Head Shaking Average Cost

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What is Head Shaking?

If your horse is uncontrollably shaking his head, he needs to be seen by an equine veterinarian. Most equines with head shaking syndrome are experiencing a great deal of discomfort and pain which can become debilitating. It is imperative that the reason for the headshaking be diagnosed and treated.

Head shaking is a common, normal reaction a horse has when he is being annoyed or bitten by insects. Persistent, uncontrolled, violent, vertical head shaking, with the absence of biting insects, is considered abnormal behavior.

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Symptoms of Head Shaking in Horses

Other symptoms in addition to vertical head shaking may include one or more of the following:

  • Horse rubs his nose and muzzle violently on objects
  • Head slinging or twisting
  • Sores on face
  • Inflamed nostril
  • Hair loss on the face
  • The horse bangs his head against the stall
  • Head shaking becomes more severe in sunlight
  • Head shaking triggered by exercise, heat or wind
  • Hypersensitivity to touch
  • Sneezing
  • Snorting
  • Coughing
  • Horse stares blankly into space
  • Unable to be ridden because of the persistent head shaking
  • Eye tearing or swelling
  • Anxiety
  • Depression
  • Seasonal head shaking

Causes of Head Shaking in Horses

  • Fungal infection
  • Middle ear infection
  • Dental issues
  • Sinus infection
  • Ear mites
  • Allergies
  • Sensitivity to light
  • Over vaccinating 
  • Reaction to vaccinations
  • Trauma to the muzzle resulting in nerve damage
  • Hormonal
  • Neuropathic pain
  • Use of an improper bit

Diagnosis of Head Shaking in Horses

Keeping a daily log of when your horse has bouts of head shaking or any other symptoms, prior to the veterinarian’s visit may help the veterinarian with his diagnosis.

The veterinarian will go over the medical history of the horse and discuss any previous injuries or health ailments. He may ask to see vaccination, dental, and deworming records.  The veterinarian will need to know a timeline of when you noticed the head shaking, or other symptoms. This is where a daily log can be very helpful. The veterinarian will then perform a full physical exam. The horse’s physical exam may include:

  • Listening to his heart, lungs and gastrointestinal tract with a stethoscope
  • Blood pressure
  • Weight
  • Hoof testing
  • Skin exam
  • Rectal exam
  • Check ears and nostrils 
  • Pupillary light reflex test 
  • Check corneal reflex 
  • Check the color of the gums
  • Palpation of the limbs and muscles
  • Palpation of lymph nodes
  • Dental exam, checking for swelling, abscess, dental caps, abrasions, or lesions on cheek or tongue
  • Overall body condition of the horse

 Diagnostic tests may include:

  • Complete blood count - Checks the count of platelets, red and white blood cells; this helps determine if there is a bacterial infection or if the horse is anemic
  • Serum chemistry panel - This blood test checks on organ functions (kidneys, liver, blood protein and electrolytes)
  • Serum allergy test (SAT) -  If the veterinarian believes that the headshaking is due to an allergy he will recommend this test; it aids in determining the allergens the horse may be allergic too
  • Fecal Exam - Can help diagnose parasites and if there is any blood in the feces 

If ear mites are suspected, the veterinarian will swab the inside of the horse’s ear, put a sample on a slide and check for mites under the microscope A urinalysis may be done to verify kidney function and to test for crystals, blood or bacteria in the urine. X-rays of the head may be suggested to check for any abnormalities.

A nasopharyngeal endoscopy may be recommended. A small camera on a long tube is inserted in the horse’s nostril for an internal view. Sometimes a cytology brush is used to collect skin for a culture. This test can help diagnose respiratory diseases, tumors, discharge, and inflammation.

Treatment of Head Shaking in Horses

Treatment for head shaking in horses will depend on what the veterinarian diagnosed.  

Fungal infections are usually treated with a medicated shampoo and antibiotics.  If ticks were found, they will need to be removed.  Topical medications may include an antibiotic and corticosteroid ointment.  Oral antibiotics may also be prescribed.

Dental issues may include abstraction of a tooth or dental cap. Sinus infections in horses may be treated with an antibiotic, sinus flush, and steam inhalation therapy. Ear mites are treated with topical insecticides applied with a swab.  If there is a bacterial infection, the horse will be prescribed antibiotics.

Allergy treatment may include avoidance of the allergen, corticosteroids, antihistamines and allergy shots. If there is a sensitivity to light, tinted goggles or glasses, a mask, or an ultraviolet screens may be suggested, along with avoidance of bright sunlight.

Homeopathic supplements,  such as Capster may be suggested for vaccination reactions. Hormonal or seasonal head shaking may be treated with hormone therapy. Neurological issues, such as hypersensitivity of the cranial facial nerves (this is an extremely painful condition similar to neuralgia in humans) can be reduced by avoiding the triggers ( sunlight, wind, stress and biting bugs).

Magnesium supplements may help with reducing firing of nerve cells. Spirulina is a homeopathic product that can also help.  Medications may include dexamethasone orally, and cyproheptadine, a histamine and serotonin inhibitor drug.

Recovery of Head Shaking in Horses

Follow-up visits will be necessary to check on the horse’s progress. Prognosis of head shaking is dependent on what the underlying condition was. In most cases, it is controllable, by use of medications and avoidance of the triggers. Patients with allergies may need to have lifelong allergy shots.

Head Shaking Questions and Advice from Veterinary Professionals

Welsh D
7 Years
Moderate condition
1 found helpful
Moderate condition

Has Symptoms

Runny Nose
Head Shaking
Watery eyes

Quattro did have a runny nose and watery eyes in July before he developed a head shake. We discovered that by touching behind his ear, his shaking would be provoked. His eyes and nose stopped running in September, but the shaking continued. It happens while I ride him and when he’s in his stable. The bridle causes him to shake and so does touching his ear. We have tried pulling back his bridle and plaiting his mane so that it doesn’t tickle him but to no avail. Any ideas?

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18 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Heading Shaking and Throwing Head

Steffie throws her head in cross ties, while riding (also causing owner to fall), and out in the pasture. We have tried chiropractic work to see if she was uncomfortable in any way (did not help). We thought the head throwing was an attitude while riding so we tried to work her through it but nothing changed. Any suggestions?

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12 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

Ear Itching

My horse is holding his ear at an angle that is not natural It also seems to be itchy He gently rubs the base of his ear on his leg and then there is lots of head shaking Advice appreciated

Dr. Michele King, DVM
Dr. Michele King, DVM
1611 Recommendations
Thank you for your email. Since I cannot examine Eigor, it would be best to have him seen by your veterinarian. They can examine him and determine what is going on with his ear and recommend treatment for him. He may have a parasite, or an infection that needs to be treated. I hope that he is okay.

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