Veterinary advice should be sought before applying any treatment or vaccine.

Equine Self-mutilation Syndrome

Flank-biting, Self-directed Aggression

Equine self-mutilation syndrome (ESMS) is a behavioral condition in predominately male horses, involving sudden, unexplained and repeated self-mutilation attempts or actual flank-biting behavior in horses. It is considered very similar to Tourette's syndrome (TS) in humans.

Equine self-mutilation syndrome (ESMS) in horses versus Tourette's syndrome (TS) in humans: Comparison of similarities:

	ESMS	TS
Clinical signs	Head and neck motor tics Hemiballismus (constant, undirected, purposeless striking out with either a forelimb or hindlimb) Occasional bizarre vocalizations Fixation with environmental boundaries	Head and neck motor tics Hemiballismus (constant, undirected, purposeless striking out with either a forelimb or hindlimb) Occasional bizarre vocalizations Fixation with environmental boundaries
Age of onset	Young horses	Juvenile
Gender predisposition	Geldings and stallions	Males

Symptoms

Head and neck twitching

Spontaneous kicking or pawing

Bizarre,unsolicited vocalizations

Excessive head tossing

Constant stiffing

Sudden explosive bouts of self mutilation or flank-biting

Diagnosis

History
Clinical signs
Physical exam

Support

Therapies

Therapies	Details
Naltrexone
Morphine
Acepromazine
Buspirone
Long-acting tranquilizers	Fluphenazine, reserpine
Increased activity
Increased social contact	Provide with a companion (other horse(s), goat, miniature horse, etc)
Change in diet	Minimize or eliminate all grains and concentrates
Physical restraint to protect from injury	Grazing muzzle, sheet, neck cradle, short tethers, side poles, hobbles