Impact of Different Diagnostic Procedures on Diagnosis, Therapy, and Outcome in Horses with Headshaking: Recommendations for Fast-Track Advanced Diagnostic and Therapeutic Protocols.

The research focuses on how using different diagnostic procedures affects the detection, treatment, and outcomes in horses suffering from a condition known as headshaking. It recommends adopting more efficient diagnostic and therapeutic practices, particularly the CT scan of the head, to identify if the animal is suffering from primary (idiopathic) or secondary headshaking.

Understanding Headshaking in Horses

• This study revolves around a condition in horses known as headshaking (HS), where the dominant diagnosis is idiopathic trigeminal-mediated headshaking (i-TMHS) if no underlying disease is found.
• The diagnosis of HS often has to rule out different factors by analyzing the horse’s history, presenting clinical signs, and conducting several medical investigations.
• Therefore, horses showing symptoms of HS often undergo many diagnostic procedures and treatments.

Methodology: Retrospective Analysis of Patient Records

• The research takes into account the digital records of 240 horses previously diagnosed with HS, studying the influence of various diagnostic procedures on diagnosis, therapy, and outcome.
• The methodology included a standardized protocol of conducting a thorough examination of the horse, including ophthalmologic, orthopaedic, neurologic, and dental evaluations, blood work, and several imaging techniques such as endoscopy, radiographs, CT scans, and MRI.

Findings

• In the course of the analysis, investigators discerned multiple findings, but only 6% of these were clinically relevant, leading these horses to be diagnosed with secondary headshaking (s-HS).
• Horses diagnosed with s-HS showed positive outcomes after treatment.
• Almost all clinically relevant findings (9 out of 10 cases) were observed via CT scans of the head, with other diagnostic measures having a far less significant impact.

Recommendations

• The research suggests that diagnosing horses with HS should focus on distinguishing between i-TMHS and s-HS.
• The clinical relevance of symptoms in the horses should be confirmed through diagnostic anaesthesia, or via targeted therapy depending upon the risk factors, invasiveness of the procedure, and expected benefits.
• To reduce the burden of multiple examinations, investigations should primarily focus on performing CT scans of the head, especially for horses suspected of having i-TMHS based on their history, observed clinical signs, and physical examination.