Stringhalt is a neuromuscular disorder in horses characterized by an exaggerated and involuntary flexion of one or both hind limbs. This condition is most noticeable when the horse is asked to move, particularly at a walk, and can vary in severity. The precise cause of stringhalt is not completely understood, but it is believed to involve abnormal nerve function. There are two main types: classic stringhalt, which is often idiopathic, and Australian stringhalt, which has been associated with the ingestion of certain toxic plants. Diagnosis is typically based on clinical signs, as there are no specific tests for stringhalt. Treatment options may include surgical intervention or management changes, but the effectiveness can vary among individual horses. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, clinical presentation, and management strategies for stringhalt in horses.
Valberg SJ.Movement disorders are defined as involuntary movements that are not due to a painful stimulus or associated with changes in consciousness or proprioception. Diagnosis involves ruling out any lameness and neurologic disease and characterizing the gait during walking backward and forward and trotting. Shivers causes abnormal hindlimb hypertonicity during walking backward and, when advanced, a few strides walking forward. Stringhalt causes consistent hyperflexion during walking forward and trotting and variable difficulty when walking backward. Classification and potential causes are discussed a...
Valberg SJ, Baird JD.Pelvic limb movement disorders unrelated to lameness or proprioceptive ataxia have been described in horses for centuries. The two best described are Shivering and Stringhalt. Shivering is unique in that it is primarily apparent when horses are asked to walk backward, without affecting forward gaits until quite advanced. Horses exhibit abduction and either hyperflexion or marked hyperextension of one or both pelvic limbs when walking backward, resulting in a pause at the peak of the stride cycle and reluctance to move backward. Generally, Stringhalt differs from Shivering in that it produces c...
Brockman T."Stringhalt" is a horse condition that causes one or both hind legs to spasm when walking, trotting or backing. The condition is thought to be related to a neurological cause from either plant toxicity or peripheral nerve injury. The prognosis is poor and the horse's performance and quality of life can be affected. Treatment has included surgically cutting the digital extensors with varied results. The objective of the study is to utilize soft tissue release via acupressure, trigger point and myofascial release to decrease symptoms of stringhalt. The case study is a 12 year old Akhal-Teke hors...
Draper AC, Trumble TN, Firshman AM, Baird JD, Reed S, Mayhew IG, MacKay R, Valberg SJ.To investigate and further characterise posture and movement characteristics during forward and backward walking in horses with shivering and acquired, bilateral stringhalt. Objective: To characterise the movement of horses with shivering (also known as shivers) in comparison with control horses and horses with acquired bilateral stringhalt. Methods: Qualitative video analysis of gait in horses. Methods: Owners' and authors' videos of horses with shivering or stringhalt and control horses walking forwards and backwards and manually lifting their limbs were examined subjectively to characterise...
Domange C, Schroeder H, Violle N, Peiffer J, Canlet C, Paris A, Priymenko N.Mining the brain metabolome to understand behavioural disruptions induced in mouse fed Hypochoeris radicata (L.), a neurotoxic plant for horse. C57BL/6J mice orally exposed to 9% H. radicata (HR) are metabolically competent laboratory animals which can be used as model of Australian stringhalt, a neurological horse disease induced by HR ingestion. So, the present study was conducted to assess the brain metabolome and the behavioural performances of mice fed with a 9%-HR-based diet for 21 days. By the end of the period of exposure, mice were investigated for motor activity and coordination, anx...
MacKay RJ, Wyer S, Gilmour A, Kongara K, Harding DR, Clark S, Mayhew IG, Thomson CE.Pasture-associated stringhalt is an acquired equine disease characterized by peripheral neuropathy and hyperflexion of the pelvic limbs. The disease occurs most commonly during periods of drought in horses grazing pastures heavily contaminated by Hypochaeris radicata. We hypothesized that stringhalt is caused by neurotoxins elaborated by H. radicata in response to the stress of drought conditions. Supernates were collected from H. radicata that were stressed (or not) by immersion in copper chloride solution, then extracted with ethyl acetate and dried. Dilutions of extracts from stressed (SE) ...
