title: Treatment of idiopathic headshaking in horses with pulsed high-dose dexamethasone.
abstract: BACKGROUND
  Treatment of idiopathic headshaking in horses is complicated by an incomplete understanding of underlying pathophysiology and partially effective treatments. If an inflammatory etiology exists, corticosteroids could be beneficial.
  
  
  OBJECTIVE
  An anti-inflammatory dose of dexamethasone reduces the signs of idiopathic headshaking in a field setting.
  
  
  METHODS
  Convenience sample of 20 adult horses with idiopathic headshaking syndrome. Cases were recruited from the general population and diagnosed by attending veterinarians.
  
  
  METHODS
  Prospective, blinded clinical trial. Pulsed dosing was with oral dexamethasone (60 mg PO Q24h × 4 days, q3 weeks for 4 months) or placebo (inert paste). Owners were blinded and asked to score the headshaking from 0 to 4 (4 = most severe) 3 days per week. The change in headshaking scores (HS) over each treatment pulse was compared between groups by ordinal logistic regression.
  
  
  RESULTS
  Twelve horses completed the trial. There was no significant difference between treated or placebo horses (P = .987). Sun (P ≤ .001), wind (P = .028), and exercise (P ≤ .045) significantly increased HS.
  
  
  CONCLUSIONS
  No benefit of dexamethasone treatment was detected for idiopathic headshaking. The results confirmed previous reports of common triggers for headshaking behavior
authors.forename: J E
authors.initials: JE
authors.lastname: Tomlinson
authors.forename: P
authors.initials: P
authors.lastname: Neff
authors.forename: R C
authors.initials: RC
authors.lastname: Boston
authors.forename: H
authors.initials: H
authors.lastname: Aceto
authors.forename: R D
authors.initials: RD
authors.lastname: Nolen-Walston
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D006257:Head / Q000503:physiopathology*; D006734:Horse Diseases / Q000188:drug therapy / Q000503:physiopathology*; D006736:Horses; D016015:Logistic Models; D011446:Prospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D003907:Dexamethasone