Saturday, August 3, 2013

Headshaking Syndrome - good days and bad days

I've started a daily diary of Echo's headshaking symptoms, along with treatments. I'm trying to make a page that shows my spreadsheet, but so far Blogspot is not cooperating with Google Docs, so you'll have to wait for the nitty-gritty details. Let's just say that there are days when the only symptoms he shows are sneezing and a little nose-rubbing, and days when he's so uncomfortable that cannot eat at all, unless it's pitch black out. Those are the days that break my heart.

Before I get into things, let me define the behaviors that Echo shows as a result of headshaking:

  • Rubbing his nose/face on anything and everything, hard
  • Snorting and sneezing (most noticeable when he's running around, or while eating)
  • Pausing while eating - just sort of standing in front of his feed bowl, looking like he wants to eat but just can't. These pauses can last from a few seconds to minutes, and sometimes they're as long as his entire dinner time. This is when he just can't eat.
  • Flipping his head and neck in an up-and-down motion
  • Jerking his head up and in, as if he's been stung on his nose by a bee

We started Dex Pulse Therapy (DPT) on Saturday, July 20. He got 60 mg on the 20th and 21st, 40 mg on the 22nd and 23rd, and 20 mg on the 24th and 25th.

During and for several days after DTP, his symptoms were reduced to almost nothing. He'd dive into his dinner and polish it off, whereas before we started DTP he practically couldn't eat his dinner, and exhibited head flipping and jerking symptoms while trying to eat. I was gone the 26-28th, but MC house-sat and said Echo ate everything. It was also rainy and cloudy while I was gone, and I definitely think that helps. Unfortunately, by the 30th he was pausing for long periods of time while eating, and on the 31st he simply would not eat dinner at the usual time. We managed to get him to eat at 10 pm when it was pitch black out - he ate quite happily and showed no headshaking symptoms then.

Echo has a Guardian mask, which blocks 95% of UV rays, which arrived on the 20th. He's been wearing it from sunup till full dark every day since. I don't know how much it really helps him, but I suspect it does as he shows no symptoms at all when it's dark out. I am kind of unwilling to take the mask off during the day and see how bad his symptoms become, but we will probably do that at some point in time as part of the data collecting.

I've also started keeping Cash and Echo up in the barn during the day. They hate being stalled, but the barn is essentially a big run-in shed, so I simply put all their hay up in the shady area, and that seems to keep them up for the most part. I've also started to feed more alfalfa, per the vet's request. Echo has suddenly decided that it's OK stuff, so he and Cash split a couple of flakes, along with a bucket soaked beet pulp, every morning. They also still get regular hay, so I can't really tell if the change of diet is making a difference. I guess time will tell.

Since the symptoms have gotten so much worse again, and we still have two weeks to go before the next round of DPT, I consulted with my vet yesterday (the 2nd) about other treatment alternatives. Starting today (the 3rd), he's on 4 mg of dex daily, along with 6 G of Magnesium. Generally, folks don't have a lot of success with low doses of dex, and long term usage carries quite a few risks, but anything is worth a try right now. The Mg helps calm the nerve firings, so maybe that will reduce his symptoms as well. We're going to try this for a week or two and see where we're at, then reassess.

Unfortunately, there aren't a lot of other options to try, and none of them seem to be 100% effective. If the dex and Mg don't help, we will likely try a short-term nerve block to see if that works. If it does, then we'll do a longer-term block. I could try Cypro (an antihistamine), but it's really expensive, causes colic and laminitis, and is testable. It also tends to stop working after 6-18 months of use.

This disease seems to be a big guessing game, where you throw things at your horse and hope like hell that something works to relieve his pain. We're still looking for something that works, because the alternative to finding something is really too sucky to contemplate.

24 comments:

  1. These "voodoo" treatments, as my hubby calls them, are really hard on your nerves. You either don;t know what's wrong or you don't know how to fix it. Waiting for that eureka moment is sooo stressful.

    I know that you will always do what is best for Echo.

