Current Headshaking Treatments (2011) found to reduce or eliminate headshaking syndrome:
A very important rule of thumb! A treatment should only be considered successful if it has been shown to greatly reduce or eliminate headshaking for 6 months or more. Of course even a day’s relief is better than no relief, but this should be the goal. This is because headshakers have periods of natural remission where they do not exhibit symptoms. These periods can range from day to day, week to week or month to month. Usually they do not stay in remission more than 6 months. This periodicity makes it very hard to tell if the headshaking has stopped due to a treatment or natural remission. It is also why there are scammers on the internet who can claim success with their treatment even though the treatment would not pass this criteria. Buyers Beware!
1) Dexamethasone Pulse Therapy (injectable liquid): this is the best treatment that I recommend. I have had close to 90% success on over a hundred horses around the world. I spent 5 years studying and developing this protocol on donated headshakers. There are many horses that have been on the dex pulsing for years and have been rideable and back to the way they were before the headshaking started.
All doses are given ORALLY by syringe. It is best to avoid giving it in the feed if possible.
You can use less liquid if you use the 4mgs/ml concentration.
Give 60mgs liquid dexamethasone, ORALLY, daily, for four consecutive days.
Repeat in 21 days.
Important! This dose is for a 400-600kg horse.
Continue protocol for at least 4-6 months. After that you may extend out the time between pulses gradually to every 28 days, 32 days and so on. Resume the above protocol if symptoms start to appear. Most horses eventually only need to be pulsed seasonally as they start to have symptoms and can go off the treatment in the off season.
Although the pulsing greatly reduces the chance of side effects, this protocol is not for use in horses with Cushings, Founder, Laminitis or any infections. I have never had any side effects reported to date and I have treated hundreds of horses with this protocol, but there always is a chance that a side effect may occur.
Low doses of steroids with long term tapering are not effective! The desired effect is dose and time dependant.
The results from the study I conducted n conjunction with the New Bolton Center on the DPT should be on my website after January, 2012.
2) Cyproheptadine: an antihistamine and serotonin antagonist. Sedation and colic are the main reported side effects. Seems to mostly help those horses that are light sensitive.
Dosage: 0.3mg/kg twice daily orally or as directed by your vet
3) Use of a nose net for counter-stimulation. This takes a few times for the horse to become accustom to it. It is best to only put it on for a few minutes at first and walk or lunge the horse so he can gradually get use to it. Some horses do ok with a weighted half net or beads. Some do not tolerate these at all
4) Guardian Mask or sun blocking fly mask: helps with sunlight sensitivity and should be used at all times, 24/7 for full effect.
5) Diet: Regular diet with as few supplements as possible. A mineral balancer may be helpful. I have not seen any headshaker cured by changing feeds or hay. The only supplement that I recommend is Quiessence. Start at the recommended dose and increase to 3 or 4 times that dose. Mag Ox or other magnesium supplements may help but I think the chromium in the Quiessence may be needed for best results.
6) Trigger Avoidance until symptoms are under control
Triggers include anything that initiates tics:
Sunlight: use mask, UV screens and blankets, dark stalls
Wind: avoid fans directly on face or fan sounds
Riding: may be possible with mask or nose net
Bathing and/or grooming: soft brush, avoid soaps near face
Stress: slow quiet work, long and low
Bugs: fly repellant, fly sheet and mask, avoid riding in tall grass
7) Allergy desensitization: Often the first inclination with headshaking is to assume it is caused by allergies. This is still unknown. What looks like an allergy, smells like an allergy but does not respond to conventional allergy treatments? If anyone has input on this I would be very interested in hearing it.
This would be an option if you or your vet are reluctant to try the dex pulsing first.
Not many horses stop headshaking with allergy desensitization alone. I have had a few that stopped with the combination of dex pulsing and the allergy shots but I think it was mostly because of the dex.
It is preferable to do a dermal test (gold standard) at a vet school or clinic where they do many allergy tests. Blood testing may also be done. I like Bio-Medical labs the best. I feel like the reason many horses are not helped by this treatment because of the quality of the lab.
This may be useful data for investigators and your own veterinarian.
If you choose to also do the dex pulsing, do the allergy testing before starting the dex treatment. It does take at least 6 months to see results. Often tests need to be redone if the horse is moved or continues to have symptoms. Sometimes the shots can elicit headshaking symptoms but these are temporary.
Note: There is also a vaccination called Equity that controls LH and FSH (known to be high in headshakers). It is only available in New Zealand at this time. There is anecdotal evidence that this has eliminated headshaking in those horses.
I strongly recommend keeping a daily journal and would appreciate getting any data that you observe
More information on dexamthasone:
“ Dexamethasone … is used in high doses … for anaphylactic reactions, spinal cord trauma, or shock”. This implies that it is useful for allergic reactions, nerve compression, or toxemia. “Systemic side effects to corticosteroids are generally dependant on dose and duration of the treatment. Short-term administration of even large doses is unlikely to cause serious harmful side effects due to adrenal suppression”. (Dexamethasone For Veterinary Use, Forney, Barbara, DVM, www.wedgewoodpharmacy.com/monographs/dexamethasone2.asp).
Contact Pam Neff at p.neffdressage@yahoo.com for more information.
DPT study with New Bolton update.
This study will begin in April 2011. We are currently recruiting participants, contact Pam Neff at: p.neffdressage@yahoo.com
