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Franzen V, Gruber NA, Klußmann S, Schoster A, May A. Effect of repetitive transcranial magnetic stimulation on trigeminal-mediated headshaking in 17 horses. J Vet Intern Med 2024; 38:2758-2765. [PMID: 39264234 PMCID: PMC11423477 DOI: 10.1111/jvim.17194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Accepted: 08/22/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Trigeminal-mediated headshaking is a neuropathic facial pain condition in horses. No treatment has been entirely successful. Repetitive transcranial magnetic stimulation (rTMS) is used in human medicine as a treatment for various neuropathic pain conditions, and good results have been achieved in cases of trigeminal neuralgia. OBJECTIVES Apply rTMS to horses with trigeminal-mediated headshaking (TMHS) and to evaluate tolerability, application of the setting, and success rate. ANIMALS Seventeen horses with nonseasonal signs of TMHS. METHODS Other underlying causes of headshaking were ruled out. The rTMS was performed under standing sedation on 5 consecutive days applying 3 sets of 500 stimulations each, with a stimulation strength of 5 Hz. Horses were evaluated on Day 1 (t0) and Day 5 (t1) of the treatment and 2 (t2) and 4 weeks (t3) afterwards using a special scoring system. RESULTS The rTMS was well tolerated. Headshaking signs during exercise were decreased by 70% (Day 5; t1). Four weeks after rTMS, signs were still decreased (mean reduction of 50%) during exercise. Improvement of mean resting and exercise scores was significant (P < .05) and effect sizes between pretreatment and all time points after treatment (t1, t2, t3) were large (>±0.8). CONCLUSIONS AND CLINICAL IMPORTANCE Repetitive transcranial magnetic stimulation may be a promising treatment for neuropathic pain and headshaking in affected horses. Pain-free periods after treatment differ individually, and repeated treatment may be necessary. More studies should be performed to determine ideal settings for horses.
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Affiliation(s)
- Vanessa Franzen
- Equine HospitalLudwig Maximilians University MunichMunichGermany
| | | | - Sven Klußmann
- Equine HospitalLudwig Maximilians University MunichMunichGermany
| | | | - Anna May
- Equine HospitalLudwig Maximilians University MunichMunichGermany
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Becker R, Haenssgen K, Precht C, Khoma OZ, Hlushchuk R, Koch C, Kaessmeyer S, de Preux M. An anatomical study of the subarachnoid space surrounding the trigeminal ganglion in horses-in preparation for a controlled glycerol rhizotomy in equids. Front Vet Sci 2024; 11:1424890. [PMID: 39091385 PMCID: PMC11291345 DOI: 10.3389/fvets.2024.1424890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 07/08/2024] [Indexed: 08/04/2024] Open
Abstract
Introduction Equine trigeminal-mediated headshaking is a painful neuropathic disorder comparable to trigeminal neuralgia in humans. The selective destruction of pain fibers within the trigeminal ganglion, called rhizotomy, is the surgical treatment of choice for idiopathic trigeminal neuralgia refractory to medical treatment in humans. The human trigeminal ganglion is enclosed by a dural recess called the Meckel's or trigeminal cave, in which the ganglion is surrounded by a cerebrospinal fluid (CSF)-filled subarachnoid space. During glycerol rhizotomy, glycerol is percutaneously injected in this CSF-filled space. Until now, information about the anatomy of the dural recess and the subarachnoid space surrounding the trigeminal ganglion is lacking in horses. The aim of this study was to explore if a CSF-filled subarachnoid space around the trigeminal ganglion exists in horses. Materials and methods Six equine cadaver heads were investigated for CSF accumulation around the ganglion with a 3 Tesla MRI. After anatomical dissection to expose the trigeminal root, a polymer-based radiopaque contrast agent was injected through the porus trigeminus into the subarachnoid space (cisternography). The exact delineation and the volume of the contrast agent accumulation were determined on subsequent micro-computed tomographic scans and segmentation. Finally, the distribution of the contrast agent within the subarachnoid space was examined histologically in three specimens. Results In all 12 specimens included in this study, the trigeminal ganglion was surrounded by a subarachnoid space forming a trigeminal cistern. The mean volume of the trigeminal cave in this study was 0.31 mL (±SD: 0.11 mL). Distribution of the contrast agent along the peripheral nerves (i.e., ophthalmic, maxillary and/or mandibular nerve) was observed in 7 out of 12 specimens. Discussion/conclusion A subarachnoid space surrounding the trigeminal ganglion exists in the horse and could be targeted for glycerol rhizotomy in horses suffering from trigeminal-mediated headshaking. However, the clinical relevance of contrast agent distribution along the peripheral nerves remains to be assessed.
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Affiliation(s)
- Richard Becker
- Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland
| | - Kati Haenssgen
- Division of Veterinary Anatomy, Department of Clinical Research and Veterinary Public Health, Vetsuisse-Faculty, University of Bern, Bern, Switzerland
| | - Christina Precht
- Division of Clinical Radiology, Vetsuisse-Faculty, University of Bern, Bern, Switzerland
| | | | | | - Christoph Koch
- Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland
| | - Sabine Kaessmeyer
- Division of Veterinary Anatomy, Department of Clinical Research and Veterinary Public Health, Vetsuisse-Faculty, University of Bern, Bern, Switzerland
| | - Mathieu de Preux
- Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland
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Pickles KJ, Marlin DJ, Williams JM, Roberts VLH. Use of a poll-mounted accelerometer for quantification and characterisation of equine trigeminal-mediated headshaking. Equine Vet J 2024. [PMID: 39020521 DOI: 10.1111/evj.14132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 06/05/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND Equine trigeminal-mediated (TGM) headshaking (HS) is a neuropathic facial pain syndrome characterised by varying intensity and frequencies of head movements and signs of nasal irritation. An accurate method for quantification and/or characterisation of HS severity is lacking. OBJECTIVES To develop and validate an objective measure of TGMHS. STUDY DESIGN Prospective case control study. METHODS Horses presenting for investigation of HS were recruited alongside those presenting for forelimb lameness (LAME) and pre-purchase examination as well as healthy controls (CONTROL). Head movement data were collected for 5 min whilst trotting on the lunge using a tri-axial accelerometer, with a range of ±16 g and sampling rate of 800 Hz, attached to the bridle headpiece. Recordings were exported for processing. Peak detection was performed using minimum and maximum thresholds of -1 g and +1 g (corrected for gravity) and a minimum peak width of 10 samples. RESULTS Fifty-six horses were included in the study; 18 TGMHS, 10 non-TGMHS, 12 LAME and 16 CONTROL. Characteristics and frequency of vertical (Z axis) head movements of TGMHS horses differed significantly from other horses. TGMHS horses had peaks with greater mean and maximum positive g-force (P < 0.005) and lower mean and minimum negative g-force (P < 0.001), greater frequency of peaks/min (P < 0.001) and over 12 times greater percentage of peaks >+2 g compared with other horses (P < 0.001). Receiver operator curve characteristics of percentage of peaks >+2 g (CI 0.72-0.95), percentage of peaks <-2 g (CI 0.66-0.92) and percentage of peaks <-2 g and >+2 g (CI 0.72-0.96) showed excellent discrimination of TGMHS horses from LAME, CONTROL and non-TGMHS horses. MAIN LIMITATIONS Referral population of horses, small sample size and control horses were not evaluated for orthopaedic disease. CONCLUSIONS Accelerometer data from trotting exercise on the lunge provides an objective measure of HS and can differentiate between TGMHS, non-TGMHS, normal head movements and those associated with forelimb lameness. Accelerometer use may aid HS diagnosis and monitoring of management strategies.
