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Basics

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BASICS

Definition!!navigator!!

  • A stereotypic behavior is a relatively invariant, repetitive pattern of movement with no obvious purpose
  • It arises from a thwarted normal maintenance behavior (walking), but is performed excessively and out of context to the exclusion of normal behaviors, and so is a welfare concern
  • Equine locomotor stereotypic behaviors include stall/box-walking; weaving; fence running
  • Weaving consists of an obvious lateral swaying movement of the head, neck, forequarters, and sometimes hindquarters, with the limbs typically tensing in the sequence of the walk or trot, even if the animal does not move forward (see Web Video 1). The horse may toss, nod, and shake its head at the same time, but this should not be confused with the separate condition of headshaking syndrome

Pathophysiology!!navigator!!

  • Unclear but appears to relate to motivational conflict
  • Proposed mechanisms implicate serotonergic and dopaminergic systems, but there is no evidence of dysfunction

Systems Affected!!navigator!!

  • Behavioral—may interfere with expression of normal maintenance behaviors or with performance of learned responses
  • Musculoskeletal—uneven hoof wear or muscle development
  • Decreased performance if the behavior is performed to the point of fatigue or self-injury but this is rare

Genetics!!navigator!!

A genetic predisposition is suspected, but the precise nature of inheritance has not been determined.

Incidence/Prevalence!!navigator!!

Weaving occurs in about 3% of horses but the prevalence varies with circumstances (range 0–10%). For stall-walking average prevalence is around 2% (range 0–7%).

Geographic Distribution!!navigator!!

Worldwide

Signalment!!navigator!!

  • No age or sex predilection, but the occurrence of 1 locomotor stereotypic behavior increases the risk of another
  • Warmbloods and Thoroughbreds are at a general increased risk of developing stereotypic behaviors
  • More common among endurance horses and horses with reduced or restricted exercise (<1.5 ha), especially if kept in face-to-face stalls, where locomotion is likely to be frequently thwarted as they try to interact with horses opposite
  • Median age of onset is 64 weeks for weaving and 60 weeks for box-walking

Signs!!navigator!!

General Comments

  • Time spent performing the behavior varies. The behaviors are often elicited by arousal associated with a desire to engage with stimuli outside the stall (e.g. food or other horses being led to and from barns or pastures, toward or away from herd mates; or in anticipation of pleasurable experiences outside the stall). The intensity of the behavior may increase at times of increased emotional arousal
  • Stall-walking—circular pacing when confined to a stall. The horse may circle in 1 or both directions, repeatedly tracing its path, sometimes even placing its feet in exactly the same place during each circuit
  • Weaving—rhythmic side-to-side swaying of the head and neck, often accompanied by an obvious alternate stepping in place with the front limbs and possibly all 4 limbs to the beat of the walk or trot
  • Fence running—the horse walks, trots, or canters in a repetitive pattern along a fence line or before a gate, with the distance traveled and the location and features of the turns being the same each time
  • Head nodding, tossing, and shaking as well as kicking out at the stall walls or door may also occur with any of these locomotor behaviors

Historical Findings

Owners may report a gradual onset or an inciting event after which the behavior was seen to become more obvious.

Physical Examination Findings

Unremarkable, except for possible lesions from rubbing on the stall door etc. or uneven shoe or hoof wear.

Causes!!navigator!!

Environment and management practices that inhibit expression of locomotion or locomotor expectations (e.g. periods of extensive exercise followed by periods of enforced rest).

Risk Factors!!navigator!!

  • Endurance horses
  • Abrupt box weaning
  • Any bedding other than straw

Diagnosis

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DIAGNOSIS

Differential Diagnosis!!navigator!!

  • Anxiety specific to separation from herd mates
  • Bilateral foot-related lameness causing shifting from 1 limb to the other
  • A learned response reinforced by a reward (e.g. a horse shakes its head and bangs the stall door at feeding time and is fed by the caretaker; thus reinforcing the behavior)

CBC/Biochemistry/Urinalysis!!navigator!!

NA

Other Laboratory Tests!!navigator!!

NA

Imaging!!navigator!!

N/A unless laminitis or similar foot lameness suspected.

Other Diagnostic Procedures!!navigator!!

N/A

Treatment

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TREATMENT

Aims!!navigator!!

  • Ethologically based approaches to address behavioral needs, especially the balance between exercise, diet, and confinement. Housing which allows greater social contact either directly or via a mirror should be encouraged if the horse is sociable
  • Devices and management measures that focus on preventing performance of the behavior without addressing the psychologic aspects do not constitute humane treatment. Anti-weaving stall doors may reduce neck swaying during weaving, but can redirect the behavior into another form, e.g. box-walking
  • Psychoactive medication is experimental and rarely justified in practice

Appropriate Health Care!!navigator!!