Domange C, Casteignau A, Collignon G, Pumarola M, Priymenko N.Seventy horses with clinical evidence of Australian stringhalt were studied in France from 2003 to 2008. All horses but one had history of bilateral stringhalt and grazed pastures infested with Hypochoeris radicata (L.). They displayed hind limbs hyperflexion and an abnormal gait because of a distal axonopathy with a skeletal muscle denervation and atrophy. Fifty percentage of them recovered spontaneously in 8 months, and only the more affected horses were unable to recover even if they looked healthy on dry and hot days. Clinical troubles revealed also depression or aggressive behaviour, sugg...
Wijnberg ID, Schrama SE, Elgersma AE, Maree JT, de Cocq P, Back W.Therapeutic options for stringhalt in horses are limited, whereas medical experiences with botulinum toxin type A (Botox) have been positive. To evaluate its effectiveness in horses, surface electromyography (sEMG) signals before and after injection need to be quantified. Objective: Treatment of healthy ponies and cases with Botox should reduce muscle activity in injected muscles and reduce spastic movements without adverse side effects. Methods: Unilaterally, the extensor digitorum longus, extensor digitorum lateralis and lateral vastus muscles of 6 healthy mature Shetland ponies and 2 talent...
Wijnberg ID, Back W, van der Kolk JH.This paper describes a case of unilateral stringhalt present for 18 months in the right hind limb of a 4-year-old Warmblood gelding. The only abnormalities detected by electromyography (EMG) were a prolonged insertion activity, fibrillation potentials, and positive waves at rest and enhanced EMG activity in the right lateral digital extensor muscle on muscle contraction. This was interpreted as denervation and hyperirritability of this muscle. Both similarities and differences with Australian stringhalt could be found. As described for horses suffering from Australian stringhalt, phenytoin sod...
Crabill MR, Honnas CM, Taylor DS, Schumacher J, Watkins JP, Snyder JR.A review of medical records was used to identify 10 horses in which stringhalt developed subsequent to trauma to the dorsal metatarsus. Six horses developed stringhalt within 3 months after injury, 3 horses developed stringhalt > 3 months after injury, and time from injury to stringhalt was unknown for 1 horse. Horses were treated with exercise, including daily hand-walking with pasture turnout, followed by lunging; or surgically, using lateral digital extensor myotenectomy. Of the horses treated with exercise, 1 had resolution of stringhalt, 2 improved but had residual stringhalt, and 1 ha...
Slocombe RF, Huntington PJ, Friend SC, Jeffcott LB, Luff AR, Finkelstein DK.Nine horses with clinical signs of Australian Stringhalt were killed and tissues collected for a detailed pathological study. Lesions were limited to peripheral nerves and muscles. The most severely affected nerves were the superficial and deep peroneal, distal tibial, plantar digital, volar and recurrent laryngeal nerve with changes characterised by a selective loss of large diameter myelinated fibres with various degrees of demyelination, fibrosis, Schwann cell proliferation and onion-bulb formation. A routine evaluation of the brain and spinal cord by light microscopy failed to reveal any c...
Huntington PJ, Seneque S, Slocombe RF, Jeffcott LB, McLean A, Luff AR.Five horses with Australian stringhalt were treated with 15 mg/kg phenytoin orally for 2 weeks. During the second week of the trial, 3 of the horses were given an additional dose of 10 mg/kg phenytoin. The response to treatment was clinically assessed by grading the severity of the gait abnormality at the walk, trot, turning and backing twice daily. There was a significant (P less than 0.05) improvement in the gait abnormality when pre-treatment values were compared with the mean of the last 3 assessments before treatment stopped. When reassessed 2 weeks after treatment ceased, there remained ...
Cahill JI, Goulden BE, Jolly RD.A detailed investigation of the neuropathology of a horse affected with stringhalt was performed. Qualitative and quantitative light and electron microscopy, and single teased fibre preparations of peripheral nerve demonstrated predominantly axonal degeneration, the stage of which was appropriate for the duration of clinical signs. There was selective involvement of large myelinated nerve fibres. A proximal to distal increase in the severity of pathological changes was present in the peripheral nerves. The long left recurrent laryngeal nerve was the most severely affected, followed in order by...