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Affiliation(s)
- Kirstie Jane Pickles
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
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Nessler JN, Delarocque J, Kloock T, Twele L, Neudeck S, Meyerhoff N, Riese F, Cavalleri JMV, Tipold A, Feige K, Niebuhr T. Sensory nerve conduction stimulus threshold measurements of the infraorbital nerve and its applicability as a diagnostic tool in horses with trigeminal-mediated headshaking. BMC Vet Res 2024; 20:201. [PMID: 38750534 PMCID: PMC11097574 DOI: 10.1186/s12917-024-04068-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND To determine whether sensory nerve conduction stimulus threshold measurements of the infraorbital nerve are able to differentiate horses with idiopathic trigeminal-mediated headshaking (i-TMHS) from healthy horses and from horses with secondary trigeminal-mediated headshaking (s-TMHS). In a prospective trial, headshaking horses were examined using a standardized diagnostic protocol, including advanced diagnostics such as computed tomography and 3-Tesla-magnetic resonance imaging (MRI), to differentiate s-TMHS from i-TMHS. Clinically healthy horses served as controls. Within this process, patients underwent general anesthesia, and the minimal sensory nerve conduction stimulus threshold (SNCT) of the infraorbital nerve was measured using a bipolar concentric needle electrode. Sensory nerve action potentials (SNAP) were assessed in 2.5-5 mA intervals. Minimal SNCT as well as additional measurements were calculated. RESULTS In 60 horses, SNAP could be recorded, of which 43 horses had i-TMHS, six had suspected s-TMHS, three horses had non-facial headshaking, and eight healthy horses served as controls. Controls had a minimal SNCT ≥ 15 mA, whereas 14/43 horses with i-TMHS and 2/6 horses with s-TMHS showed a minimal SNCT ≤ 10 mA. Minimal SNCT ≤ 10 mA showed 100% specificity to distinguish TMHS from controls, but the sensitivity was only 41%. CONCLUSION A minimal SNCT of the infraorbital nerve ≤ 10 mA was able to differentiate healthy horses from horses with TMHS. Nevertheless, a higher minimal SNCT did not exclude i-TMHS or s-TMHS and minimal SNCT does not distinguish s-TMHS from i-TMHS.
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Affiliation(s)
- Jasmin Nicole Nessler
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany.
| | - Julien Delarocque
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Tanja Kloock
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Lara Twele
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Stephan Neudeck
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Nina Meyerhoff
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Franziska Riese
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Jessica-M V Cavalleri
- Clinical unit of equine internal medicine, Department of small animals and horses, University of veterinary medicine, Vienna, Austria
| | - Andrea Tipold
- Department of Small Animal Internal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
| | - Tobias Niebuhr
- Clinic for Horses, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Foundation, Hannover, Germany
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Kloock T, Pickles KJ, Roberts V, Uhlendorf F, Twele L, Wilkens HL, Stehle E, Feige K, Niebuhr T. History, Rest and Exercise Score (HRE-S) for assessment of disease severity in horses with trigeminal-mediated headshaking. Equine Vet J 2024; 56:464-474. [PMID: 37608443 DOI: 10.1111/evj.13986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/20/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND In horses with trigeminal-mediated headshaking (TMHS), clinical signs are likely to be expression of neuropathic facial pain. Currently, subjective assessment of disease severity is used as measure of compromise of animal's welfare. OBJECTIVES To develop and validate a precise scoring system for TMHS: History, Rest and Exercise Score (HRE-S). The HRE-S consists of three subscores: history score (H-S), resting score (R-S) and exercise score (E-S). STUDY DESIGN Retrospective observational study. METHODS Seven masked observers with different experience used HRE-S to score 40 video recordings taken during rest and lungeing including five duplicates. Video recordings were taken from nine horses with TMHS and three controls. Inter- and intraobserver reliability and practicability of HRE-S were assessed. For every video recording severity of clinical signs was graded by every observer using an intuitive global-type-scale and interobserver reliability was calculated. Convergent validity was evaluated comparing HRE-S to groups created by an existing score (grade 0-3). Discriminant validity was analysed comparing HRE-S to groups created by intuitive global-type-scale. RESULTS Reliability for HRE-S was excellent, irrespective of observers experience: Spearman's Rho = 0.946, p < 0.001 (intraobserver reliability) and intraclass correlation coefficient = 0.98, p < 0.001 (interobserver reliability). Interobserver reliability for intuitive global-type-scale was fair to substantial: Fleiss' κappa = 0.48 (R-S) -0.63 (E-S). Groups created by intuitive global-type-scale had significantly different R-S and E-S (p < 0.05), demonstrating discriminant validity. Convergent validity was proven as horses with grade 3/3 had significantly higher average E-S and total scores compared with an existing score than those with grade 0/3 or 1/3 (p < 0.001). MAIN LIMITATIONS Retrospective nature, video recordings, sample size. CONCLUSIONS HRE-S is a valid and reliable score evaluating disease severity in TMHS, independent of observers' experience.
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Affiliation(s)
- Tanja Kloock
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Kirstie J Pickles
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK
| | | | | | - Lara Twele
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Henriette L Wilkens
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | | | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Tobias Niebuhr
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
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Kloock T, Hellige M, Kloock A, Feige K, Niebuhr T. Application of the HRE-S to 140 horses with trigeminal-mediated headshaking and the association of clinical signs with diagnosis, therapy, and outcome. Front Vet Sci 2024; 11:1329054. [PMID: 38645651 PMCID: PMC11027008 DOI: 10.3389/fvets.2024.1329054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/15/2024] [Indexed: 04/23/2024] Open
Abstract
Background Horses with trigeminal-mediated headshaking (TMHS) exhibit different headshaking patterns (HSPs), electric shock-like jerking, signs of nasal irritation, and painful facial expressions. The History Rest and Exercise Score (HRE-S) was developed to objectively clarify the severity of the condition in affected horses. This score considers the history and severity of clinical signs at rest and exercise. This study aimed to assess the frequency of different clinical signs and their individual associations with diagnosis, treatment, and outcome in horses diagnosed with TMHS.The clinical records of horses presented with headshaking (HS) at the Clinic for Horses, University of Veterinary Medicine Hannover, between 2006 and 2021 were assessed retrospectively for clinical signs, diagnosis, and treatment. A total of 140 horses were included in the study. Video recordings were evaluated using the HRE-S and compared to the score described by Talbot. Following discharge, owners were interviewed via telephone about the outcome. Correlations between the presence and severity of clinical signs, diagnosis, and outcome were evaluated. Results The following clinical signs were significantly correlated with a higher HRE-S and grade by Talbot: HS at walk (independently of HSP) (52.9%, 74/140), increased total number of demonstrated HSP (independent of the dominant HSP) (more than one HSP per horse in 91.4%, 128/140), signs of nasal irritation (75.9%, 104/137), painful facial expression (67.8%, 80/118), and electric shock-like jerking (77.5%, 107/138). Diagnosis and outcome do not correlate with the presence of the above-mentioned clinical signs. Conclusion The HRE-S was confirmed as a valid tool to evaluate disease severity in a cohort of 140 horses with HS. Additionally, clinical signs identified as indicators for higher disease severity may have a stronger negative effect on patient welfare, but they do not correlate with diagnosis or outcome.
