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.