  • Treatment plan focuses on management practices such as decreasing confinement, isolation, and emotional arousal
  • Manage as an outpatient
  • Recommended modifications in management practices—increased turnout time, preferably with a compatible companion; increased grazing time; increased opportunities for social contact within the confines of the stall
  • Deep bedding, especially straw, which gives the horse something to investigate, decreases wear and tear on the horse's feet and extremities. Stalls may need protection from incidental damage caused by kicking
  • Increasing time spent foraging using double or triple layers of hay net with small holes or toys that release food when moved about by the horse can help, but may increase oral frustration (see chapter Oral stereotypic behaviors). If using multiple hay nets, there should be some hay between the net layers. 2 or 3 nested nets can be hung at a safe height in different corners of the stall. Feeding forage from the floor in piles around the circuit traced by a stall-walker may encourage a more natural browsing pattern
  • Increase contact between individuals when housed, if safe to do so, e.g. through bars between stalls if group housing deemed too risky. An unbreakable scratch-resistant mirror (e.g. polished steel) may be provided to the side of the door where the horse weaves as an alternative to a companion and seems to serve as a distraction when the horse is at the front of the stable and about to weave. This is not suitable for unsociable horses

Activity!!navigator!!

Maintain a consistent high level of grazing, turnout, and aerobic activity in accordance with the work of the horse.

Diet!!navigator!!

Increased roughage, reduce/eliminate concentrate.

Client Education!!navigator!!

  • Caution owners against reinforcing undesirable, repetitive behaviors
  • Scientific evidence does not support that these behaviors cause unthriftiness

Surgical Considerations!!navigator!!

N/A

Medications

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MEDICATIONS

Drug(s) of Choice!!navigator!!

  • Medications are generally not justified on risk, welfare, cost, and feasibility grounds. Owners should be counseled accordingly
  • Opioid antagonists, such as naltrexone and naloxone, have a short half-life, high cost, and require IV administration
  • Tricyclic antidepressants and SSRIs such as amitriptyline, clomipramine, doxepin, fluoxetine, and imipramine might be theoretically useful for increasing inhibitory control, but few (if any) uses of these drugs in horses are reported. The risks generally outweigh any potential benefits. Paroxetine has been used to reduce weaving at a dose of 0.5 mg/kg PO every 24 h

Contraindications!!navigator!!

If medication is used, careful monitoring of serum chemistry values and clinical signs is essential.

Precautions!!navigator!!

  • Owners should be aware that use of psychotropic medication constitutes experimental and off-label use and is not usually justifiable on welfare grounds
  • Owners should sign an informed consent form and receive an explanation (preferably in writing) of the medication, selection rationale, expected benefits, and possible side effects
  • CBC and serum chemistry panel are recommended before initiating drug therapy
  • Laboratory diagnostics should be repeated 6 weeks after start of medication and whenever clinical signs warrant
  • Cardiac conduction abnormalities are a contraindication for use of tricyclic antidepressants, which are arrhythmogenic in humans and may be so in horses

Possible Interactions!!navigator!!

Combinations of tricyclics and SSRIs may be synergistic and should not be used.

Alternative Drugs!!navigator!!

Acepromazine has been used experimentally, but is not justifiable in practice.

Follow-up

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FOLLOW-UP

Patient Monitoring!!navigator!!

  • Drug dosages may need adjustment, so weekly follow-up is recommended. If long-term use of medication is intended, semiannual or annual monitoring of CBC and serum chemistry is recommended
  • Monitor owner compliance regarding management recommendations. Intervals for follow-up vary depending on problem severity

Prevention/Avoidance!!navigator!!

Avoid abrupt weaning, and provide social contact when possible. Maintain a consistent exercise regime in accordance with the use of the horse, and avoid unnecessary concentrate, using forage in place wherever possible. Avoid inadvertent reinforcement through the provision of food and social contact when the horse shows these behaviors or other signs of high arousal.

Possible Complications!!navigator!!

Situations of stress and especially frustration may exacerbate these problems.

Expected Course and Prognosis!!navigator!!

Treatment is aimed at improving welfare and minimizing the display of the behaviors; owners should be counseled about such management and to avoid measures which simply prevent the behavior and potentially increase frustration.

Miscellaneous

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MISCELLANEOUS

Associated Conditions!!navigator!!

  • Lameness
  • Impaired performance

Age-Related Factors!!navigator!!

Median age of onset is just over a year.

Pregnancy/Fertility/Breeding!!navigator!!

Use of medication is contraindicated in pregnant individuals.

Synonyms!!navigator!!

  • Compulsive disorders
  • Obsessive–compulsive disorders
  • Stable vices
  • Stereotypies

Abbreviations!!navigator!!

SSRI = selective serotonin-reuptake inhibitor

Suggested Reading

Cooper JJ, McDonald L, Mills DS. The effect of increasing visual horizons on stereotypic weaving: implications for the social housing of stabled horses. Appl Anim Behav Sci 2000;69(1):6783.

Crowell-Davis SL, Murray T. Veterinary Psychopharmacology. Ames, IA: Blackwell Publishing, 2006.

McGreevy P. Equine Behavior: A Guide for Veterinarians and Equine Scientists, 2e. Philadelphia, PA: WB Saunders, 2012.

Mills DS, McDonnell SM. The Domestic Horse: The Origins, Development and Management of its Behaviour. New York, NY: Cambridge University Press, 2005.

Mills DS, Taylor KD, Cooper JJ. Weaving, headshaking, cribbing, and other stereotypies. Proc Am Assoc Equine Pract 2005;51:220230.

Author(s)

Author: Daniel S. Mills

Consulting Editor: Victoria L. Voith

Acknowledgment: The author and editor acknowledge the prior contribution of Soraya V. Juarbe-Díaz.