Headshaking in horses

Headshaking has been well described as a syndrome for many years but is still a largely misunderstood condition.

Headshaking has been well described as a syndrome for many years but is still a largely misunderstood condition.

Although headshaking was historically thought to be a behavioural problem, we now know that in many cases the condition is caused by extreme pain across the face. This pain causes the horse to headshake, strike out at the face or rub the face in an attempt to gain some relief from the pain.

There are many reasons why a horse may headshake, with most headshaking horses showing inital signs at between 4 and 10 years of age.

Signs that a horse may be a headshaker include:
  • Repetitive upwards movements of the head
  • Nostril clamping
  • Pinching of the muzzle
  • Striking out at the face
  • Rubbing the nose / face

It is still not clear what the exact cause of the disease is, and when no physical cause for the headshaking can be found, horses are diagnosed with “Idiopathic Headshaking” or now more frequently termed trigeminal-mediated headshaking (TMH). Our understanding of the disease is improving but unfortunately there are limited successfull treatments available.

Studies have found that up to 98% of horses presenting to a referral hospital for investigation of headshaking are diagnosed with TMH. When local anaesthetic is infiltrated around a branch of the trigeminal nerve (a nerve block), a majority of horses affected by TMH stop headshaking for the duration of the local anaesthetic. Strongly indicating that the headshaking is caused by facial pain. Whilst this technique would be impractical to use as a treatment for headshaking, it is used to aid diagnosis of headshaking caused by a facial pain syndrome.

The pain originates from a branch of the trigeminal nerve that runs along the face. This is the same nerve that is affected in a condition seen in humans, known as Trigeminal Neuralgia, which has many clinical similarities with Idiopathic Headshaking. Trigeminal Neuralgia is characterised by sharp, shooting pains across the face. As with headshaking, the symptoms are unable to be controlled through the use of ordinary pain killers. The pain is so severe that Trigeminal Neuralgia has been dubbed ‘the suicide disease’, owing to the high rate of suicides in patients diagnosed with the condition.

Because headshaking is associated with such severe pain, and is typically a progressive disease, it is advisable to contact your vet if you suspect your horse may have developed headshaking. Diagnosis of TMH is a ‘rule-out’ diagnosis and requires multiple diagnostic tests which may require referral to a specialist.

Multiple treatment options for TMH have been investigated, with varying levels of success. The use of nose nets has been found to be effective in the management of some cases. Speak to your vet about what other options may be available.

Special thank to our bursary student Amy Coleman for her input into this advice.

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