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.