Equestrian Days - Equine Tourette Syndrom - Self Mutilation in Horses

Pepper Belle
Equine Tourette Syndrome

I’ll be honest. When Jim Rintoul at Community Feed Stores in East Longmeadow asked, "Did you hear about the horse with Tourette Syndrome?" I thought I was being set up for a punch line.

Was this a joke, "Pardon my horse’s bad behavior, it’s just Tourette’s," I wondered? All I knew about Tourette Syndrome was what I had seen on television, where patients typically were characterized by the disorder’s most unsettling symptom: involuntary vocal outbursts of obscenities. I thought of a few horses that had probably told me to f*** off at one time or another. But could a horse be diagnosed with a human disorder? "Go see Willie Ferrero at Masconette Farm," said Jim. "Ask him about Pepper Belle."

Masconette Farm
Set in the bucolic hills of East Longmeadow, where farmstands and family-owned garden centers still dominate the landscape, Willie and Peggy Ferrero and their son, "Big John," operate a small Standardbred racing barn called Masconette Farm.

"How do you think we got the name," laughs the retired postmaster who at 73 has retained the sparkle in his eyes of a horseman half his age. "We’re right on the Mass/Connecticut state lines."

Willie has lived in East Longmeadow his entire life, much of it while married to Peggy. So after all that time he was pretty sure that he’d seen it all. But things changed in 1991 when he bred his Silent Majority mare, Cool Pat, to a stallion named Frugal Gourmet. Pat had $70,000 in lifetime earnings and had finished fifth in the New York Sire Stakes. Frugal Gourmet had won $1.3 million in his harness racing career and his get were proven winners. It looked like a perfect match.

"We’ve taken different paths than expected," says the former sulky driver. That’s an understatement.

Tourette and Equine Tourette Syndrome
Tourette Syndrome, also known as Tourette’s Syndrome or TS, is a chronic neurological disorder of unknown cause characterized by multiple, repeated and uncontrolled behaviors, involuntary vocalizations known as tics, or both. While the basic cause of TS is unknown, current research suggests it is related to an abnormality in the gene(s) affecting the brain’s metabolism of neurotransmitters (chemicals in the brain that carry signals from one nerve cell to another). It is named for Dr. Georges Gilles de la Tourette, a French neurologist who first described the condition in 1885.

"There are fourteen symptoms of TS," says Willie. "Pepper has them all." When confined to her stall, the mare may bite her flanks, throw fits,
vocalize, or kick her walls 50-60 times an hour. While under observation at Tufts, where she was initially diagnosed as a two-year-old, Pepper was recorded throwing as many as 200 kicks an hour.

One of the more unique neurological aspects of TS is a fear of doorways or framed entrances. In Pepper’s case, she might panic and refuse to load. So John installed a boat winch on the Masconette Farm trailer to encourage her. "She’s the kind of horse that, if you fight her, she’ll fight back," says John. "So it’s easier to rig a system that won’t allow her to outmuscle you." It doesn’t happen all the time. Like other brain disorders, its symptoms can be inconsistent and hard to predict.

Coprolalia, the involuntary vocalizations that many equate with TS, is a symptom in less than ten percent of all cases. "Most people with coprolalia -- cursing or swearing -- can redirect the profanity to other non-obscene sounds," says Mark Levine, vice president of development for the Tourette Syndrome Association in Bayside, New York. In Pepper’s case, activity keeps many of her symptoms at bay. In addition to regular turnout and exercise, a mirror hangs in her stall to distract her from her otherwise destructive behavior.

"Destructive" is perhaps an apt description of Pepper’s disorder, which has also been labeled Equine Tourette Syndrome or -- as identified in the original research paper by Tufts animal behaviorist Nicholas H. Dodman, BVMS -- Equine Self-Mutilation Syndrome.

Equine Self-Mutilation
"At first, we thought she had colic," says Willie. Pepper Belle was Cool Pat’s first foal and she arrived 30 days past her due date. In addition to
video cameras monitoring Pat’s stall, John and his dad had taken turns during the nights watching the mare. During one of Willie’s watches he fell asleep in his leather chair. His last check at 3:30 a.m. showed Cool Pat walking around and picking on her hay.

