Headshaking Mystery

In March 1999, shortly after our article on headshaking, we received a letter Christi Bender, who had a severe headshaking problem with her mare, Bounce. The case attracted the attention of Dr. Eleanor Kellon, our technical editor.

The next 15 months were a frustratingly slow progression, punctuated by crushing setbacks, chronicling nearly any possible approach conceivable. It is also a shining example of how perseverance and willingness to be open to ideas and approaches can lead to success.

The Letter (March 4, 1999)
Dear Horse Journal,
I just read your headshaking article and want to share my current and ongoing experience. My homebred Thoroughbred mare lives on my property with four other horses and appears happy. She has at least six hours of turnout a day, plenty of attention and enjoys a regular routine. She is affectionate and never aggressive.

In October 1998, she started aggressive, persistent headshaking whenever she trotted or cantered. She became virtually unrideable in a 24-hour period. There were no warnings. There was no sensitivity to touch anywhere, no runny nose, weeping eyes (Editor: This was later found to be incorrect), or dry skin.

At first she drug her nose on the ground, snorting, then she started flipping her head up and down and from side to side. After about 20 minutes, she added striking. I tried to ride her through it, but she was persistent.

Over the next week I tried all different equipment with no improvement. I also consulted the dentist, who floated her teeth, and my normal vet (vet #1), who put her on an antihistamine and Azium (dexamethasone). No change. Bloodwork was normal.

I put her in a round pen with nothing on her. The behavior continued, although she responded to my verbal commands. She didn’t appear angry or in pain, but she couldn’t control her actions.

I tried varying her routine with exercise at night, away from home, alone, in the ring, before eating, after eating, on the trail, in familiar company and with unfamiliar company.

I tried bute, banamine, ace and valerian root. I tried dietary changes. I tried long workouts during which time I ignored the behavior. Verbal discipline of the behavior and lots of praise at the walk when she did not flip her head didn’t help. I pulled her shoes and gave her a month off, thinking the problem was stress-related. Nothing.

I didn’t ride her again. I monitored her behavior in the round pen with no equipment. She remained compliant, but her behavior did not change at all.

After a month off, I had vet #2 examine her. He didn’t find anything wrong and suggested acupuncture. Vet #3 did acupuncture on her head. There was no change, but some tenseness was noted in her right jaw. Vet #4 found nothing. Vet #1 scoped her. Nothing. Vet #5 prescribed cyproheptadine and drew blood for allergy tests. The cyproheptadine did not help. He also chiropractically adjusted her, but no improvement was noted. We took her off the cyproheptadine.

Dentist #2 found nothing wrong with her mouth. Vet #6 did acupuncture on her whole body. Nothing. A behaviorist told me to stay in constant physical contact with her and to praise her verbally and with “treats” regardless of her behavior.

If I jogged next to her with my hand on her halter and talked to her she was better. If, however, I backed up, even just two feet and continued to jog next to her she flipped her head. I am not sure if she was being “good” when I am near her because she does not want to flip her head into me (Editor: Or because she is being distracted).

She is currently on no medication and on her normal diet. I am awaiting the results of her allergy tests. I have contacted a homeopath who is working on a remedy.

-Christie Bender

Our Involvement
Several things about Christi’s initial history led us to believe this headshaking had a physical cause:

1. It appeared overnight.
2. She responsed to commands.
3. The problem is the same under saddle or when loose.

We strongly suspected a physical cause despite no response to cyproheptadine and the negative physical and dental exams.

We first asked Christi to check for sensitivity over the entire face using the tip of a pencil (like your vet does during a neurological exam). She found increased sensitivity just above the corners of the mouth and over the lower lip, but nothing was done with this as Christi also reported she had a breakthrough using a gadget she designed that incorporated side reins and an overcheck. This limited head movement in all directions. Not surprisingly, Bounce’s initial reaction was not favorable, but she learned it was futile to fight it.

Bounce continued shaking once or twice on every circle. After three to four weeks of longeing with this device, Christie rode her with draw reins, and the ride went pretty well. Christi was optimistic, but we still were not convinced.

In late May, Christi reported Bounce’s problem worsened. This time she sent the mare to a trainer, who was confident he could fix it. Three weeks later Bounce was sent back, described as “50% fixed” — reportedly not shaking unless tired, irritated or frustrated.

Periods of bad weather and unrelated setbacks interrupted any serious riding for a couple of weeks, but two patterns began to emerge:

1) Bounce was worst when bad weather was approaching, and
2) Long intervals between riding usually resulted in at least one good experience, but she could not be ridden on back-to-back days without marked headshaking.

Christi was understandably depressed. We encouraged her to explore a possible physical cause again, including a facial nerve block, topical capsaicin over the facial nerve or a BioScan LED device. Christi couldn’t find a vet willing to do the facial nerve-block.

A BioScan technician found about 90 reactive points (many head, neck, shoulder and rump — rump probably being secondary). Christi rode Bounce right after her first whole-body treatment. She shook a number of times but weakly. The most dramatic change was marked relaxation, an effect we also noted with whole-body treatments (see LEDs, July 2000).

Later that day, when the acute effects had worn off, Bounce was turned out. Instead of just walking over to the nearest pile of hay per usual, she trotted off energetically. The BioScan whole-body treatments continued, but the dramatic relaxation was not seen again. Bounce seemed to settle into a pattern where the first five to 10 minutes would involve some headshaking, then she would stop.

BioScan light-cap treatments were added, which provided a big change. Eventually, Bounce stopped headshaking in the field. By August, she was being ridden consistently, with little-to-no headshaking. Christi was able to ride her for six consecutive days with minimal head movements for the first few minutes.