Cahill JI, Goulden BE, Pearce HG.A review of the literature on stringhalt in horses is presented, including the aetiology, clinical signs, pathology and treatment of this disease. Three New Zealand outbreaks of stringhalt are reported and discussed. The occurrence of these (and most previously reported outbreaks) in the late summer and autumn, and the association of the disease with various weeds, indicates a likely toxic aetiology.
Wijnberg ID, Schrama SE, Elgersma AE, Maree JT, de Cocq P, Back W.Therapeutic options for stringhalt in horses are limited, whereas medical experiences with botulinum toxin type A (Botox) have been positive. To evaluate its effectiveness in horses, surface electromyography (sEMG) signals before and after injection need to be quantified. Objective: Treatment of healthy ponies and cases with Botox should reduce muscle activity in injected muscles and reduce spastic movements without adverse side effects. Methods: Unilaterally, the extensor digitorum longus, extensor digitorum lateralis and lateral vastus muscles of 6 healthy mature Shetland ponies and 2 talent...
Cahill JI, Goulden BE, Pearce HG.A review of the literature on stringhalt in horses is presented, including the aetiology, clinical signs, pathology and treatment of this disease. Three New Zealand outbreaks of stringhalt are reported and discussed. The occurrence of these (and most previously reported outbreaks) in the late summer and autumn, and the association of the disease with various weeds, indicates a likely toxic aetiology.
Cahill JI, Goulden BE, Jolly RD.A detailed investigation of the neuropathology of a horse affected with stringhalt was performed. Qualitative and quantitative light and electron microscopy, and single teased fibre preparations of peripheral nerve demonstrated predominantly axonal degeneration, the stage of which was appropriate for the duration of clinical signs. There was selective involvement of large myelinated nerve fibres. A proximal to distal increase in the severity of pathological changes was present in the peripheral nerves. The long left recurrent laryngeal nerve was the most severely affected, followed in order by...
Slocombe RF, Huntington PJ, Friend SC, Jeffcott LB, Luff AR, Finkelstein DK.Nine horses with clinical signs of Australian Stringhalt were killed and tissues collected for a detailed pathological study. Lesions were limited to peripheral nerves and muscles. The most severely affected nerves were the superficial and deep peroneal, distal tibial, plantar digital, volar and recurrent laryngeal nerve with changes characterised by a selective loss of large diameter myelinated fibres with various degrees of demyelination, fibrosis, Schwann cell proliferation and onion-bulb formation. A routine evaluation of the brain and spinal cord by light microscopy failed to reveal any c...
Domange C, Schroeder H, Violle N, Peiffer J, Canlet C, Paris A, Priymenko N.Mining the brain metabolome to understand behavioural disruptions induced in mouse fed Hypochoeris radicata (L.), a neurotoxic plant for horse. C57BL/6J mice orally exposed to 9% H. radicata (HR) are metabolically competent laboratory animals which can be used as model of Australian stringhalt, a neurological horse disease induced by HR ingestion. So, the present study was conducted to assess the brain metabolome and the behavioural performances of mice fed with a 9%-HR-based diet for 21 days. By the end of the period of exposure, mice were investigated for motor activity and coordination, anx...
Crabill MR, Honnas CM, Taylor DS, Schumacher J, Watkins JP, Snyder JR.A review of medical records was used to identify 10 horses in which stringhalt developed subsequent to trauma to the dorsal metatarsus. Six horses developed stringhalt within 3 months after injury, 3 horses developed stringhalt > 3 months after injury, and time from injury to stringhalt was unknown for 1 horse. Horses were treated with exercise, including daily hand-walking with pasture turnout, followed by lunging; or surgically, using lateral digital extensor myotenectomy. Of the horses treated with exercise, 1 had resolution of stringhalt, 2 improved but had residual stringhalt, and 1 ha...
Draper AC, Trumble TN, Firshman AM, Baird JD, Reed S, Mayhew IG, MacKay R, Valberg SJ.To investigate and further characterise posture and movement characteristics during forward and backward walking in horses with shivering and acquired, bilateral stringhalt. Objective: To characterise the movement of horses with shivering (also known as shivers) in comparison with control horses and horses with acquired bilateral stringhalt. Methods: Qualitative video analysis of gait in horses. Methods: Owners' and authors' videos of horses with shivering or stringhalt and control horses walking forwards and backwards and manually lifting their limbs were examined subjectively to characterise...