When John woke up at 6:00 a.m. he shouted to his father, "There’s something dark in the straw! It looks like foal." Pepper Belle entered the world apparently healthy and happy. She poked around Pat’s milk bag and began nursing on her valuable colostrum. By 9:30 a.m., the farm’s vet, Dr. Eliam O’Leary of Granby, Connecticut, had examined mare and foal and declared everything "was just fine."

For the next two years, things stayed fine for the little Standardbred filly. John started her in harness and Pepper showed all the athletic talent they had hoped she would inherit from her sire and dam. Each day Big John would jog her for 30 minutes on the track, then give her a bath and turn her out in the paddock.

"Horses love to frolic in a paddock and Pepper was no different," says Willie. "She seemed to be developing some odd behaviors, however. She would bite at her flanks and chase her tail as a puppy might do. Horses sometimes bite their flanks if they have colic or stomach problems. Pepper began to do this so often that Big John thought she might be suffering with colic, although Pepper never lost her appetite and had no trouble making manure." Big John recognized that his colic treatments were having no effect on Pepper. When more than a week passed without signs of improvement, he called Dr. O’Leary. He didn’t express any great urgency and emergencies kept coming up, so it was five days before the vet arrived. By then Pepper’s behavior had grown even more baffling. For four days she had been kicking her stall walls incessantly and making weird sounds not usually heard from horses. High, squeaky noises almost like a baby crying.

Comparing Horses and Humans
Meanwhile, less than 100 miles away in Grafton at the School of Veterinary Medicine, Tufts University, four researchers led by animal behaviorist Nicholas H. Dodman, BVMS, were undertaking a comparative study of equine mutilation behavior and TS.

"We asked 48 regional and national equine-oriented magazines and newsletters to publish a notice of our interest in contacting owners of horses that appeared to have self-mutilation syndrome," explains Dr. Dodman. "The notice contained words such as self mutilation and flank biting, and described the abnormal behavior as biting at the flank, chest or legs. Nineteen magazines with a combined circulation of over 450,000 published the notice and a similar notice sent to a state stallion exhibition in Michigan."

"Fifty-two owners of 59 horses responded," Dr. Dodman says. "Two cases were omitted because an organic cause was determined. Various breeds were affected, and of the 57 horses, 20 were stallions, 31 were geldings, and six were mares. Affected horses tended to develop the condition prior to sexual maturity. Clinical signs included biting at the flank or pectoral areas, bucking, kicking, vocalizing, rubbing, spinning, or rolling. Several management and environmental factors were examined, but none were found to be exclusively related to the expression of the disorder. Castration was associated with improvement in seven of 10 stallions. Medications and changes in management reduced or prevented the behavior in some horses." "The syndrome," Dodman and his team concluded, "appears to be similar to Tourette’s Syndrome of human beings." The study, published in the Journal of the American Veterinary Medical Association, Vol. 204, indicates that affected horses respond in the same way to medications -- neuroleptic or antihypertensive drugs -- as humans with TS.

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Diagnosing Pepper Belle
One of those who had read the Tufts notice was Dr. O’Leary, who contacted Dr. Dodman and described Pepper Belle’s symptoms. The researcher was immediately interested.

That January, with the harness racing season in its lull and Pepper not responding to treatments, they trucked the mare to Tufts for six weeks of observation. Pepper was put in a padded stall and monitored 24 hours a day by video camera while Dr. Dodman determined if she had Equine TS.

The final diagnosis confirmed their suspicions. Now that they had determined the cause, Dr. Dodman recommended medication as the treatment. Only Pepper Belle was a professional harness racing horse. To carry Masconette’s red, white and green colors at Plainridge or Yonkers, she had to be drug-free. "There were two reasons why we didn’t put Pepper on medication," says Willie. "First, the cost was quite prohibitive at $50 a day and the drugs couldn’t guarantee her well-being. Finally, she is a Standardbred racehorse. We intended for her to race and any type of drug would make her ineligible."

Pepper Shows Her Colors
Pepper Belle had earned her name from the feisty and ladylike sides of her nature. Willie hoped she would rely on those qualities to face the challenges ahead. She was now three years old, fit and ready to qualify to race. TS or no TS.

