Page 76 - May 2017

HeadsHaking treatments aimed at eliminating or reducing tHe beHavior include . . .
Nose mask. These should fit firmly around the muzzle and attach to the noseband to apply pressure over the face and give some relief.
“Some of these horses respond to a nose mask,” Wilkins continued. “I used to make these out of pantyhose, but very few people wear pantyhose anymore. The nose mask
is something that can fit firmly around the muzzle, attached to the noseband. Its purpose is not to filter out bugs or dust, but to put pressure over that part of the face. I usually cut openings for the nostrils. It’s similar to pushing against your nose when you have to sneeze.” It gives some relief from that sensation.
These horses are extra-sensitive to many things; therefore, insect control is also important because they are easily affected by anything flying around their face.
“Some people feel that magnesium supple- mentation may help, but you need to be careful with that and not over-sedate the horse with too much magnesium,” Wilkins says. “There is a product called Quiessence that can be used.
Some people use this in show horses to keep them quiet. It may provide some relief to some headshakers, and we recommend a slightly higher dose than what is on the label, but we also tell people to work with their veterinarian to find out what the effective dosage should be, if it is helpful.
“We used to use a lot of cyproheptadine
on these horses, but this drug may cause some horses to colic. Some horses respond very well to this treatment, but you can’t use this in a show horse or racehorse. Another treatment
is dexamethasone pulse therapy. This may
be worthwhile if the horse has an inflam- matory response in the nerve. If the nerve is the primary cause, dexamethasone may help. Some horses do very well with this treatment,” she says.
“It may be worth trying, but data on treat- ments can be hard to get because horses don’t
Special face masks. A horse can wear these as needed or continually to provide a visor or sunglasses effect for the eyes.
always do the headshaking at the time we are examining them. When we do trigeminal nerve blocks, the horse must be doing the headshaking at the time or we can’t tell whether it works. It’s like blocking a lameness. If the horse isn’t lame, there is no reason to block them to see if it helps. You don’t learn anything,” she explains.
“Headshaking is probably primarily related to the trigeminal nerve.”
“There are horses that have reportedly responded to allergy desensitization shots antihistamine. There are several things to
try, but I recommend to owners that they
try one thing at a time. If they are doing the dexamethasone pulse therapy, it should be an oral treatment, not injections. Anyone trying this should work with his or her veterinarian for the proper protocol. This can be tried for four to six months. The dexamethasone is generally given for four days and then off for 21 days, on again for four days, off for 21 days, etc. Your veterinarian can help you figure out what might be best for your horse.”
Horse owners need to be aware that steroids should not be given to horses that might be prone to laminitis and may also result in lami- nitis in horses without a history of laminitis. “This is a rare complication, but can occur,” Wilkins says. “So, horse owners need to be aware of this.” Steroids may also make a horse more susceptible to infections because of its effects on the immune system.
Insect control. Some horses are extremely sensitive and are easily affected by anything flying around their face.
“Sometimes the headshaking may be related to allergies, but if a person is going
to do allergy testing for the horse, it should be done before starting any steroid treatment because the steroids would affect the allergy tests. Diet changes usually don’t make a dif- ference for headshakers, though we usually recommend that they not be fed alfalfa, rye, or clover because these can be allergenic,” Wilkins says.
“I recommend starting with the safest treatments first,” she says. “We generally look at the horse’s reaction to light and try the UV blocking face mask, a nose net for riding, and a bug repellent. If none of those are helping and the allergy testing hasn’t shown anything, you might try the magnesium supplement. If that doesn’t help, you could try the cyproheptadine, and lastly, the dexamethasone pulse therapy.
“Something else that could be tried is gabapentin, a drug sometimes used for pain. Carbamazapine has also been used. And acupuncture has been tried and will help
some horses. The problem with most drugs is that they can’t be used in competition horses. Trigeminal neurectomy has sometimes helped, but I haven’t done one of those in a very long time because I haven’t had to. For some horses, this can be life-saving. But, I consider this to be a treatment of last resort as a type of salvage pro- cedure. It doesn’t do anything to treat the prob- lem, it just stops the sensation,” says Wilkins.
Many horses will respond favorably just
to sunlight blocking. “Others will respond to the dexamethasone pulsing, while others will respond to allergy testing and desensitization, but you want to start with a good physical examination,” Wilkins says. “Eye/ear/mouth examination, endoscopy, bloodwork and skull radiographs are the first things I do.”
and just
74 SPEEDHORSE, May 2017
equine health