Headshaking in horses is a frustrating condition and can be more than an occasional flip of the nose. The action can escalate to the point that the horse becomes dangerous to handle: he may throw his head up violently or strike at his face.
It's not clear why a horse might become a headshaker, but many cases are believed to be in response to pain in the trigeminal nerve. Other causes for headshaking include poorly fitting tack, dental disorders, nasal congestion, ear ticks or mites, guttural pouch issues, masses in the nasal passages, and equine protozoal myelitis, among others.
Dr. Nadine Ogden and colleagues from the Leahurst Equine Hospital at the University of Liverpool in the United Kingdom found that two cases of headshaking and hypersensitivity at the clinic were the result of head injuries. These injuries involved the infraorbital branch of the trigeminal nerve.
The first case was an 8-year-old Warmblood which presented to the clinic with headshaking and pain upon palpation of the face. The gelding began headshaking the same time the owners found a small wound on his face, which was thought to be self-inflicted.
Ten days before going to the clinic, the horse began to rub his muzzle and flip his head both at rest and while working. An X-ray was completed while the horse was at the clinic and showed a small bone fragment next to the infraorbital nerve.
The horse was sedated and the fragment was removed. He showed no signs of headshaking immediately after the surgery, but clinical signs returned once the horse went home. He returned to the clinic five weeks later because of continued headshaking. An X-ray determined that some bone fragments remained. This time the horse was put under general anesthesia and the bone fragment was surgically removed.
Six months later, the gelding was neither sensitive nor headshaking.
A second headshaking case involved a 6-year-old Welsh mare that was sent to the clinic after the sudden onset of muzzle rubbing. The mare also struggled to eat for 12 hours.
Imaging found a nondisplaced comminuted fracture of the right hemi-mandible. The fracture line and bone fragments were lying on the mental nerve. The mare was given pain medication and tapering anti-inflammatories to make her more comfortable as the fracture healed.
The mare was showing reduced headshaking and muscle rubbing four months after diagnosis and the onset of treatment.
The researchers note that differentiating injury-induced headshaking from idiopathic headshaking is important in both the horse's treatment and prognosis. Long-term follow-up is needed, they conclude.
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