This is Dr. John Madigan's headshaking syndrome research questionaire at U.C. Davis. Research in this area is ongoing, and we are still collecting data in the form of questionnaires filled out by owners and attending veterinarians of horses with this condition. You will find one of these questionnaires below. If you suspect that your horse has a headshaking disorder, please fill it out and return to Dr. John Madigan, Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California at Davis, Davis, CA 95616. Thank you!

As part of ongoing studies by Dr. John E. Madigan at the University of California - Davis, we would appreciate your completing the following questionnaire. All results are confidential and will be used to determine natural history, course of the disorder, and response to therapy. Thank you for your assistance. If there are questions that you cannot answer please move to the next question and provide as prompt a return of the questionnaire as possible. Please add any comments next to any questions if you desire.

Address
 
 

Horse's name Age Breed Sex

Color Color of sire Color of dam

1. What was the month and year of onset of headshaking?

2. How long have you been the owner of the horse (date of purchase or ownership)?

What time of year was the horse purchased?

3. For what type of riding is the horse used (i.e. pleasure, dressage, jumping, eventing,

etc.)?

4. What is the horse's geographic location (state)?

What kind of housing does it have (pasture, paddock, stall, etc.)?

5. How severe is the headshaking (circle one)?

mild (can ride horse) moderate severe

Does headshaking prevent you from fully utilizing your horse?

Do you consider the horse dangerous because of its headshaking? If so, in what way?

6. Does headshaking start and/or stop at particular times of the year?

If so, when? Please give details:

7. Does the horse have any vices?

Is it a good reliable horse except for the headshaking?
 
 
 
 
 
 

8. Please circle any of the following clinical signs you observe in your horse:

a. Shaking head from side to side.

b. Shaking head up and down.

c. Acting like a fly or insect flew up its nose.

d. Excessive snorting of the nose.

e. Repetitive sneezing.

f. Rubbing the nose on objects.

g. Rubbing nose on ground while moving.

h. Onset of headshaking at rest.

i. Onset of headshaking at rest and with exercise.

j. Onset of headshaking only with exercise or with other (fill in):

___________________________________________________.

k. Striking at head with front foot.

l. Seeking shade in the environment.

m. Worse on bright sunny days.

n. Worse on cloudy days.

o. Reduced symptoms at night.

p. Headshaking with exercise only when ridden and not with free exercise or lungeing.

q. Anxious expression when headshaking.

r. Reluctance to move when headshaking.

s. Avoidance of light. If yes, please describe - ___________________________

_________________________________________________________________.

t. Staring out into space as if seeing objects that no one else sees. If yes, what

time of year and how often does this happen? ___________________________

_________________________________________________________________.

u. Becoming panicky following staring episodes or for unexplained reasons. If

yes, please describe: ______________________________________________ _________________________________________________________________.

v. Headtilt or cranial nerve dysfunction.

w. Stumbling, incoordination, or loss of smoothness of gait.

x. Seizures.

y. Focal sweating on body at rest.

z. Loss of muscles mass in specific area(s) of the body.

aa. Other symptoms (please describe in the space below or attach a separate

sheet):

bb. Licking of lips and/or excessive opening and closing of mouth
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

SECTION ON TREATMENT

1. Has your horse been treated with cyproheptadine?

If yes...

- What dose (i.e. how many pills per day and mg strength of pills)?

- How did you administer the medication?

- How long was the horse treated?

- Did the horse improve? Circle one:

Greatly improved (no symptoms when on cyproheptadine)

Somewhat improved (controllable but still occasional headshaking)

No response to treatment

- How long did it take before the horse showed improvement on cyproheptadine,

and what time of year was it?

2. What other medications have been tried, and what were the results (i.e. improvement

or no improvement)?

Drug: Improved? Yes No

Drug: Improved? Yes No

Drug: Improved? Yes No

3. Has your horse had chiropractic treatment for headshaking?

If yes, what was the response? (Circle one)

Headshaking stopped completely Improved Slightly improved No effect

4. Has your horse had acupuncture for headshaking?

If yes, what was the response? (Circle one)

Headshaking stopped completely Improved Slightly improved No effect

5. Does your horse improve when cloth or material is placed on the muzzle?

Have not tried.

Yes, improved (please describe).

Tried, but saw no improvement.

6. Does the horse improve when it is blindfolded or its eyes are shaded?

Have not tried.

Yes, improved (please describe).

Tried, but saw no improvement.

7. List any other treatments that have been tried and whether improvement was noted,

including the duration of the treatment and time of year:
 
 
 
 

8. Has your horse been diagnosed as having Photic Headshaking? If yes, who made the

diagnosis?

9. Have you tried insect or fly control? Does this influence headshaking?

10. What other symptoms are seen with your horse that may or may not be related to

headshaking?

11. Why do you think your horse is headshaking?

12. Did your horse have any vaccinations, deworming, or illness prior to the initial onset

of headshaking (within 6 weeks of first onset)?
 
 

13. Has your horse ever been vaccinated with a vaccine to protect against the herpes

virus, such as Pneumabort-K or Rhinomune? If so, when was that in relation to onset

of headshaking symptoms?

14. If a gelding, when was your horse gelded?

15. If a mare, does she exhibit abnormal estrus patterns?
 
 

16. Please make any additional comments you feel are important regarding headshaking

and your horse:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Please return this questionnaire to:

Dr. John Madigan

Department of Medicine and Epidemiology

School of Veterinary Medicine

University of California, Davis

Davis, CA 95616
 
 

Please visit The UC Davis Center For Equine Health website for addtional information at http://www.vetmed.ucdavis.edu/ceh The Horse Report: Writer/Editor: Laurie FioEditor/WriterCenter for Equine HealthSchool of Veterinary MedicineUniversity of CaliforniaOne Shields AvenueDavis, CA 95616-8589phone: (530) 752-4434fax: (530) 752-9379e-mail: ltfio@ucdavis.edu