![]() In its most severe form, the hindlimb is abducted and hyperflexed and horses may lean so far toward the weight-bearing hindlimb that they almost fall over. If the limb is picked up without exceeding a certain degree of flexion, hyperflexion may not occur. Similar to Shivers, the hindlimb muscles may tremble, and the tail may be elevated, and the horse agitated when lifting the limb. Standing hyperflexion is more often unilateral than bilateral and less likely to progress than Shivers. Because horses with standing hyperflexion do not show hyperflexion with backward gaits, the author suggests that the term standing hyperflexion should be applied to such cases rather than Shivers. The term Shivers has been applied by some veterinarians to horses that solely exhibit hindlimb hyperflexion when manually lifting the limb, however, this clinical sign encompasses many other painful disorders. The disease primarily affects one or both hind limbs with or without tail elevation and trembling. Shivers may be extremely difficult to detect in the early stages, and careful observation may be required before the diagnosis can be made. The diagnosis of a characteristic case of Shivers seldom presents a problem, however the signs of Shivers may be intermittent, occasional, or latent and very difficult to confirm. The clinical spectrum of Shivers in horses is very variable in the degree or manifestation of signs. While it is clear that certain breeds are more frequently affected than others, height is also a strong predictor of Shivers risk. No investigation into estimates of the prevalence of Shivers in other breeds exists. One study of the prevalence of Shivers in Belgian Draft Horses found that 19% of horses examined had signs of Shivers. Other typical signs include trembling of the tail while held erect, trembling of the thigh muscles and a flexed and trembling hind limb. The classic disease called Shivers is a gradually progressive, chronic neuromuscular disease in horses that is characterized by gait abnormalities when backing up. However, a number of disorders can create irritation in the hind limbs of horses and cause this type of sign. Many horses that hold a hind limb flexed and tremble are said to have Shivers. In ponies, shivers is considered uncommon to rare. Horses over 16.3 hands tall are also more susceptible than shorter horses.The syndrome affects several breeds, including draft horses, Warmbloods and Warmblood crosses, and occasionally lighter breeds of horses, including light harness horses, hunters, hunter-jumpers, hacks, Quarter Horses, and Thoroughbreds. Both genders can be affected, but geldings are three times more likely to be diagnosed with the disorder. Usually horses with Shivers will show signs before age 10. In a comparative neuropathology textbook published in 1962 it was stated that “in the heyday of equine practice” shivering was “as common as dirt.” Most horses with Shivers begin to show signs before 5 years of age, and the majority of cases (74% of horses surveyed in a recent study) are progressive in severity. It has been stated that the condition is reasonably common, uncommon, and rare to very rare. ![]() Shivers or shivering are names that have been applied to a chronic neuromuscular syndrome in horses that has been recognized for centuries.
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