things to happen--only good things. May Echo improve and thrive and this problem not be a big deal.

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    1. Laura, thanks. I'll try to find Linda's blog and see what she did. I also hope that we're able to manage this fairly easily and it turns out not to be a big deal!

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  14. Awe, Jen, so sorry to read this one. Things sure do pile up, don't they?

    On the mask thing, we do have an Area II horse I see now and again who does wear a full fly mask while competing due to eye damage. USEA has a disclosure/vet from and you talk to the PGJ at events. But you can get special medical compensation for a lot of different things and headshaking is totes legit recognized as a real medical thing.

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    1. E79, wow, it's good to hear that someone actually does event with this, and that the USEA is understanding of it. Mind you, we're a looong way from a recognized event, but it's good to know that when we're ready for that, it's an option.

      My vet also told me that they make sun-blocking contact lenses for horses with eye problems that have been used on headshakers as well. That's kinda cool, except I can't even imagine trying to put contact lenses on a horse! Yikes!

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    2. OMG, horse contacts? Wow, I learn something new every day!!! If you happen to think of it, email me a reminder, and I can talk to a couple friends who are wayyyyy high up in the USEA/USEF structure, enough to be able to tell me what you have to do to get an exemption letter. I mean, it's not even that big of a leap from a flybonnet, which is also allowed if conditions warrant.

      Dammit, google, I am not a robot, but I do have astigmatism and an eye Rx of 8 -- I cannot read your blurry numbers, LOL!!!

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  15. I'm so terribly sorry to hear this. Here's to hoping the universe backs off. I strongly believe that you will be able to help Echo - you are such a dedicated horse owner, if anyone can help him its you.

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    1. Megs, thanks for your kind words. I hope the universe hears you and makes it so!

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  16. I am so sorry! It seems like the universe just piles the shit on. I empathize with how your feeling. I 2nd the thought that you are fantastic horse owner and that you will do what ever it takes for Echo to feel normal.

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    1. Aw, thanks Gina, I really try hard to do right by the boys. Let's just hope that SOMETHING works!

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  17. Thanks everyone for sending such positive and hopeful thoughts to Jen; its great to see the support she has through this blog. - the hubby who is away and not able to give her the hug she really needs (and I really need) over the last couple of weeks

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  18. I am so sorry to hear this! You are an awesome person and handling everything the universe is throwing at you so well - even if it doesn't seem like it to you. Sending hugs and good thoughts your way.

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    1. WIHAH, thanks for the hugs and good thoughts!

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  19. You poor thing! It sounds like you're on track to manage it and keep him comfortable. Fingers crossed for you!

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  20. *hugs* We've talked but reiterating you have a good path forward

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  21. I am currently treating our mare for COPD and I have her on the herb Turmeric (it has helped her immensely) this is the company I order from, you might think of ordering the melatonin from them, it's much cheaper and they have a liquid form of it. http://www.swansonvitamins.com/q?kw=melatonin
    Our mare was one day away from euthanasia because of the severity of her COPD, There was nothing more the Vet could do for her.She had been on steroids for 8 months, had foundered without symptoms. She had been on turmeric about a week,at that time she couldn't lay or roll and eating was a struggle,we made the decision to let her go. The day before my husband went out to give her a peppermint and say hello, he came back in and said she was breathing better. I went out to feed and noticed she was very dirty, she had rolled! for first time in weeks.Her breathing was better and a week later no heaving and no cough. Here we are 4 months out and she is breathing normal and her hooves are starting to look nearly normal.
    Sometimes you have to try the unconventional remedies.
    Good luck and I'll keep you in my prayers.

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  22. Hey I live in Austin and my horse was diagnosed with headshaker syndrome this week - I would love to talk with yoh about treatment options etc. My email is mberbrick at grandecom.net.

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