🧠 Stringhalt in Horses Vet Guide 2025 by Dr Duncan Houston

Welcome to your expert veterinary guide on Stringhalt, a movement disorder in horses. Authored by Dr Duncan Houston BVSc, this comprehensive resource covers the symptoms, underlying causes, diagnostics, treatment options—including surgery and complementary therapies—nutrition, and prognosis. With a clear and supportive tone, I aim to help you confidently navigate this challenging condition. 🐴

1. What Is Stringhalt?

Stringhalt, also called equine reflex hypertonia, is a neuromuscular gait abnormality where horses exhibit an **involuntary exaggerated upward flexion** of one or both hindlimbs during walk—especially when turning, initiating movement, or backing up :contentReference[oaicite:3]{index=3}.

2. Forms & Causes

• Australian Stringhalt: Linked to toxins from flatweed (Hypochaeris radicata) prevalent in drought-affected pastures :contentReference[oaicite:4]{index=4}.
• Pseudostringhalt: Mimics stringhalt but is secondary to pain in the leg or foot :contentReference[oaicite:5]{index=5}.
• Idiopathic (unilateral/bilateral): No clear cause; sometimes linked to peripheral neuropathy and distal axonopathy of sciatic, peroneal, tibial nerves :contentReference[oaicite:6]{index=6}.

3. Clinical Signs & Grading

Signs range from mild jerks to severe spasms where the hind foot may touch the abdomen. It commonly worsens during walking or backing, but may improve at faster gaits :contentReference[oaicite:7]{index=7}.

Grade system adapted from research by Huntington et al. :contentReference[oaicite:8]{index=8}.

4. Diagnosis & Differentiation

Diagnosis is primarily clinical by observing gait, especially backward movement. Differential diagnoses include:

• Shivers: Occurs during backing, but involves tremor, resistance, and tail elevation—Shivers spares forward gait :contentReference[oaicite:9]{index=9}.
• Lameness or pain: Pseudostringhalt is ruled out by lameness evaluation.
• Neuropathies: Confirmed via EMG, nerve conduction tests :contentReference[oaicite:10]{index=10}.

5. Treatment Options

5.1 Remove Toxic Exposure

For Australian cases, relocating from contaminated pasture typically leads to recovery over months to 18 months :contentReference[oaicite:11]{index=11}.

5.2 Surgery (Tenectomy/Excision)

Harvesting part of the lateral digital extensor muscle via myotenectomy yields ~50% success long-term in idiopathic cases—recovery may take weeks :contentReference[oaicite:12]{index=12}.

5.3 Pharmacological Treatments

• Phenytoin: Anticonvulsant reducing dystonic steps, with some success :contentReference[oaicite:13]{index=13}.
• Muscle relaxants & sedation: Acepromazine, baclofen, methocarbamol—often temporary :contentReference[oaicite:14]{index=14}.
• Botox (Botulinum A): Preliminary case evidence suggests benefit :contentReference[oaicite:15]{index=15}.

5.4 Complementary Therapies

A case study used **myofascial release, acupressure, and trigger-point therapy**, reducing spasms frequency significantly :contentReference[oaicite:16]{index=16}.

5.5 Nutrition & Supplements

Antioxidants & nerve-supportive nutrients such as vitamin E, thiamine (B1), omega-3s may help nerve health :contentReference[oaicite:17]{index=17}.

6. Prognosis & Outlook

Outcomes depend on type and severity:

• Australian Stringhalt: Often resolves after pasture change; recovery may span 3 months to 1.5 years :contentReference[oaicite:18]{index=18}.
• Idiopathic/Stringhalt: Variable; surgery helps ~50%; pharmacologic and rehab aids may improve signs :contentReference[oaicite:19]{index=19}.

Even chronic cases may return to light work, though dressage/jumping suitability is often compromised :contentReference[oaicite:20]{index=20}.

7. Veterinary Management Checklist

• Perform thorough neurologic and lameness exams.
• Observe gait during walk, trot, backward and turning.
• Test for pasture toxins if Australian form suspected.
• Consider EMG or nerve conduction studies.
• Recommend pasture relocation for toxin-linked cases.
• Discuss surgical tenectomy where appropriate.
• Begin nutrition protocols (E, B vitamins, omega‑3).
• Coordinate rehab: light exercise, massage, physical therapy.
• Opt for sedated farriery visits for safety and ease.
• Monitor progress through video documentation.

8. Owner FAQs

Can horses recover without treatment?

Yes—especially Australian cases see spontaneous improvement after removal from toxic pastures :contentReference[oaicite:21]{index=21}.

Is it painful?

It’s not painful in itself, but exaggerated movements can cause strain or secondary issues.

Will supplements help?

Antioxidants and nutrients (vitamin E, B1, omega‑3s) may support recovery or nerve function :contentReference[oaicite:22]{index=22}.

Should I consider surgery?

Yes, for idiopathic or chronic cases—discuss tenectomy with your vet regarding risks and recovery.

9. Summary Table

10. Final Thoughts 🐴

Stringhalt is a complex, often treatable gait disorder. Early pasture management, surgical options, supportive therapies, and targeted nutrition can significantly improve functionality and comfort. Even chronic cases may enjoy a quality life with veterinary collaboration.

For tailored treatments—nutritional plans, surgical referrals, rehabilitation strategies—our **Ask A Vet** team is here. Download the Ask A Vet app for 24/7 vet chat, customized recommendations, and support on your horse’s journey. 🌟