Big John continued to train Pepper without the aid of medication, promising Dr. Dodman that he would keep records on her training and the progress of her
disorder, and contact him if he learned anything new.

Kara Kirchherr, who used to exercise Pepper Belle for Masconette Farm, remembers her training days. "Pepper was great when I drove her. The times I noticed her ‘tics’ were when I handled her on the ground. On some occasions if you were to walk up to her and pat her face or neck she would squeal. Then later, you could do the same thing and she’d just stand there and let you pet her."

"At night she showed her Tourette’s tics," John says. But as Kara had concluded, when Pepper was jogging on the track, she showed no symptoms at all. Racing was her best medicine.

On August 18, 1995, Pepper Belle stepped out on a harness track for the first time, "She swished her tail and said, ‘Later, fellas," Willie remembers. That season she had three straight wins her first three times out. Over her career she started 15 times, with five wins for Masconette Farm and four seconds.

In 1996, in her last race, Pepper won by four lengths, finishing her mile in 2:01:04, only three-fifths of a second off her lifetime mark. Because TS didn’t end her racing career. A bowed tendon did.

A New Career
There’s a saying that when one door closes another opens. With a racehorse that could no longer race, Willie faced a dilemma. As one of only a handful of horses ever diagnosed with this misunderstood disorder, could TS offer Pepper a new life? He decided, yes.

"Pepper Belle lives and wins with Tourette Syndrome, and if she can do it, so can the many children and adults who have TS." There are 200,000 known cases of TS in humans in the United States, plus millions more who exhibit some symptoms or are affected by associated behaviors. Willie thought Pepper could show them they were winners, too.

"Meeting Pepper Belle for the first time was an experience," says Mark. "I couldn’t believe I was actually seeing symptoms which did indeed parallel human symptoms." Willie presented Mark with the idea of using Pepper as an equine ambassador for TS, visiting schools and talking to groups of children and adults about TS. Big John could jog Pepper for the group, they could show her racing videos, and a TS representative could answer questions about TS. The idea, like the horse, was a winner.

" She is a terrific teaching tool and motivational symbol," says Mark. "Pepper is unique in how she is spreading the news about a most misunderstood and unrecognized disorder. She helps people see past their limitations. Kids immediately fall in love with Pepper the minute they see her and stroke her mane. They cheer her in the videos of her races and listen intently to the message we present about TS and tolerance of people with it and all other disabilities. She leaves a tremendous impact."

Willie, Big John and Pepper Belle -- now 12 years old -- have visited schools throughout western Massachusetts and Connecticut, including the Milford
Middle School and John F. Kennedy Middle School in Enfield, Connecticut. Carl F. Ohlin, principal at the JFK Middle School, thanked Willie and Pepper, "The main message presented to students was to help them understand the difficulties people with TS have to face. I know the message was received because my daughter Hannah’s response was ‘the assembly was neat.’ Keep up the good work."

And so they are. Willie has written a book, "Pepper Belle," published by Xlibris Corporation, www.xlibris.com, chronicling Pepper’s diagnosis with that of a fictional little girl named Betsy who is struggling to understand her own life with TS. It took six years for Willie to write it, in longhand, twice beating cancer along the way, and he dedicates the book to those with TS "so their lives may be filled with peace, love and the understanding of those fortunate to be blessed with good health." The book is available for sale to organizations as a fund raising project by contacting Beth Staples at Xlibris, (215) 923-4686 x190, or beth.staples@xlibris.com.

On Saturday, June 14, Masconette Farm will see its biggest dream come true –– Pepper Belle Day. The day’s attractions will include a race named in Pepper Belle’s honor. Pepper Belle Day is at the Plainridge Racecourse in Plainville, MA, from 1:00pm to 11pm. See the ad on page 15 of the Horse Whisperer for more details.

As for Pepper, Willie hopes 2003 will be the year that she breeds successfully. TS data suggests Pepper’s chances (as a mare) of genetically passing the disorder on to a foal are small. While Dr. Dodman hopes to conduct further genetic research, the risk of inheritable symptoms appears higher in stallions. "I’d love to follow her adventures as a mom with a foal," says Willie