Headshaking in horses: possible aetiopathogenesis suggested by the results of diagnostic tests and several treatment regimes used in 20 cases

Twenty mature horses with typical headshaking of 2 week-7 year duration were studied. Clinical examinations included radiography of the head and nasopharyngeal endoscopy. All were assessed at rest and at exercise, both before and after fitting an occlusive nasal mask, application of tinted contact lenses and the perineural anaesthesia of the infraorbital and posterior ethmoidal branches of the trigeminal nerve. Infraorbital anaesthesia had no effect in 6/7 cases but 11/17 (65%) cases showed a 90-100% improvement following posterior ethmoidal nerve anaesthesia. Tinted contact lenses had no apparent long-term benefit, although 2 cases showed a transient improvement. We found no other evidence to suggest a photic aetiology in the current series of cases. Treatment regimens based on the results of the diagnostic investigative methods included sclerosis of the posterior ethmoidal branch of the trigeminal nerve. This was effective in some cases but the benefits were temporary. Cyproheptadine alone was ineffective but the addition of carbamazepine resulted in 80-100% improvement in 80% of cases. Carbemazepine alone was effective in 88% of cases but results were unpredictable at predefined dose rates. The positive response to carbamazepine, combined with the clinical features is consistent with involvement of the trigeminal nerve, particularly the more proximal branches such as the posterior ethmoidal nerve. Headshaking has some clinical features in common with trigeminal neuralgia in humans. As a result of the findings detailed in this paper, we conclude that a trigeminal neuritis or neuralgia may be the basis of the underlying aetiopathology of equine headshaking. Initial observations of the positive response of headshakers to carbamazepine therapy is encouraging. However, future studies will include a more detailed investigation of dosages, duration of effectiveness (in some cases it appears short-lived) and other effects. In practice there is a realistic possibility of controlling but not curing headshaking with carbamazepine therapy at the present time. Other future investigations will include details of the functional anatomy of the trigeminal nerve and the role of the P2 myelin protein in headshaking and other neurological disease.     

Morphological variations of the infraorbital canal during CT has limited association with headshaking in horses

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.     

Fungal sinusitis resulting in suspected trigeminal neuropathy as a cause of headshaking in five horses

Primary fungal sinusitis was identified in 5 horses displaying signs of headshaking. All 5 horses had fungal plaques adhered to the infraorbital canal (IOC). Headshaking signs were exhibited by 3 horses prior to treatment and 2 horses after treatment. Standing computed tomography (CT) identified erosion of the IOC in the 2 cases in which it was performed. Fungal culture and PCR identified 3 species of fungi, Rhizomucor pusillus, Scedosporium apiospermum and Aspergillus nidulans which have not previously been described as a cause of sinusitis in horses. Surgical debridement followed by topical antifungal therapy was used in all 5 horses. Recurrence of the fungal plaques in 4 horses necessitated further treatment. The headshaking signs and nasal discharge resolved in 3 horses allowing a return to their previous use. Two horses developed persistent headshaking signs despite multiple treatments. Primary fungal sinusitis should be considered as a cause of headshaking signs in horses, due to a suspected trigeminal neuropathy. Computed tomography is valuable in identifying erosion of the IOC which is not identified with conventional radiography. Three out of the 5 cases were treated successfully but permanent resolution of the fungal infection is difficult to achieve once the bone overlying the infraorbital nerve has been eroded.     

Use of a gonadotrophin-releasing hormone vaccine in headshaking horses

The aim of this study was to investigate the use of a gonadotrophin-releasing hormone (GnRH) vaccine in the treatment of headshaking in horses. Fifteen geldings received two doses of the GnRH vaccine four weeks apart. Serum was collected before and after vaccination to measure concentrations of luteinising hormone (LH) (10 horses) and follicle-stimulating hormone (FSH) (six horses). Owners recorded the frequency of seven common headshaking behaviours using a visual analogue scale (VAS) before vaccination and at two, four, eight, 12, 16 and 20 weeks after vaccination. Serum LH (P=0.008) and FSH (P=0.03) concentrations decreased significantly following vaccination. Although approximately one-third of the owners reported a subjective improvement in headshaking, serial scoring did not indicate a reduction in headshaking behaviours following vaccination with a commercial GnRH vaccine. Vaccination reactions were observed in four of 15 horses (27 per cent), including one case of severe, presumed immune-mediated, myositis.     