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    1. Lol, Gina, they really do seem like 'voodoo' treatments. It's hard to treat a syndrome where the trigger is unknown and the disease itself isn't understood. It seems like trying to treat migraines of fibromyalgia in humans. Hopefully we'll find something that works.

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  2. You know I'm here and hoping for the best for you and Echo. Stay strong.

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  3. Awww, I hate when I have to just guess along too! Great idea on the spreadsheet though and I've got everything crossed for you and Echo!!

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    1. Spreadsheets are one of those times where my data-driven OCD tendencies actually come in handy! Hopefully we'll be able to find a pattern and a treatment that works.

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  4. Excuse me for not paying attention if you already addressed this Jen, but had Echo ever shown any symptoms at his previous barn, or at the interim place he stayed? Is it common for this condition to appear out of the blue?

    Sending jingles out to Austin! One day at a time...

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    1. We don't know if he ever showed any symptoms while turned out in Florida. He was basically out to pasture for 2 years, without a whole lot of attention, so it's doubtful that anyone would have noticed. He did not show any symptoms when I tried him out in Florida in February, nor while he was at Adopted Horse Parent's house from mid-Feb through mid-March.

      And yes, sadly, it's quite common for these symptoms to appear out of the blue.

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  5. :( I like your lists, charts, and insane note taking.

    After reading your notes and research, I think Cuna might actually be a mild head shaker. The head shaking/flipping is totally him. I always think it's bug related, but given that bugs are also seasonal, who knows.

    Fingers crossed for you guys.

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    1. SB, it is an up-and-down shake, like in the vid of Echo, or more of a side-to-side? Headshakers are up-and-down. And it's often seasonal, so it's entirely possible that Cuna has a mild case.

      You should take a vid and send it to UC Davis. They're doing a ton of research there - even if Cuna's case is mild, it would be another data point for them.

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  6. Thinking of you and fingers crossed that Echo gets some relief. And you also. I can only imagine how frustrating and sad this would be.

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    1. Laura, it's pretty depressing, not gonna lie. Thanks for the crossed fingers - let's hope we can find something that works out!

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  7. Sorry for everything you are going through. I hope Echo gets better.

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  8. Glad to have an update- been thinking and wondering about you and Echo.
    Hoping that it all gets better for you. I've got everything crossed! Give Echo a smooch for me.

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    1. Sometimes it's hard to update when you don't have anything fabulous to share, you know? I hate to sound like I'm whining all the time.

      Echo sends a delicious grain-slobber smooch back to you! ;)

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  9. Thank you for the update, I have been wondering how you and Echo have been doing. I wish I could offer some suggestions to help, though it sounds like you are literally doing everything possible and then some. Hang in there.

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    1. Unfortunately this is very much a wait-and-see-what-works game. I am just hoping that SOMETHING will help. Anything.

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  10. The aversion to sunlight is really strange. Hopefully, it means that he may get relief as you approach the winter solstice. You bought him during the winter, right?

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    1. Actually, lots of horses are photic headshakers, and it does get better in the winter. Maybe I'll have a nice horse October-April, and he'll only be affected during the summer? Only time will tell.

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  11. We're rooting for you to find a treatment that is compatible with Echo, hopefully sooner than later. I'm sure your organization and documentation of all his symptoms will make it that much easier to manage this, especially in the long term. Sending hugs to all your boys!

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    1. Thanks, Megs. Finding a treatment that works - and keeps working - is the ultimate goal here. Unfortunately, overall prognosis for something is poor. :(

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  12. Jen, I've been hunting for this link - you may already have seen it - but I came across it months ago and didn't save it as I didn't have a head-shaker(!). Its interesting though because a lot of the problems they describe ring bellswith feet too - funny old thing(!)...

    Anyway, here it is: http://www.webtrenddesigns.com.au/Head%20Shaking/hsarticles.html

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    1. Nic, thanks for this! There are some super-helpful articles in there. I actually passed a few on to my vet.

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