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Affiliation(s)
- Tanja Kloock
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Maren Hellige
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Anke Kloock
- Department of Cell Biology, NYU Langone Medical Center, New York City, NY, United States
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
| | - Tobias Niebuhr
- Clinic for Horses, University of Veterinary Medicine Hannover, Hanover, Germany
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Kloock T, Hellige M, Kloock A, Feige K, Niebuhr T. Impact of Different Diagnostic Procedures on Diagnosis, Therapy, and Outcome in Horses with Headshaking: Recommendations for Fast-Track Advanced Diagnostic and Therapeutic Protocols. Animals (Basel) 2022; 12:3125. [PMID: 36428354 PMCID: PMC9686903 DOI: 10.3390/ani12223125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Most horses affected by headshaking (HS) are diagnosed with idiopathic trigeminal-mediated headshaking (i-TMHS) when no underlying disease is found. Diagnosis is made by the exclusion of differentials considering history, clinical signs, and diagnostic investigations. Therefore, in horses presented with headshaking, many diagnostic procedures and therapies are conducted. Retrospectively, the digital patient records of 240 horses with HS were analysed regarding the impact of diagnostic procedures on diagnosis, therapy, and outcome. Horses were extensively examined using a standardised protocol including clinical (ophthalmologic, orthopaedic, neurologic, dental) examination, blood analysis, and imaging techniques (endoscopy, radiographs, computed tomography (CT), and magnetic resonance imaging). Many findings were revealed but were of clinical relevance in only 6% of the horses. These horses were, therefore, diagnosed with secondary headshaking (s-HS). In addition, all of these horses demonstrated a positive outcome. The CT of the head revealed 9/10 of the clinically relevant findings. Other diagnostic procedures had no major additional impact. Conclusively, the diagnostic investigation of horses with HS should aim at differentiating i-TMHS from s-HS. The clinical relevance of findings should be verified through diagnostic anaesthesia or targeted therapy depending on risks, invasiveness, and expected benefits. To reduce the multitude of examinations, diagnostic investigations should focus on the CT of the head in those horses with suspicion of i-TMHS based on typical history, clinical signs, and physical examination.
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Affiliation(s)
- Tanja Kloock
- Clinic for Horses, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, 30559 Hanover, Germany
| | - Maren Hellige
- Clinic for Horses, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, 30559 Hanover, Germany
| | - Anke Kloock
- Department of Cell Biology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016, USA
| | - Karsten Feige
- Clinic for Horses, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, 30559 Hanover, Germany
| | - Tobias Niebuhr
- Clinic for Horses, University of Veterinary Medicine Hannover Foundation, Bünteweg 9, 30559 Hanover, Germany
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Fairburn AJ, Meehan LJ, Roberts VLH. Computed tomographic findings in 101 horses presented for the investigation of headshaking. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Alison J. Fairburn
- Bristol Veterinary School University of Bristol Somerset UK
- Bell Equine Veterinary Clinic, Mereworth Kent UK
| | - Lucinda Jayne Meehan
- Bristol Veterinary School University of Bristol Somerset UK
- VetCT, St. John's Innovation Centre Cambridge UK
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Pickles K. Trigeminal‐mediated headshaking: A diagnostic challenge. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kirstie Pickles
- School of Veterinary Medicine and Science University of Nottingham Leicestershire UK
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10
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Ellis KL, Contino EK, Nout‐Lomas YS. Poor performance in the horse: Diagnosing the non‐orthopaedic causes. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Katherine L. Ellis
- Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - Erin K. Contino
- Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - Yvette S. Nout‐Lomas
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
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Ogden N, Thomas H, Carslake H, Kane‐Smyth J. Trigeminal neuropathy in two horses following trauma to the infraorbital and mental nerves. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Nadine Ogden
- Leahurst Equine Hospital University of Liverpool Neston UK
| | - Hannah Thomas
- Thomas Veterinary Services Gwernyffynnon Farm Rhosesmor UK
| | - Harry Carslake
- Leahurst Equine Hospital University of Liverpool Neston UK
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Stange LM, Krieter J, Czycholl I. Comparison of the Current Situation of Equine Headshaking Syndrome in France and Switzerland Based on an Online Survey. Animals (Basel) 2022; 12:ani12111393. [PMID: 35681857 PMCID: PMC9179245 DOI: 10.3390/ani12111393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/06/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Headshaking syndrome is a frustrating health problem in horses whose aetiopathogenesis is poorly understood. This study was dedicated to investigating signalment and therapeutic interventions in headshakers in France and Switzerland. To do this, an online survey was developed and distributed via the Internet. This showed that mainly middle-aged geldings were affected. The breeding distribution matched the breeding distribution of the relevant country. Furthermore, alternative healing methods were used by the horse owners, which have not yet been scientifically examined. Overall, it was possible to formulate conclusions regarding signalment and therapies used in practice. Abstract Equine headshaking syndrome (EHS) is characterised as non-physical and involuntary movement of the horse’s head and neck. Although EHS is clinically simple to diagnose, its aetiopathogenesis often remains unclear. The aim of this study was to gain an overview of signalment and therapy possibilities used in France and Switzerland. To do this, an online survey was developed and distributed via newsletters. A total of 933 complete, answered surveys from France (n = 804) and Switzerland (n = 129) were evaluated. The median age in France was 12.4 years (CH = 14.3). Mostly geldings were affected (58.5%FRA, 57.4%CH). There was an association with Warmbloods in Switzerland (55.8%CH), but in France, in addition to Warmbloods (34.4%FRA), Thoroughbreds (27.2%FRA) were also affected. Moreover, horses affected by EHS often show stereotypical behaviour (15.7%FRA, 14.7%CH). A total of 38.4%FRA and 67.4%CH of horse owners utilised therapy measures, with nose covers being most commonly used (19.9%FRA, 30.2%CH). Horse owners resorted to alternative treatments that had not previously been studied in context with EHS (15%FRA, 20.9%CH). Conservative treatments, such as medication, were used by 5.4%CH and 1.9%FRA. This study provides an overview of the status of horses affected by EHS in France and Switzerland and thus offers a fundamental step to understanding the consequences of welfare issues associated with EHS.
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Affiliation(s)
- Laura Maxi Stange
- Institute of Animal Breeding and Husbandry, Kiel University, 24118 Kiel, Germany; (J.K.); (I.C.)
- Correspondence: ; Tel.: +49-431-880-4363
| | - Joachim Krieter
- Institute of Animal Breeding and Husbandry, Kiel University, 24118 Kiel, Germany; (J.K.); (I.C.)
| | - Irena Czycholl
- Institute of Animal Breeding and Husbandry, Kiel University, 24118 Kiel, Germany; (J.K.); (I.C.)