Caudal compression of the infraorbital nerve: A novel surgical technique for treatment of idiopathic headshaking and assessment of its efficacy in 24 horses

Reasons for designing and reporting technique: Idiopathic headshaking has remarkable similarities to human neuropathic facial pain syndromes associated with post herpetic and trigeminal neuralgia. These derive from abnormal sensory function within the peripheral or central pathways of the trigeminal nerve (TgN). Limiting input from the TgN can be helpful in controlling the perception of pain. Rhizotomy of the infraorbital branch of the TgN as it emerges from the infraorbital canal has been reported but has a poor efficacy. A novel technique involves compression of the nerve at a more caudal location within the infraorbital canal and the technique requires validation. Hypothesis: Caudal compression of the infraorbital nerve with platinum coils, performed in horses diagnosed with idiopathic headshaking, results in a decrease in clinical signs. Methods: Caudal compression of the infraorbital nerve, using platinum embolisation coils, was performed under fluoroscopic guidance. Clinical records of 24 idiopathic headshakers that had undergone this procedure were reviewed. Follow‐up information was obtained by telephone questionnaire with the owner or referring veterinary surgeon. Results: All 24 horses had at least one surgical procedure. Median follow‐up time was 6 months. There were 2 horses which had surgery 2 weeks before follow‐up and these were excluded from the analysis of outcome. Following one surgery, 13/22 horses (59.0%) had a successful outcome. Of the 9 horses that did not improve, surgery was repeated in 6 cases. Two of these horses had a successful outcome. Overall, a successful outcome was obtained in 16/19 horses (84.2%). Conclusions: This surgical technique is likely to prevent input from the TgN at a more caudal location then the previously described infraorbital neurectomy. The technique requires refinement.     

Electrically elicited blink reflex in horses with trigeminal and facial nerve blocks

OBJECTIVE: To reassess reference values for the components of the electrically induced blink reflex, document reference values for facial motor nerve conduction velocity, and demonstrate usefulness of the blink reflex as a diagnostic tool in peripheral facial and trigeminal nerve dysfunction in horses. ANIMALS: 10 healthy adult horses (8 males, 2 females) without neurologic abnormalities. PROCEDURE: Blink reflex tests were performed by electrical stimulation of the supraorbital nerve and facial (auriculopalpebral) nerve. Reflex and direct muscle-evoked potentials of the orbicularis oculi muscles were recorded from concentric needle electrodes inserted bilaterally in these muscles. Supraorbital and auriculopalpebral nerve blocks were performed by lidocaine hydrochloride injections. RESULTS: Supraorbital nerve stimulation elicited 2 or 3 ipsilateral and 1 contralateral reflex muscle potential in the orbicularis oculi muscles. Auriculopalpebral nerve stimulation elicited a direct and a reflex potential in the ipsilateral orbicularis oculi muscle. After left supraorbital nerve block, no responses could be elicited ipsilaterally or contralaterally upon stimulation of the blocked nerve, but bilateral responses were obtained upon stimulation of the right supraorbital nerve. After right auriculopalpebral nerve block, no responses were recorded from the right orbicularis oculi muscle upon stimulation of left or right supraorbital nerves. CONCLUSIONS AND CLINICAL RELEVANCE: Reference values for the components of the blink reflex and facial motor nerve conduction velocity will allow application of these tests to assist in the diagnosis of equine neurologic disorders involving the trigeminal and facial nerves, the brainstem, and the cranial end of the cervical segment of the spinal cord. This study reveals the usefulness of the blink reflex test in the diagnosis of peripheral trigeminal and facial nerve dysfunction in horses.     