This pattern held for a few weeks, although Christi noted headshaking in the stall or field would appear if a low-pressure storm was approaching. (It’s interesting to note that people with peripheral nerve problems like Bell’s palsy are also often sensitive to weather.)

In late August, Bounce had a relapse, but Christi had stopped all treatments. She tried to work Bounce without any treatments and reached a plateau where she would headshake for the first half of a ride, then work out of it.

Throughout this period, a connection to bad weather and worsening headshaking was obvious. Once the weather went into a consistently clear pattern, Bounce would perform well without treatments.

Other commitments and a bout of colic sidelined Bounce for three weeks. She was ridden sporadically after this, always with time between rides.

Christi resumed the light cap, which made a big difference. About this time, we also learned of an important symptom that Christi had not reported.

Bounce’s left eye waters, not constantly but more often than not, and often enough that she had the tear duct flushed and the eye examined (no p roblem found). She also noted that whenever the eye watered Bounce would headshake. If it was dry, Bounce would be fine. We felt this was a solid piece of evidence to support the idea Bounce had a “pinched”/irritated nerve.

Bounce stayed about the same through mid-December, worse with bad weather and with left-eye tearing a good predictor of how bad the shaking would be. She would start most rides with headshaking the first few minutes, intermittently after that.

Bounce went to a schooling event in December and was given a packet of Azium that morning. Christi thought it helped. We suggested she try B6 supplementation, which is helpful in some human syndromes involving pinched/irritated nerves. Within a few days the left eye stopped tearing. If the B6 was stopped, the eye would tear within two days. This was more evidence we were likely dealing with a nerve irritation.

Late in December, Christi fine-tuned her scanning equipment. She reported major readings occurred from spots behind both ears (locations of superficial nerves, may have been artifact from bridle/halter), on the left side of her face along the cheek bone in line with her eye (an acupuncture point for eye problems, location of facial nerve branch to the eye), and at a spot on her neck that corresponded with a therapeutic point for cervical spine problems.

If the weather was good and she received her treatments, Bounce was pretty good. If not, she deteriorated. Obviously, we had found effective ways to deal with her, but the original problem remained.

The stress was taking its toll on Bounce, too. She had another bout of colic and a bad reaction to a series of vaccines. She was depressed or irritable more often than not.

At the end of January 2000, Bounce was visited by a “horse communicator” who told Christi Bounce had a constant bad headache and shooting pains down the left side of her face, numb left ear and a problem with her upper cervical spine. She pointed out to Christi that the wing of the atlas, that broad bone at the start of the cervical spine in the upper neck, just behind the poll, was much more prominent on the right side.

While we remain skeptical of psychics, this woman was obviously an astute observer and skillful in physical exam. Her observation was the impetus needed to get Bounce scheduled to see a chiropractor and vet team.

On February 6, Bounce had lateral (side-to-side) X-rays taken of her upper neck. She also underwent a grueling session of manipulations in an attempt to realign her spine, the result of which she was sore and much worse for two weeks afterward — not exactly the expected result but they did suggest they indeed had the right area pinpointed.

To make matters worse, the vet insisted Bounce was a photic headshaker, despite being told an extensive trial of cyproheptadine made no difference.

We got a copy of her X-rays and couldn’t see anything wrong. We also sent them to Dr. Jill Beech of New Bolton Center, an expert in cervical-spine problems, who also said she couldn’t see anything. Despite the disappointing lack of specifics from the limited X-rays, we felt the physical findings and history supported an upper cervical spine problem.

Christi was referred to a veterinarian/chiropractor in her area, who evaluated the history and told Christi she should not force things back into alignment. Instead, the vet would work on releasing tight muscles and ligaments, slowly but steadily encouraging the soft tissue and bone to resume its normal configuration.

This made sense, and Bounce began a series of intense treatments with electroacupuncture from the vet, deep-tissue massage and release from a physical therapist, and stretching, massage, pulsed electromagnetic field and liniment treatments.

Like any rehabilitation process, it was painful at times and slow, but Bounce responded. The asymmetrical neck loosened up and filled out, taking on a normal looking crest again. Bounce seemed happier.

The snorting disappeared first, followed shortly by the headshaking. Within about two months, Bounce was normal in the field, normal in her stall and back doing light work.

When work resumed at end of April, Bounce showed several episodes of shaking that were clearly attitude. This was more the classical head-throwing of an irritated horse than the violent movements she had shown before.

Christi didn’t want to repeat the mistake of using a lot of equipment to hide the problem and vacillated between treating her with kid gloves and laying down the law. She was cautioned by the treating veterinarian not to do anything that would force Bounce into a fixed frame. Bounce had a good deal of “babying,” so she was definitely on the independent side.

In Bounce’s defense, she had also had more than her share of long-term pain and probably could be excused for having a short fuse. She was also out of shape and had to deal with all the routine aches and pains horses go through when being conditioned.

We suggested a gentle, firm touch, knowing they would have to work through this themselves but also that if Bounce got away with too much she easily could turn into a behavioral headshaker.

Bounce still gets maintenance massage from the physical therapist, and Christi has learned how to recognize and deal with areas of spasm and muscle tension. Her vet keeps track of her with maintenance exams and electroacupuncture as needed.

If there was any doubt that Bounce’s headshaking these days is habit/behavioral, it was put to rest the day Christi took Bounce into the ring and she became irritated, shaking her head like crazy. Christi responded with one good wack of the crop and the behavior stopped.

Also With This Article
Click here to view “Doping Headshakers.”

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