- Pig Improvement Company (PIC), 100 Bluegrass Commons Blvd. Ste 2200, Hendersonville, TN 37075, USA
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Aleman M, Sheldon SA, Jospin G, Coil D, Stratton‐Phelps M, Eisen J. Caecal microbiota in horses with trigeminal‐mediated headshaking. Vet Med Sci 2022; 8:1049-1055. [PMID: 35060350 PMCID: PMC9122421 DOI: 10.1002/vms3.735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Trigeminal‐mediated headshaking (TMHS) in horses is a form of neuropathic pain of undetermined cause that often results in euthanasia. The role of microbiota in TMHS has not been investigated in diseased horses. Objective To investigate if gastrointestinal microbiota in the cecum is different in horses with TMHS compared to a control population, during a summer season with clinical manifestations of disease. Animals Ten castrated horses: five with TMHS and five neurologically normal controls. Methods All horses were sourced from our institution and kept under the same husbandry and dietary conditions. All horses were fed orchard grass hay for 30 days and then were euthanized due to chronic untreatable conditions including TMHS and orthopedic disease (control group). Caecal samples for microbiota analysis were collected within 20 min after euthanasia. Sequencing was performed using an Illumina MiSeq platform and the microbiome was analyzed. Results The caecal microbiota of horses with TMHS was similar to control horses in terms of diversity but differed significantly with Methanocorpusculum spp. having higher abundance in horses with TMHS. Conclusions and clinical importance Methanocorpusculum spp. was more abundant in the cecum of horses with TMHS. However, its role in disease is unknown. Furthermore, it could also represent an incidental finding due to our small population size.
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Affiliation(s)
- Monica Aleman
- Department of Medicine and Epidemiology University of California Davis Davis California USA
| | - Shara. A. Sheldon
- Department of Medicine and Epidemiology University of California Davis Davis California USA
| | - Guillaume Jospin
- The Genome Center University of California Davis Davis California USA
| | - David Coil
- The Genome Center University of California Davis Davis California USA
| | | | - Jonathan Eisen
- The Genome Center University of California Davis Davis California USA
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De Bonis A, Marsh O, Stabile F. Mimicking focal epileptic seizures‐episodic pain due to a facial foreign body in a puppy: Imaging characteristics and treatment. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Andrea De Bonis
- Southfields Veterinary Specialists, Southfields Laindon Essex UK
- Veterinary Teaching Hospital University of Teramo Teramo Italy
| | - Oliver Marsh
- Southfields Veterinary Specialists, Southfields Laindon Essex UK
| | - Fabio Stabile
- Southfields Veterinary Specialists, Southfields Laindon Essex UK
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15
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Paulussen E, Decloedt A, Vera L, Lefere L, van Loon G. Unilateral jugular vein stenosis in five horses and experience with percutaneous transluminal angioplasty. Equine Vet J 2021; 54:710-718. [PMID: 34486172 DOI: 10.1111/evj.13506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/07/2021] [Accepted: 08/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Venous stenosis, a possible cause of jugular dilatation and congestion, is well known in human medicine but has poorly been described in horses. OBJECTIVE To report unilateral jugular vein stenosis as a cause of jugular vein dilatation in horses and describe treatment by percutaneous transluminal angioplasty (PTA). STUDY DESIGN Case report. METHODS Details of horses diagnosed with unilateral jugular stenosis were retrieved from medical records. RESULTS Five horses were presented with a non-painful, unilateral dilatation of the jugular vein of which two horses showed headshaking during exercise. In one horse an indwelling catheter had been used and jugular dilatation developed 4 weeks later. In the other horses, no intravenous injections had been administered in the months before jugular dilatation developed. Ultrasonographic examination revealed venous stenosis in all horses approximately 5-10 cm cranial to the thoracic inlet. The internal diameter at the level of this stenosis was only 1-3.1 mm. The length of the stenosis was about 15-19 mm with a markedly thickened intima and media on ultrasonography. After enoxaparin treatment, PTA was performed in three horses. During the procedure the stenotic vein was dilated three times with progressively increasing pressures up to 12 atm. The stenotic diameter increased to a maximum of 4.9 mm with improved jugular blood flow. Aftercare included anti-inflammatory and anti-thrombotic therapy. CONCLUSION Jugular vein stenosis occurs in horses and should be included in the differential diagnoses of unilateral jugular vein dilatation. It may present in the absence of previous intravenous treatment. PTA of the jugular vein is feasible to improve jugular blood flow.
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Affiliation(s)
- Ellen Paulussen
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Annelies Decloedt
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lisse Vera
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Laurence Lefere
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Gunther van Loon
- Equine Cardioteam, Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Equine Cervical Pain and Dysfunction: Pathology, Diagnosis and Treatment. Animals (Basel) 2021; 11:ani11020422. [PMID: 33562089 PMCID: PMC7915466 DOI: 10.3390/ani11020422] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 01/14/2023] Open
Abstract
Simple Summary Neck pain and dysfunction in the horse is becoming an increasingly important topic among riders, trainers and veterinarians. Some horses may present for a subtle performance decline, while others may show dramatic, dangerous behavior. It is important to recognize how to carefully evaluate the horse in an effort to understand the different types of pain that may be contributing to the different behaviors. The musculoskeletal and nervous systems may both play a role in the development of clinical signs. Recognizing that there are many diagnostic options as well as several treatments choices is important. This synopsis covers the disease processes that may contribute to the development of neck pain and dysfunction in the horse, as well as several possible diagnostic and treatment options. Abstract Interest in the cervical spine as a cause of pain or dysfunction is increasingly becoming the focus of many equine practitioners. Many affected horses are presented for poor performance, while others will present with dramatic, sometimes dangerous behavior. Understanding and distinguishing the different types of neck pain is a starting point to comprehending how the clinical presentations can vary so greatly. There are many steps needed to systematically evaluate the various tissues of the cervical spine to determine which components are contributing to cervical pain and dysfunction. Osseous structures, soft tissues and the central and the peripheral nervous system may all play a role in these various clinical presentations. After completing the clinical evaluation, several imaging modalities may be implemented to help determine the underlying pathologic processes. There are multiple treatment options available and each must be carefully chosen for an individual horse. Provided is a synopsis of the current knowledge as to different disease processes that can result in cervical pain and dysfunction, diagnostic approaches and treatment strategies. Improving the knowledge in these areas will ideally help to return horses to a state of well-being that can be maintained over time and through the rigors of their job or athletic endeavors.
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Overview of the Current Situation in a Sample of Headshakers and Owner Assessment of Effective Therapeutic Measures Used in Germany. J Equine Vet Sci 2020; 95:103270. [PMID: 33276935 DOI: 10.1016/j.jevs.2020.103270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022]
Abstract
Equine headshaking syndrome is a problematic behavior that has been described in literature for more than 100 years. The signs of headshaking syndrome appear frequently and violently so that riding the horse can be dangerous. The aim of this research was to gain an overview of the underlying causes of equine headshaking syndrome to identify effective treatment options, reduce the distress of horses and, in a second step, potentially improve therapeutic possibilities for horse owners and veterinarians. Most studies on prevalence originate from Anglo-American countries, so this research was to provide an overview of German horses; therefore, an online survey was designed by experts in the field (researchers and veterinarians) and answered by German horse owners. Questionnaires were pretested by a small group of horse owners (n = 5) and redesigned accordingly. The final questionnaire consisted of 27 questions, which were divided into seven open questions with an associated text field and 20 multiple-choice questions (Supplementary Material 1). For some of the multiple-choice questions, multiple answers were permitted. In total, 163 completed questionnaires were obtained from owners of headshaking horses (ntotal = 163). Gender distribution of the horses resulted in 64.4% geldings, 33.7% mares, and 1.8% stallions. Most horses were German warmbloods (55.4%). The average age was 12.7 years (with a wide range of 5 to 34 years). The vertical movement of the head was the most frequently mentioned symptom in 75.5% of the evaluated horses. In 18.4% of the cases, the horse owners identified stress as the main trigger for headshaking. Furthermore, 18.4% claimed that their horses suffered from additional stereotypical behavior. The percentages do not refer to the same horses here. 11.0% of the participants in this study tried scientifically evaluated therapies such as surgical therapy (1.2%) or medical treatment (9.8%). In addition, 54.0% of the owners utilized a nose cover to reduce the symptoms of the headshaking syndrome. A high percentage of 84.0% used alternative therapies such as physiotherapy (31.9%), change of equipment (22.7%), or change of riding style (29.4%). Overall, this study provides a useful overview of causes and effective therapies.