Nociceptive trigeminal reflexes in non-sedated horses

Electrically induced reflexes can be used to investigate the physiology and pathophysiology of the trigeminal system in humans. Similarly, the assessment of the trigemino-cervical (TCR) and blink reflexes (BR) may provide a new diagnostic tool in horses. The aim of this study was to evoke nociceptive trigeminal reflexes and describe the electrophysiological characteristics in non-sedated horses. The infraorbital (ION) and supraorbital nerves (SON) were stimulated transcutaneously in 10 adult Warmblood horses in separate sessions using train-of-five electrical pulses. The current was increased gradually until the TCR threshold was found. The stimulus-response curve of the TCR was evaluated. At the same time as TCR, the BR response was also assessed. Surface electromyographic (EMG) responses were recorded from the orbicularis oculi, splenius and cleidomastoideus muscles. Latency, duration, amplitude of the reflexes and behavioural responses were analysed. Noxious electrical stimulation of the ION or SON evoked reflex EMG responses, with similar features regardless of the nerve that had been stimulated. Stimulations of increasing intensity elicited reflexes of increasing amplitude and decreasing latency, accompanied by stronger behavioural reactions, therefore confirming the nociceptive nature of the TCR. These findings provide a reference for the assessment of dysfunction of the equine trigeminal system.     

Overview of the Current Situation in a Sample of Headshakers and Owner Assessment of Effective Therapeutic Measures Used in Germany

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 (n_total = 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.     

Observations on headshaking in the horse

The clinical records of 100 cases of headshaking in horses were reviewed. Possible causes of the abnormal behaviour were identified in 11 animals; these included ear mite infestation, otitis interna, cranial nerve dysfunction, cervical injury, ocular disease, guttural pouch mycosis, dental periapical osteitis and suspected vasomotor rhinitis. However, in only two of these could it be shown that correction of the abnormality led to elimination of the headshaking. The additional clinical signs exhibited by the other idiopathic cases of headshaking included evidence of nasal irritation, sneezing and snorting, nasal discharge, coughing and excessive lacrimation. Many of these horses also showed a marked seasonal pattern with respect to the onset of the disease and the recurrence of signs in subsequent years. The clinical presentation of idiopathic headshakers and the seasonal incidence of the signs closely resemble allergic rhinitis in man.     

Owner survey of headshaking in horses

OBJECTIVE: To determine signalment, history, clinical signs, duration, seasonality, and response to various treatments reported by owners for headshaking in horses. DESIGN: Owner survey. ANIMALS: 109 horses with headshaking. PROCEDURE: Owners of affected horses completed a survey questionnaire. RESULTS: 78 affected horses were geldings, 29 were mares, and 2 were stallions. Mean age of onset was 9 years. Headshaking in 64 horses had a seasonal component, and for most horses, headshaking began in spring and ceased in late summer or fall. The most common clinical signs were shaking the head in a vertical plane, acting like an insect was flying up the nostril, snorting excessively, rubbing the muzzle on objects, having an anxious expression while headshaking, worsening of clinical signs with exposure to sunlight, and improvement of clinical signs at night. Treatment with antihistamines, nonsteroidal anti-inflammatory drugs, corticosteroids, antimicrobials, fly control, chiropractic, and acupuncture had limited success. Sixty-one horses had been treated with cyproheptadine; 43 had moderate to substantial improvement. CONCLUSIONS AND CLINICAL RELEVANCE: Headshaking may have many causes. A large subset of horses have similar clinical signs including shaking the head in a vertical plane, acting as if an insect were flying up the nostrils, and rubbing the muzzle on objects. Seasonality and worsening of clinical signs with exposure to light are also common features of this syndrome. Geldings and Thoroughbreds appear to be overrepresented. Cyproheptadine treatment was beneficial in more than two thirds of treated horses.     