Brockman T."Stringhalt" is a horse condition that causes one or both hind legs to spasm when walking, trotting or backing. The condition is thought to be related to a neurological cause from either plant toxicity or peripheral nerve injury. The prognosis is poor and the horse's performance and quality of life can be affected. Treatment has included surgically cutting the digital extensors with varied results. The objective of the study is to utilize soft tissue release via acupressure, trigger point and myofascial release to decrease symptoms of stringhalt. The case study is a 12 year old Akhal-Teke hors...
Valberg SJ.Movement disorders are defined as involuntary movements that are not due to a painful stimulus or associated with changes in consciousness or proprioception. Diagnosis involves ruling out any lameness and neurologic disease and characterizing the gait during walking backward and forward and trotting. Shivers causes abnormal hindlimb hypertonicity during walking backward and, when advanced, a few strides walking forward. Stringhalt causes consistent hyperflexion during walking forward and trotting and variable difficulty when walking backward. Classification and potential causes are discussed a...
Valberg SJ, Baird JD.Pelvic limb movement disorders unrelated to lameness or proprioceptive ataxia have been described in horses for centuries. The two best described are Shivering and Stringhalt. Shivering is unique in that it is primarily apparent when horses are asked to walk backward, without affecting forward gaits until quite advanced. Horses exhibit abduction and either hyperflexion or marked hyperextension of one or both pelvic limbs when walking backward, resulting in a pause at the peak of the stride cycle and reluctance to move backward. Generally, Stringhalt differs from Shivering in that it produces c...
Wijnberg ID, Back W, van der Kolk JH.This paper describes a case of unilateral stringhalt present for 18 months in the right hind limb of a 4-year-old Warmblood gelding. The only abnormalities detected by electromyography (EMG) were a prolonged insertion activity, fibrillation potentials, and positive waves at rest and enhanced EMG activity in the right lateral digital extensor muscle on muscle contraction. This was interpreted as denervation and hyperirritability of this muscle. Both similarities and differences with Australian stringhalt could be found. As described for horses suffering from Australian stringhalt, phenytoin sod...
Domange C, Casteignau A, Collignon G, Pumarola M, Priymenko N.Seventy horses with clinical evidence of Australian stringhalt were studied in France from 2003 to 2008. All horses but one had history of bilateral stringhalt and grazed pastures infested with Hypochoeris radicata (L.). They displayed hind limbs hyperflexion and an abnormal gait because of a distal axonopathy with a skeletal muscle denervation and atrophy. Fifty percentage of them recovered spontaneously in 8 months, and only the more affected horses were unable to recover even if they looked healthy on dry and hot days. Clinical troubles revealed also depression or aggressive behaviour, sugg...
Huntington PJ, Seneque S, Slocombe RF, Jeffcott LB, McLean A, Luff AR.Five horses with Australian stringhalt were treated with 15 mg/kg phenytoin orally for 2 weeks. During the second week of the trial, 3 of the horses were given an additional dose of 10 mg/kg phenytoin. The response to treatment was clinically assessed by grading the severity of the gait abnormality at the walk, trot, turning and backing twice daily. There was a significant (P less than 0.05) improvement in the gait abnormality when pre-treatment values were compared with the mean of the last 3 assessments before treatment stopped. When reassessed 2 weeks after treatment ceased, there remained ...
MacKay RJ, Wyer S, Gilmour A, Kongara K, Harding DR, Clark S, Mayhew IG, Thomson CE.Pasture-associated stringhalt is an acquired equine disease characterized by peripheral neuropathy and hyperflexion of the pelvic limbs. The disease occurs most commonly during periods of drought in horses grazing pastures heavily contaminated by Hypochaeris radicata. We hypothesized that stringhalt is caused by neurotoxins elaborated by H. radicata in response to the stress of drought conditions. Supernates were collected from H. radicata that were stressed (or not) by immersion in copper chloride solution, then extracted with ethyl acetate and dried. Dilutions of extracts from stressed (SE) ...