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18
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Lawson AL, Carslake HB, Kane‐Smyth J, Maddox TW, Talbot AM. Mineralisation of the longitudinal odontoid ligament in three horses identified on computed tomographic examination. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. L. Lawson
- Institute of Veterinary Science University of Liverpool Neston UK
| | - H. B. Carslake
- Institute of Veterinary Science University of Liverpool Neston UK
| | - J. Kane‐Smyth
- Institute of Veterinary Science University of Liverpool Neston UK
| | - T. W. Maddox
- Institute of Veterinary Science University of Liverpool Neston UK
| | - A. M. Talbot
- Institute of Veterinary Science University of Liverpool Neston UK
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Lloyd-Edwards RA, Willems DS, Beukers M, van den Brom-Spierenburg A, Vernooij JCM, Veraa S. Presumed cholesterinic granulomas detected on CT in horses are associated with increased lateral ventricle height and age. Vet Radiol Ultrasound 2020; 61:269-278. [PMID: 32020759 PMCID: PMC7317960 DOI: 10.1111/vru.12847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 10/19/2019] [Accepted: 11/19/2019] [Indexed: 11/29/2022] Open
Abstract
Cholesterinic granulomas are mass‐like lesions that form at the choroid plexus of the ventricular system. Large cholesterinic granulomas within the lateral ventricles have been reported to cause severe neurological signs. However, little data are available about their prevalence or appearance in the overall population. The objective was to report the prevalence of presumed cholesterinic granulomas on CT in a population of horses, and investigate associations between presumed cholesterinic granuloma presence, lateral ventricle size, age, and neurological signs. The study was cross sectional, CT scans of the head were assessed for presumed cholesterinic granuloma presence and size, and lateral ventricle height. Computed tomography findings and clinical information were compared using nonparametric testing. Computed tomography scans of 139 horses were included. Presumed cholesterinic granulomas were found in 22 horses (15.8%), nine were unilateral and 13 bilateral. A significant increase in prevalence was observed with age (P < .0001), with 38% of horses over 15 years old affected. The median volume of presumed cholesterinic granulomas was 242 mm3 with a range from 51 to 2420 mm3. The mean lateral ventricle height was significantly increased in horses with presumed cholesterinic granulomas present (P = .004), with a median of 7.3 mm compared to 4.9 mm without. Neurological signs were not associated with presumed cholesterinic granuloma presence or lateral ventricle height. Fourth ventricle mineralizations were found in seven horses, which may represent cholesterinic granulomas. In conclusion, presumed cholesterinic granulomas occurred in a large proportion of the examined population and are associated with increased lateral ventricle dilation and advanced age.
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Affiliation(s)
- Ralph A Lloyd-Edwards
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht, The Netherlands
| | - Dorien S Willems
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht, The Netherlands
| | - Martijn Beukers
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht, The Netherlands
| | | | - Johannes C M Vernooij
- Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Stefanie Veraa
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht, The Netherlands
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20
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Could snorts inform us on how horses perceive riding? Behav Processes 2020; 172:104041. [PMID: 31923434 DOI: 10.1016/j.beproc.2020.104041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 01/02/2020] [Accepted: 01/04/2020] [Indexed: 11/23/2022]
Abstract
Several previous studies have shown that working conditions (including riding) can induce stress in horses. Riders' actions and postures, when inappropriate, induce stress and conflict behaviours during riding and welfare impairment and negative emotional states outside work. Optimistic biases have been found in leisure horses, which, amongst positive management factors, were ridden with loose reins and low hands. Thus, one can wonder whether horses may positively perceive work or parts of it. Indicators of positive emotions are poorly known yet but we recently found that, out of the working context, a non-vocal acoustic signal, snorts, could reflect mild positive emotions in horses. We hypothesized that snorts could help identifying the working phases and actions appreciated by horses. An overview of snort production in 127 horses spread over 16 riding schools was first conducted to highlight a potential site effect. Results show a great difference in snorts frequency between facilities which may be due to different riding techniques. In order to test this hypothesis, we then focused on 37 horse-rider dyads by scoring horses' postures (neck) and riders' positions (hand, reins) during, but also out of the context of snort production. Results show that snorts were particularly associated with phases when the rider technique, i.e. long and loose reins, allowed more comfort for the horse, especially while walking. Results were more mitigated for higher paces since the association of snorts with signs of comfort was less clear-cut. Snorts could therefore be useful tools for identifying better practices, especially at slower gaits. However, care has to be taken at higher paces.
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21
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Roberts VLH, Bailey M, Patel NK. The safety and efficacy of neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal-mediated headshaking in 168 horses. Equine Vet J 2019; 52:238-243. [PMID: 31461784 PMCID: PMC7317358 DOI: 10.1111/evj.13174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 07/27/2019] [Indexed: 01/01/2023]
Abstract
Background Early results from the use of neuromodulation by percutaneous electrical nerve stimulation for the management of trigeminal‐mediated headshaking in horses were promising but lacked sufficient case numbers and long‐term follow‐up. The neuromodulatory procedure has since been established as EquiPENS™. Objectives The aim of this study was to report long‐term results from a larger number of cases and to investigate for predictors of outcome. Study design Prospective case series using international, multi‐centre data. Methods Eligible cases were horses with a veterinary diagnosis of trigeminal‐mediated headshaking, which received EquiPENS™ neuromodulation at trained centres between August 2013 and November 2017. The standard protocol was an initial three‐procedure course, with additional procedures should a horse go into remission but then relapse. Data collected included signalment, history, diagnostic tests performed, details of any complications, whether horses had gone into remission and the length of remission. Results Results were obtained from 168 horses, with 530 procedures. The complication rate was 8.8% of procedures. In all but one case, complications were mild and transient, without self‐trauma. Remission of headshaking following the initial course occurred in 53% (72/136) of horses. Median length of time recorded in remission was 9.5 weeks (range 2 days to 156 weeks ongoing). Where signs recurred, most horses went back into remission following additional procedures, usually for longer than from the previous procedure. No predictors for outcome were determined. Main limitations No placebo or control group, owner‐assessed results. Conclusions EquiPENS™ neuromodulation can be an effective and safe treatment for the management of trigeminal‐mediated headshaking in some horses. An increased understanding of neuromodulation could help optimise the technique. Advances in treatment for trigeminal‐mediated headshaking will remain limited until there is a greater understanding of the aetiopathogenesis of the condition.
