Posture and movement characteristics of forward and backward walking in horses with shivering and acquired bilateral stringhalt.
Authors: Draper A C E, Trumble T N, Firshman A M, Baird J D, Reed S, Mayhew I G, MacKay R, Valberg S J
Journal: Equine veterinary journal
Summary
# Editorial Summary Distinguishing between shivering and stringhalt remains clinically challenging, particularly when both conditions present with exaggerated hindlimb movements during backward walking. This qualitative video analysis characterised gait abnormalities across 51 affected horses and controls, identifying three distinct shivering phenotypes: hyperextension-dominant (n=13), hyperflexion with abduction (n=27), and a progressive form involving forward walking hyperflexion (n=4), alongside seven cases of acquired bilateral stringhalt. Horses with hyperflexion-based shivering and stringhalt shared a prolonged swing phase during backward walking, yet critical distinguishing features emerged during forward walking—stringhalt horses demonstrated rapid, adducted hyperflexion with acute, consistent presentation, whilst progressive shivering cases showed more sporadic, abducted hyperflexion. Understanding these specific gait signatures matters considerably for practitioners: misdiagnosis can delay appropriate management, affect prognosis counselling, and influence treatment decisions, making careful observation of both backward and forward walking patterns—particularly the character and timing of hindlimb flight phase and limb positioning—essential for accurate differentiation of these neuromuscular conditions.
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Practical Takeaways
- •Recognize that shivering presents with variable gait abnormalities; backward walking evaluation is essential for diagnosis as it reliably elicits clinical signs
- •Distinguish stringhalt from shivering by observing forward walking characteristics—stringhalt shows rapid, consistent, adducted hyperflexion while shivering-forward hyperflexion is more intermittent and abducted
- •Monitor horses with shivering-hyperflexion phenotypes closely as disease can progress to involve forward walking, indicating disease progression
Key Findings
- •Shivering presents as three distinct phenotypes: hyperextension (n=13), hyperflexion (n=27), or forward hyperflexion (n=4) during backward or forward walking
- •Shivering-hyperflexion and shivering-forward hyperflexion cases showed prolonged swing phase duration during backward walking compared to controls and shivering-hyperextension cases
- •Stringhalt can be distinguished from shivering phenotypes by rapid adducted hyperflexion during forward walking versus the abducted hyperflexion pattern seen in shivering-forward hyperflexion
- •Shivering typically affects backward walking initially and can progress to involve intermittent hyperflexion during forward walking over time