Caudal anaesthesia of the infraorbital nerve for diagnosis of idiopathic headshaking and caudal compression of the infraorbital nerve for its treatment,in 58 horses

Reasons for performing study: Idiopathic headshaking is often a facial pain syndrome, but a diagnostic protocol has not been described. In a previous study, caudal compression of the infraorbital nerve for treatment offered a fair success rate, but low case numbers and short follow‐up time were limitations. Objectives: To describe a diagnostic protocol for headshaking, examining the role of bilateral local analgesia of the posterior ethmoidal nerve (PET block). To report longer‐term follow‐up after surgery of the original cases and further cases and to determine whether changes to the technique influence success rates and complications. Methods: Records of horses that had undergone PET block and caudal compression surgery at 3 hospitals were reviewed. Modifications to the surgical technique included placing additional coils into the infraorbital canal and/or performing concurrent laser cautery of the nerve. Follow‐up information was obtained by telephone contact with owners. Results: The PET block was performed in 27 horses, with a positive result in 23 of 27 (85%). Surgery was performed in 58 horses. A successful outcome was initially achieved in 35 of 57 (63%) horses, but recurrence occurred between 9 and 30 months later in 9 (26%). Surgery was repeated in 10 of 31 (32%) horses. Final success rate, considering only response to the last performed surgery, was 28 of 57 (49%) horses with median follow‐up time of 18 months (range 2–66 months). Nose‐rubbing was reported post operatively in 30 of 48 (63%) horses. This resolved in all but 4 horses, which were subjected to euthanasia. Response to PET block or change in surgical technique did not appear to influence outcome or complications. Conclusions and potential relevance: The diagnostic protocol described is recommended for the investigation of headshakers. Caudal compression offers the best prognosis for a successful outcome compared with other treatments, for horses in which the only alternative is euthanasia. Surgical treatment of the disorder requires refinement, and the pathogenesis of the disorder requires investigation.     

Development of a technique for continuous perineural blockade of the palmar nerves in the distal equine thoracic limb

Objective To develop a technique for placing continuous peripheral nerve block (CPNB) catheters adjacent to palmar nerves in horses and to evaluate the effect of low‐volume local anesthetic (LA) infusion on nociception in the distal equine thoracic limb. Study design In vitro and in vivo laboratory investigation. Study material and animals Forty‐two thoracic limbs from 22 equine cadavers and five horses. Methods Thoracic limb specimens were dissected to find landmarks for catheter insertion adjacent to medial and lateral palmar nerves. Based on the anatomy of the proximal metacarpus, a technique for placing palmar CPNB catheters was developed and the potential for catheter dislodgement studied in vitro by fluoroscopic visualization during passive carpal flexion and dye injection following simulated limb motion. The feasibility of CPNB catheter instrumentation in standing, sedated horses was tested in five animals, with ultrasound control. Electrical and mechanical stimulation thresholds and response latencies for hoof withdrawal responses (HWR) were determined following saline or LA infusion. Results Medial and lateral CPNB catheters were inserted percutaneously 2 and 4–5 cm, respectively, distal to the accessory carpal bone and advanced for ～7 and 10 cm, respectively, to place the tip just proximal to the communicating branch of the nerves. Catheters were placed correctly in 88% and 85% of cadaver limbs. In the standing horses, LA infusion not only increased HWR thresholds and latencies to noxious mechanical or electrical stimulation but also caused vasodilation and limb swelling over time. Conclusion The technique, developed in vitro, for placing and maintaining palmar CPNB catheters in the equine thoracic limb was successfully applied in vivo. Catheters were well tolerated but LA infusion may cause limb swelling, suggesting a need for further exploration of drug and infusion regimens. Clinical relevance Continuous perineural LA infusion along palmar nerves may develop into an effective analgesic technique in horses suffering from lower limb pain.     