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Affiliation(s)
- V L H Roberts
- Bristol Veterinary School, University of Bristol, Somerset, UK
| | - M Bailey
- Bristol Veterinary School, University of Bristol, Somerset, UK
| | | | - N K Patel
- Institute of Neurosciences, Southmead Hospital Bristol, Westbury-on-Trym, Bristol, UK
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22
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Edwards RA, Hermans H, Veraa S. Morphological variations of the infraorbital canal during CT has limited association with headshaking in horses. Vet Radiol Ultrasound 2019; 60:485-492. [PMID: 31161704 DOI: 10.1111/vru.12773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/01/2019] [Accepted: 04/03/2019] [Indexed: 12/14/2022] Open
Abstract
Headshaking is a common problem in horses. The etiology is unknown but thought to involve sensory input from branches of the trigeminal nerve, some of which are within the infraorbital canal. The objective of this retrospective cross-sectional study was to describe the CT anatomy and variations of the infraorbital canal in horses with local disease processes and normal horses, and to examine associations between those findings and headshaking. Computed tomography scans were reviewed and morphological changes of the infraorbital canal were described. Presence of changes was then tested for association with headshaking prevalence, presence of disease processes in the region of the infraorbital canal, age, and sex. Nonparametric tests were used and a P-value of .05 was considered significant. A total of 218 horses were included, 9% of which had headshaking and 45% had CT lesions in the region of the infraorbital canal. Morphological changes to the bone of the infraorbital canal were found in 121 horses (56%) and included the following: increased mineralization 39 (18%), decreased mineralization 89 (41%), deformed shape 51 (23%), displaced position 43 (20%), and disruption 11 (5%). All changes of the infraorbital canal significantly increased in frequency with the presence of adjacent disease. Increased mineralization and disruption of the infraorbital canal were significantly associated with headshaking in horses with adjacent disease; the latter only reached significance after exclusion of dentally immature horses. No other changes were significantly associated with the presence of headshaking. No association was found between headshaking and the age or sex of the horse.
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Affiliation(s)
- Ralph A Edwards
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Hanneke Hermans
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Stefanie Veraa
- Division of Diagnostic Imaging, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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23
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Pickles K. Is Electrical Nerve Stimulation the Answer for Management of Equine Headshaking? Vet Clin North Am Equine Pract 2019; 35:263-274. [PMID: 31047766 DOI: 10.1016/j.cveq.2019.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Horses with trigeminal mediated headshaking (TMHS) have a decreased activation threshold of the trigeminal nerve and clinical signs are suspected to be a manifestation of trigeminal neuralgia. Electrical nerve stimulation (ENS) is used for management of neuralgia in humans and appears to work via gate control theory. Use of an equine specific percutaneous ENS program in over 130 TMHS horses has resulted in approximately 50% success return to previous work. Electroacupuncture may also be useful in the management TMHS. Optimization of ENS procedures for TMHS is likely to require a greater understanding of the etiopathogenesis of the aberrant neurophysiology.
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Affiliation(s)
- Kirstie Pickles
- Chine House Veterinary Hospital, 12 Cossington Road, Sileby, Leicestershire LE12 7RS, UK.
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Sheldon SA, Aleman M, Costa LRR, Weich K, Howey Q, Madigan JE. Effects of magnesium with or without boron on headshaking behavior in horses with trigeminal-mediated headshaking. J Vet Intern Med 2019; 33:1464-1472. [PMID: 30990929 PMCID: PMC6524471 DOI: 10.1111/jvim.15499] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 04/03/2019] [Indexed: 12/25/2022] Open
Abstract
Background Oral administration of magnesium and boron might have a beneficial effect on headshaking behavior in horses. Objective Evaluate the effects of oral magnesium alone or in combination with boron on headshaking behavior in affected horses. Animals Twelve geldings (6 healthy controls and 6 affected). Methods Prospective randomized controlled dietary trial over 42 days in 12 horses (6 horses diagnosed with trigeminal‐mediated headshaking and 6 unaffected healthy controls). All horses received a hay diet and were randomized into 3 treatment groups: pelleted feed combination (PF), pelleted feed combination with magnesium (M), and pelleted feed combination with magnesium‐boron (MB) with a week washout of hay only between treatments. Headshaking behavior and biochemical blood variables were assessed at baseline (hay only) and then after each week of supplementation. Results All 3 diet interventions increased blood ionized and total magnesium. Groups M and MB further increased Mg2+ when compared to PF. Horses receiving treatments had a significant reduction in headshaking behavior, as measured by incidence rate ratio (IRR), when compared to unsupplemented hay diet (44% for PF, IRR, 0.558; CI, 0.44, 0.72; P < .001; 52% for M, IRR, 0.476; CI, 0.37, 0.62; P < .001; and 64% for MB, IRR, 0.358; CI, 0.27, 0.48; P < .001). Conclusions and Clinical Importance Magnesium in combination with boron had the greatest decrease in headshaking. Oral supplementation with magnesium or magnesium in combination with boron should be considered in horses affected with headshaking.
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Affiliation(s)
- Shara A Sheldon
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Lais R R Costa
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Kalie Weich
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Quinn Howey
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - John E Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
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Thomson K, Chan C, Dyson S. Head tossing behaviour in six horses: Trigeminal‐mediated head‐shaking or musculoskeletal pain? EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. Thomson
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
| | - C. Chan
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
| | - S. Dyson
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
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26
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Pickles KJ. Electrical nerve stimulation for the management of equine trigeminal mediated headshaking. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.12800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K. J. Pickles
- Chine House Veterinary Hospital Sileby Leicestershire UK
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27
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Sheldon SA, Aleman M, Costa LRR, Santoyo AC, Weich KM, Howey Q, Madigan JE. Luteinizing hormone concentrations in healthy horses and horses with trigeminal-mediated headshaking over an 8-hour period. J Vet Intern Med 2019; 33:885-888. [PMID: 30773684 PMCID: PMC6430929 DOI: 10.1111/jvim.15451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/30/2019] [Indexed: 12/04/2022] Open
Abstract
Background Trigeminal‐mediated headshaking results from a low threshold for firing of the trigeminal nerve. A seasonal component has been implicated in onset of clinical signs, which occur during the spring and summer months. Geldings are overrepresented in the affected population and hormonal differences as compared to a healthy control population of geldings might contribute to headshaking. Objective/Hypothesis To assess concentrations of luteinizing hormone (LH) over an 8‐hour period in gelded healthy controls and horses affected with headshaking. Our hypothesis was that geldings with seasonal headshaking would have higher concentrations of LH over an 8‐hour period compared to control horses during the summer when affected horses manifested headshaking. Animals Twelve geldings (6 controls and 6 affected). Methods Prospective controlled trial. Blood samples were drawn every 15 minutes over an 8‐hour time period during summer from all horses to measure circulating LH concentrations by using a radioimmunoassay for equine LH. All affected horses were actively affected by headshaking at the time of sample collection. Results No statistically significant differences in LH concentrations were found throughout the study period in headshakers as compared to control horses. Time had no significant effect, but a slight decrease in LH concentrations was observed for all horses. The main limitation of the study was the low number of horses. Conclusions and Clinical Importance Horses affected with headshaking did not have significant differences in circulating LH during the late summer as compared to control horses.
