Creating a good relationship with your vet and trusting their judgement is an essential start. There are drugs available (cyproheptadine and tegretol are commonly used) and surgical techniques to cut these faulty nerves. The success of these is variable but is increasing as more is learnt about the condition.

Nose nets and other facial coverings have played a large part in returning many head shakers to normal function and are still the most successful, preventative, home treatment. A recent trial found that they halved the severity of symptoms in 50% of the horses. The equal success of half nets (that just cover the top line of the muzzle) suggest that nose nets do not actively filter out pollens – the holes are just too big! They may work by distorting the airflow to the nose. They may also serve to distract/comfort the horse, which still doesn’t mean it’s a behavioural problem! British Dressage is just one of the boards to have accepted the use of half nets in competition. Face and ear nets can be effective too – whether this suggests that for these horses there is a different cause or that they too perform a distracting/protective role is not known.

Keeping a diary of events can help you to identify trigger spots and times when the head shaking is worse. As a rule, avoiding an attack is better than attempting to ride the horse through one. Remember most head shakers are suffering from a clinical problem that they cannot help. Some owners also report improvements with stabling during the day and turnout at night in the summer and wetting hay to reduce the possibility of any respiratory complications. However, a recent report concluded that acupuncture is likely to be of little benefit in the majority of cases.

The outlook for many head shakers with careful management can be bright and whilst you may not always be able to get the best from your horse at the best time for you, a happy and rewarding relationship can still be maintained. Although it seems that in terms of potential causes we’re doing more ruling out than ruling in – we’re getting there

For more information, please visit the Equilibrium Website