Electroacupuncture as an additional treatment for headshaking in six horses

Some success has been demonstrated using percutaneous electrical nerve stimulation (PENS) to treat trigeminal-mediated headshaking (TMHS) in horses. The aim of this study is to determine whether electroacupuncture (EA) can provide similar remission from the pain of this debilitating condition. EA is less invasive than PENS and can be carried out in the stable yard without the need for a hospital setting and expensive equipment. Six horses and ponies showing clinical signs of headshaking were treated with electroacupuncture of the infraorbital nerve under light sedation. The nerve was stimulated with alternating 2 and 80 Hz frequencies for a period of 25 min with the current adjusted so that there was visible twitching of the nostrils and/or lips. Follow-up treatments were given when the signs recurred or 4–7 days later if there was no initial response. The procedure was well tolerated by all the horses. Once a response was achieved, the period of remission often increased with subsequent treatments. Median remission time for the first treatment was 5.5 days (mean 7.6 days, range 0–13 days, n = 6). second treatment 8.5 days (mean 10.6 days, range 7–21 days, n = 6), third treatment 18 days (mean 28.8 days, range 6–71 days, n = 6), fourth treatment 47.5 days (mean 10 weeks, range 11 days–23 weeks, n = 6), fifth treatment 13 weeks 5 days (mean 18 weeks 5 days, range 5 weeks–46 weeks, n = 5), sixth treatment 24 days (mean 26 days, range 13–41 days, n = 3). The three horses that started treatment in 2015 received a single treatment in April or May of 2016 and were still asymptomatic at the end of the study period in October 2016. It was concluded that EA of the infraorbital nerve is an effective and well-tolerated treatment for the management of horses considered to be experiencing trigeminal-mediated headshaking.     

Local anaesthetic techniques for the equine head,towards guided techniques and new applications

Perineural nerve blocks are often used in equine practice, especially since the use of diagnostic and surgical procedures in the standing sedated horse have expanded over recent decades. The purpose of this review is to discuss the different perineural nerve blocks for the equine head. The review starts with the currently most used blind approaches as described in textbooks and scientific studies. In human medicine, the role of guided techniques, such as ultrasound guidance, advanced imaging guidance and nerve stimulator guided techniques, is very extensively described. These techniques are promising to use in equine medicine as well. The first studies that describe these techniques in equine cases are also discussed in this review, as well as the possibilities for neuromodulation in equine pain syndromes like equine trigeminus-mediated headshaking and the role of perineural nerve blocks in diagnosing this syndrome.     

Analysis of the variations in clinical signs shown by 254 cases of equine headshaking

A national survey of headshaking in 254 horses was undertaken to describe the clinical signs of the condition as observed by horse owners. Principal component analysis was used to determine the underlying structure of 11 signs and the criteria by which the affected horses could be most effectively differentiated; the analysis suggested five components with a variance greater than one which together explained over 60 per cent of the total variance. Other analyses of the data indicated that headshaking could develop at any age and that twice as many males were affected as females; 64 per cent of the horses shook their heads seasonally and geldings were more likely than mares to be seasonally affected. Seasonal headshaking tended to be significantly worse on sunny days but improved on rainy days, windy days, at night and indoors.     

Effect of age and pregnancy on the antibody and cell-mediated immune responses of horses to equine herpesvirus 1.

The cell-mediated immune response and antibody response of horses of varying ages and of pregnant horses to equine herpesvirus 1 antigen were examined. Six to eight month old horses showed either no increase or slight increases in anti-equine herpesvirus 1 serum neutralizing antibody following vaccination and revaccination with a modified live equine herpesvirus 1 vaccine. However, these same horses showed a marked increase in the cell-mediated immune response to equine herpesvirus 1 as measured by the lymphocyte transformation test. Eighteen to 21 month old horses showed four to 64-fold increases in anti-equine herpesvirus 1 serum neutralizing antibody titer following vaccination, but the cell-mediated immune response to equine herpesvirus 1 was low or absent. Only after revaccination did they show an increased cell-mediated immune response to equine herpesvirus 1. The cell-mediated immune response of mares in the latter stages of pregnancy to equine herpesivurs 1 was suppressed although antibody titers increased as much as 16-fold following exposure to virulent equine herpesvirus 1.     