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Affiliation(s)
- Shara A Sheldon
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Lais Rosa R Costa
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Ana C Santoyo
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Kalie M Weich
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Quinn Howey
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - John E Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
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Sheldon SA, Aleman M, Costa LRR, Santoyo AC, Howey Q, Madigan JE. Intravenous infusion of magnesium sulfate and its effect on horses with trigeminal-mediated headshaking. J Vet Intern Med 2019; 33:923-932. [PMID: 30666732 PMCID: PMC6430935 DOI: 10.1111/jvim.15410] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 12/12/2018] [Indexed: 12/24/2022] Open
Abstract
Background Trigeminal‐mediated headshaking results from low‐threshold firing of the trigeminal nerve resulting in apparent facial pain. Magnesium may have neuroprotective effects on nerve firing that potentially dampen signs of neuropathic pain. This hypothesis has not been investigated in horses with trigeminal‐mediated headshaking. Objective To investigate head‐shaking behavior in affected horses after IV magnesium sulfate infusion. Animals Six geldings with trigeminal‐mediated headshaking. Methods Prospective randomized crossover study. Horses were controlled for diet and infused IV with 5% dextrose solution (DS; control solution at 2 mL/kg body weight [BW]) and MgSO4 50% solution (MSS at 40 mg/kg BW). Head‐shaking behavior was recorded at times T0 (baseline, before infusion) and T15, T30, T60, and T120 minutes post‐infusion. Venous blood variables such as pH, HCO3−, standard base excess (SBE), Na+, Cl−, K+, Ca2+, Mg2+, total magnesium (tMg), glucose, and lactate were measured; strong ion difference (SID) and anion gap (AG) were calculated for each time point. Results Blood variables including pH, Na+, Cl−, K+, SID, AG, lactate, Ca2+, tMg, and Mg2+ had significant changes with MSS as compared to DS treatment. Glucose, SBE, and HCO3− did not have significant changes. A 29% reduction in head‐shaking rate occurred after MSS treatment but no change occurred after DS treatment. Conclusions and Clinical Importance Administration of MSS IV increased plasma total and ionized magnesium concentrations and significantly decreased head‐shaking behavior in horses with trigeminal‐mediated headshaking.
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Affiliation(s)
- Shara A Sheldon
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Lais Rosa R Costa
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Ana C Santoyo
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - Quinn Howey
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
| | - John E Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
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Roberts V. Trigeminal-mediated headshaking in horses: prevalence, impact, and management strategies. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2019; 10:1-8. [PMID: 30666296 PMCID: PMC6330979 DOI: 10.2147/vmrr.s163805] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Trigeminal-mediated headshaking is a little-understood neuropathic facial pain condition of the horse. The condition may affect around 1% of the equine population to a degree of severity sufficient to require veterinary attention. As a pain condition, this represents a significant welfare issue. Horses are usually more severely affected at exercise which can leave them unable to perform, or even dangerous to ride and handle. With little known about the condition and variable response to treatments, severely affected horses are often euthanized. This review article considers the literature on trigeminal-mediated headshaking, focusing on what is known, and indeed not known, about the prevalence of the condition and its impact. The current published management options are considered, along with their challenges and limitations.
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Affiliation(s)
- Veronica Roberts
- Bristol Vet School, Faculty of Health Sciences, University of Bristol, Langford, North Somerset BS40 5HB, UK,
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Visser EMS, Caliskan N, Veraa S, Hermans H. A retrobulbar dermoid cyst with involvement of the sinus in an 18-year old pony. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- E. M. S. Visser
- Department of Equine Sciences; Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
| | - N. Caliskan
- Department of Pathobiology; Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
| | - S. Veraa
- Division of Diagnostic Imaging; Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
| | - H. Hermans
- Department of Equine Sciences; Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
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Sheldon S, Aleman M, Costa L, Santoyo AC, Howey Q, Madigan J. Alterations in Metabolic Status and Headshaking Behavior Following Intravenous Administration of Hypertonic Solutions in Horses with Trigeminal-Mediated Headshaking. Animals (Basel) 2018; 8:E102. [PMID: 29941850 PMCID: PMC6071069 DOI: 10.3390/ani8070102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/31/2018] [Accepted: 06/18/2018] [Indexed: 11/16/2022] Open
Abstract
Trigeminal-nerve-mediated headshaking represents a major welfare challenge for owners and veterinarians and is caused by a low threshold firing of the trigeminal nerve resulting in pain manifested as violent head jerking that often terminates the horse’s career and life due to poor quality of life and suffering. As metabolic changes such as acid⁻base status and electrolytes play a role in nerve firing, this study sought to assess the effects following administration of hypertonic solutions on headshaking behavior in affected horses. This prospective randomized controlled crossover design utilized six horses affected with trigeminal-mediated headshaking and three treatment groups receiving intravenous administration of 5% dextrose solution at 2 mL/kg bwt (DS), NaCl 7.5% at 4 mL/kg bwt (HS), or NaHCO₃ 8.4% at 2 mmol/kg bwt (HB). Horses were assessed for headshaking behavior changes at times T0 (baseline, before infusion) and T15, 30, 60, 120 min post infusion. Venous blood variables: pH, HCO₃−, standard base excess (SBE), Na⁺, Cl−, K⁺, Ca2+, Mg2+, total magnesium (tMg), glucose, and lactate were measured at T0 (baseline, before infusion) and T5, 15, 30, 60, 120 min post infusion. Strong ion difference (SID) and anion gap (AG) were calculated for each time point. With HB treatment, there was greater than 50% reduction in headshaking rate. There was an effect of time on increasing headshaking rate. There was an effect of breed on headshaking rate. Changes in blood parameters following DS were virtually absent. Infusion of HS caused mild changes and did not vary much from baseline except for SID and AG. Only infusion of HB caused blood pH and HCO₃− to be outside of the physiologic range (alkalemia and metabolic alkalosis, respectively), SBE to double or triple, AG to decrease, and SID to increase compared to baseline. Infusion of DS was followed by increase in blood glucose and decrease in blood Na⁺. Infusion of HS was followed by increase in Na⁺ and Cl− and decrease in Mg2+. Infusion of HB was followed by decrease in Mg2+. Blood tMg, K⁺, and Ca2+ decreased slightly, but did not vary greatly from baseline following any of the treatments, remaining within physiologic ranges. Changes in blood composition were transient. Among all treatments, only HB had an effect on headshaking rate. The limited effects following these fluids were likely due to normal mechanisms of regulation of blood levels of pH and electrolytes. Further investigations of changes in electrolytes that might affect nerve firing should be explored.
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Affiliation(s)
- Shara Sheldon
- Department of Nutrition, University of California, Davis, CA 95616, USA.