Otoscopic, cytological, and microbiological examination of the equine external ear canal

Otoscopic examination and cytology of the equine ear would be beneficial in diseases such as head trauma, headshaking, otitis externa secondary to otitis media, vestibular disease, aural neoplasia and aural pruritus secondary to parasites. In practice, otic examinations of horses are rarely done due to the perceived difficulty in visualizing the equine external ear canal and tympanic membrane, as well as the need for chemical restraint. In this study, the proximal external ear canal was examined in live horses using a handheld otoscope and in cadaver heads using video otoscopy. Visualization of the proximal ear canal of the sedated horse could be done with a handheld otoscope, but more sedation or general anaesthesia and a video otoscope would be required to adequately visualize the tympanic membrane in the live horse. The proximal ear canals of 18 horses were examined cytologically and cultured aerobically. In three horses, both ears were sampled. No cells or organisms were seen on cytological examination of 11/21 ears. Nine of the 21 ears were sterile when cultured. Ten of the 21 ears had mixed growth with low numbers of organisms (Corynebacterium sp. being most common). Two of the 21 ears had heavy growth of a single organism (Corynebacterium sp. and Staphylococcus intermedius, respectively). Equine cadaver heads were examined in cross-section by computed tomography (CT) imaging and histopathology in order to further understand the anatomy of the equine external ear canal. Equine practitioners should be aware that otic examination is possible and may provide important diagnostic information.     

Effect of the 5-lipoxygenase inhibitor, fenleuton, on antigen-induced neutrophil accumulation and lung function changes in horses with chronic obstructive pulmonary disease

The leukotrienes (LT) LTD₄ and LTB₄ have been shown to cause bronchoconstriction and neutrophil accumulation, respectively, in horse lungs. Such changes are characteristic of the equine allergic respiratory disease, chronic obstructive pulmonary disease (COPD). To further investigate the role of these putative mediators in the pathogenesis of equine COPD the effect of a 5-lipoxygenase inhibitor, fenleuton, on antigen-induced changes in horses with this condition has been examined. Six horses with COPD underwent a series of four antigen challenges, one month apart, with placebo pre-treatment on three occasions and fenleuton (4 days oral dosing 5 mg/kg) pre-treatment on one occasion. Three horses received fenleuton prior to the second challenge and three horses received the drug prior to the fourth antigen challenge. Changes in radiolabelled neutrophil distribution, lung function and peripheral leucocyte counts were monitored on each occasion for 7 h following the start of antigen challenge. Antigen challenge caused an increase in radioactive counts over the lungs and a decrease in peripheral leucocyte count. Neither response was affected by fenleuton pre-treatment. Mean maximal changes in pleural pressure (ΔP_plmax) and respiratory rate were also unaffected by fenleuton pre-treatment. However, in the two horses which responded to antigen-challenge with a particularly marked increase in ΔP_plmax (>15 cm H₂O), prior administration of fenleuton reduced the response by 64 and 63%. These results suggest that 5-lipoxygenase inhibitors warrant further investigation as bronchodilators in equine COPD.     

Equine laryngeal hemiplegia. Part V. Central nervous system pathology

Evidence of long central nerve fibre degeneration (axonal spheroids) in the lateral cuneate nuclei was found in all eight Thoroughbreds affected clinically and subclinically with equine laryngeal hemiplegia, but in only one of six control animals. It was considered that these spheroids may signify a central nervous component of the disease process of laryngeal hemiplegia although until further investigations are performed no firm conclusions regarding the relationship of these findings with laryngeal hemiplegia could be made. Examination of the left and right nucleus ambiguus of clinical and subclinical laryngeal hemiplegic horses revealed no pathological alterations.     

Histological and biomechanical effects of palatal sclerotherapy in the horse using sodium tetradecyl sulfate

Palatal sclerotherapy using sodium tetradecyl sulfate has been suggested as a treatment for dorsal displacement of the soft palate in young Standardbred horses. The present study evaluated histological and biomechanical changes in the equine soft palate following trans-endoscopic treatment with a low dose of this compound. Two horses were euthanased and examined at 2 weeks and at 1, 2, 4 and 6 months post-sclerotherapy, while two further horses served as untreated controls. The technique was easily performed in all cases without major complications. On histological examination there was no evidence of palatal necrosis, inflammation or fibrosis in any of the treated or control animals. There was no variation in the density of palatal connective tissue between individuals, and on biomechanical assessment no significant difference in the stiffness of the palatal tissue was found between treated and control horses at any time. The lower dose of sodium tetradecyl sulfate used in this study relative to previous reports, might explain the absence of tissue alterations. This method of sclerotherapy did not alter the morphology or biomechanical properties of normal equine soft palates.