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - Monica Aleman
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - Lais Costa
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - A Cristina Santoyo
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - Quinn Howey
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
| | - John Madigan
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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Roberts V. Managing headshaking in horses: an update. IN PRACTICE 2018. [DOI: 10.1136/inp.k1493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dyson S, Berger J, Ellis AD, Mullard J. Development of an ethogram for a pain scoring system in ridden horses and its application to determine the presence of musculoskeletal pain. J Vet Behav 2018. [DOI: 10.1016/j.jveb.2017.10.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Devereux S. Electroacupuncture as an additional treatment for headshaking in six horses. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12776] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- S. Devereux
- Equine Acupuncture and Chiropractic Referrals Meadow Rise Farley Salisbury Wiltshire UK
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Ross SE, Murray JK, Roberts VLH. Prevalence of headshaking within the equine population in the UK. Equine Vet J 2017; 50:73-78. [PMID: 28608565 DOI: 10.1111/evj.12708] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/06/2017] [Indexed: 12/27/2022]
Abstract
REASON FOR PERFORMING STUDY Headshaking in horses has been reported to be most commonly due to idiopathic neuropathic facial pain (trigeminal-mediated headshaking). The prevalence of headshaking in horses in the UK is unknown. OBJECTIVES To estimate owner-reported prevalence of headshaking in horses in the UK and to report their case background and disease characteristics, as reported by owners. STUDY DESIGN Cross-sectional web based owner questionnaire. METHODS The questionnaire was advertised online via social media, horse forums, veterinary websites and equestrian magazines from 17th June 2016, until >1000 responses had been obtained. All UK horse owners were eligible to complete the questionnaire, however only one questionnaire could be completed per owner. RESULTS The estimated prevalence of owner-reported headshaking in the sample population of horses (n = 1014), within the last year, was 4.6% (95% confidence interval 3.5-6.1), whereas 6.2% (95% confidence interval 4.9-7.9) of horses were reported by their owners to have shown signs of headshaking at any time-point since ownership. There was no association of sex or breed. Nineteen percent of headshaking horses were reported to show headshaking at rest. Fewer than one-third (30.2%, n = 19) of headshaking horses had been examined by a veterinarian for headshaking. Of horses seen by a veterinarian, the cause for headshaking remained unknown in the majority of cases (57.9% responses) and trigeminal-mediated headshaking was reported as a diagnosis in just one case. MAIN LIMITATIONS The accuracy in data reporting by horse owners was not verified in this study. There may be a potential for bias towards over-reporting due to the nature of survey participation. CONCLUSIONS Within this sample, owner-reported prevalence of signs of headshaking within the last year, in horses in the UK was 4.6%. Over two-thirds of owners of headshaking horses did not seek veterinary intervention for headshaking. Trigeminal-mediated headshaking was rarely reported by owners as a diagnosis.
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Affiliation(s)
- S E Ross
- School of Veterinary Sciences, University of Bristol, Somerset, UK
| | - J K Murray
- School of Veterinary Sciences, University of Bristol, Somerset, UK
| | - V L H Roberts
- School of Veterinary Sciences, University of Bristol, Somerset, UK
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Abstract
There has been great progress in the understanding of basic neurobiologic mechanisms of pain, but this body of knowledge has not yet translated into new and improved analgesics. Progress has been made regarding pain assessment in horses, but more work is needed until sensitive and accurate pain assessment tools are available for use in clinical practice. This review summarizes and updates the knowledge concerning the cornerstones of pain medicine (understand, assess, prevent, and treat). It highlights the importance of understanding pain mechanisms and expressions to enable a rational approach to pain assessment, prevention, and management in the equine patient.
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Roberts VL, Fews D, McNamara JM, Love S. Trigeminal Nerve Root Demyelination Not Seen in Six Horses Diagnosed with Trigeminal-Mediated Headshaking. Front Vet Sci 2017; 4:72. [PMID: 28555189 PMCID: PMC5431280 DOI: 10.3389/fvets.2017.00072] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/25/2017] [Indexed: 11/25/2022] Open
Abstract
Trigeminal-mediated headshaking is an idiopathic neuropathic facial pain syndrome in horses. There are clinical similarities to trigeminal neuralgia, a neuropathic facial pain syndrome in man, which is usually caused by demyelination of trigeminal sensory fibers within either the nerve root or, less commonly, the brainstem. Our hypothesis was that the neuropathological substrate of headshaking in horses is similar to that of trigeminal neuralgia in man. Trigeminal nerves, nerve roots, ganglia, infraorbital, and caudal nasal nerves from horse abattoir specimens and from horses euthanized due to trigeminal-mediated headshaking were removed, fixed, and processed for histological assessment by a veterinary pathologist and a neuropathologist with particular experience of trigeminal neuralgia histology. No histological differences were detected between samples from horses with headshaking and those from normal horses. These results suggest that trigeminal-mediated headshaking may have a different pathological substrate from trigeminal neuralgia in man.
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Affiliation(s)
- Veronica L Roberts
- School of Veterinary Clinical Sciences, University of Bristol, Bristol, Somerset, UK
| | - Debra Fews
- School of Veterinary Clinical Sciences, University of Bristol, Bristol, Somerset, UK
| | - Jennifer M McNamara
- Centre for Comparative and Clinical Anatomy, University of Bristol, Bristol, UK
| | - Seth Love
- Department of Neuropathology, University of Bristol Institute of Clinical Neurosciences, Southmead Hospital, Bristol, UK
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Diseases of the Nervous System. Vet Med (Auckl) 2017. [PMCID: PMC7322266 DOI: 10.1016/b978-0-7020-5246-0.00014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Roberts VLH, Patel NK, Tremaine WH. Neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal-mediated headshaking: A safe procedure resulting in medium-term remission in five of seven horses. Equine Vet J 2015; 48:201-4. [DOI: 10.1111/evj.12394] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 11/18/2014] [Indexed: 12/26/2022]
Affiliation(s)
- V. L. H. Roberts
- School of Veterinary Sciences; University of Bristol; Somerset UK
| | - N. K. Patel
- Institute of Neurosciences; Southmead Hospital; Bristol UK
| | - W. H. Tremaine
- School of Veterinary Sciences; University of Bristol; Somerset UK
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Wilmink S, Warren-Smith CMR, Roberts VLH. Validation of the accuracy of needle placement as used in diagnostic local analgesia of the maxillary nerve for investigation of trigeminally mediated headshaking in horses. Vet Rec 2015; 176:148. [PMID: 25433055 DOI: 10.1136/vr.102518] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Diagnostic local anaesthesia of the maxillary nerve is a valuable aid in the diagnosis of trigeminally mediated headshaking in horses. Our objective is to validate the accuracy of needle placement in this procedure and to identify any correlation between accuracy of the technique and operator experience. Using a small volume of contrast medium, the procedure was performed bilaterally on 30 horse cadaver heads by three groups with different levels of experience with the technique. The location of deposition was then identified using computed tomography (CT). Contrast medium was deposited around the target site in 53.3% (32/60) of injections. An experienced operator succeeded in deposition around the target area significantly (p<0.05) more often (80%, 16/20) than did the less and non-experienced performers (40%, 16/40). A negative response to diagnostic local anaesthesia of the maxillary nerve does not disprove facial dysaesthesia as the cause of headshaking in that horse as a false negative response could arise due to failure to deposit local anaesthetic around the target area. Increased experience in performing the procedure decreases the probability of false negative results.
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Affiliation(s)
- S Wilmink
- Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
| | - C M R Warren-Smith
- Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
| | - V L H Roberts
- Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, North Somerset, UK
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Roberts V. Idiopathic headshaking: Is it still idiopathic? Vet J 2014; 201:7-8. [DOI: 10.1016/j.tvjl.2014.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 05/04/2014] [Indexed: 10/25/2022]
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