Shivers in Horses: Hindlimb Tremors, Backing Problems, and Management

Quick Answer
  • Shivers is a chronic, usually progressive equine movement disorder most often noticed when a horse backs up or when a hind foot is lifted.
  • Common signs include sudden hindlimb hyperflexion or hyperextension, trembling, tail elevation, and resistance during hoof cleaning or farrier work.
  • There is no single confirmatory test or cure, so your vet diagnoses shivers by watching the horse move and ruling out problems like stringhalt, lameness, and EPM.
  • Many mildly affected horses can stay comfortable and active with consistent exercise, turnout, trigger reduction, and hoof-care planning.
  • Typical US diagnostic and management cost range is about $250-$1,500+, depending on whether the visit includes a farm call, neurologic and lameness exams, sedation, imaging, or referral workup.
Estimated cost: $250–$1,500

What Is Shivers in Horses?

Shivers is an equine movement disorder that usually affects the hind limbs. It is most obvious when a horse is asked to back up. Instead of stepping backward smoothly, the horse may suddenly jerk one or both hind legs upward or outward, hold the limb in an abnormal position, tremble, and sometimes raise the tail. In more advanced cases, signs may also appear during the first few forward steps after standing or during sharp turns.

Current evidence supports shivers as a neurologic disorder rather than a training problem or a horse being difficult. Research has linked shivers with degeneration involving Purkinje cell axons in the cerebellum, which helps coordinate movement. That said, not every horse progresses at the same rate. Some remain mildly affected for years, while others develop more obvious weakness, muscle loss, and trouble with hoof handling over time.

For pet parents, one of the most frustrating parts is that a horse may look fairly normal until a specific movement is requested. That can make the condition easy to miss early on. If your horse suddenly struggles with backing, picking up hind feet, or standing for the farrier, it is worth asking your vet to watch those exact movements.

Symptoms of Shivers in Horses

  • Abnormal hindlimb movement when backing
  • Muscle trembling or shaking
  • Tail elevation during an episode
  • Difficulty lifting or holding up a hind foot
  • Stress-related worsening
  • Signs during the first few forward steps or sharp turns
  • Thigh muscle atrophy or hindquarter weakness
  • Reduced performance or increased risk of secondary lameness

Mild shivers can be easy to overlook, especially if signs only appear when backing or during farrier work. See your vet promptly if your horse has new trouble backing, repeatedly snatches a hind leg away, develops muscle loss, or seems unsafe to handle. See your vet immediately if the signs come on suddenly, the horse is falling, dragging limbs, acting painful, or showing other neurologic changes, because problems such as EPM, trauma, or severe lameness can look similar.

What Causes Shivers in Horses?

The exact cause of shivers is still not fully understood. The strongest current evidence points to a neurologic problem involving the cerebellum, especially degeneration affecting Purkinje cell pathways that help coordinate precise movement. That helps explain why the signs are so movement-specific and why backing is often the clearest trigger.

Shivers also appears to have a breed and body-type pattern. It is reported more often in taller horses and in breeds such as Warmbloods, draft breeds, Thoroughbreds, and some Quarter Horses. A genetic predisposition is suspected, but no single cause has been confirmed for routine clinical testing.

Episodes can become more noticeable with stress, excitement, or prolonged stall rest. That does not mean stress causes the disease. It means stress may make an underlying movement disorder easier to see. Because other conditions can mimic shivers, your vet still needs to rule out orthopedic pain, stringhalt, equine protozoal myeloencephalitis, and other neurologic or musculoskeletal problems before settling on this diagnosis.

How Is Shivers in Horses Diagnosed?

Your vet diagnoses shivers mainly through history and observation. The most important part of the exam is often watching the horse back up. A horse with shivers may show sudden hindlimb hyperflexion or hyperextension, trembling, and difficulty placing the foot back down. Your vet may also watch the horse walk forward, turn, stand square, and have each hind foot lifted to see whether the signs are reproducible.

There is no single blood test, scan, or stall-side test that confirms shivers. Instead, diagnosis is based on the characteristic movement pattern and ruling out look-alike conditions. Depending on the case, your vet may recommend a neurologic exam, lameness exam, flexion tests, hoof evaluation, and sometimes imaging or referral if the picture is unclear.

This step matters because some horses that resist hind-foot handling do not have shivers at all. They may have hock pain, stifle pain, back pain, or another orthopedic issue. A careful workup helps your vet build a practical plan and gives you a better sense of safety, prognosis, and what management changes are most likely to help.

Treatment Options for Shivers in Horses

Spectrum of Care means you have options. Here are treatment tiers at different price points.

Budget-Conscious Care

$250–$600
Best for: Mild, fairly classic cases where the horse is otherwise stable and the main goal is practical day-to-day management.
  • Farm call and focused physical exam
  • Observation while backing and hind-foot handling
  • Basic neurologic and lameness screening
  • Management plan centered on regular turnout and consistent exercise
  • Trigger reduction, handling changes, and farrier scheduling adjustments
  • Discussion of whether a vitamin E-based nutrition review is reasonable
Expected outcome: Many mildly affected horses can remain comfortable and useful for months to years with steady management, though signs may slowly progress.
Consider: Lower upfront cost, but fewer diagnostics mean less certainty if the signs are atypical or if another condition is also present.
Most Common

Recommended Standard Treatment

$600–$1,500
Best for: Most horses with new or progressing signs, unclear diagnosis, performance decline, or safety concerns during hoof care.
  • Comprehensive farm or hospital exam
  • Full neurologic and lameness evaluation
  • Assessment for look-alike conditions such as stringhalt, EPM, and orthopedic pain
  • Targeted diagnostics as indicated, which may include bloodwork or selected imaging
  • Written management plan for exercise, turnout, hoof care, and work expectations
  • Sedation support for farrier care when needed, often using medications such as xylazine or detomidine under veterinary guidance
Expected outcome: Often allows a clearer diagnosis and a more tailored long-term plan. Many horses can continue light to moderate work, while more severe cases may need reduced expectations.
Consider: More complete information and planning, but higher cost range and more time spent on workup.

Advanced / Critical Care

$1,500–$4,000
Best for: Complex cases, horses with atypical signs, high-value performance horses, or horses where safety and diagnosis remain uncertain after first-line evaluation.
  • Referral to an equine hospital or specialty practice
  • Advanced neurologic and orthopedic workup
  • Expanded imaging or additional testing to rule out concurrent disease
  • Specialized rehabilitation or sports-medicine consultation
  • Repeated reassessments for horses with worsening weakness, muscle atrophy, or major performance goals
  • Detailed farrier-veterinary coordination for horses that are difficult or unsafe to trim or shoe
Expected outcome: Helpful for defining limits, ruling out other disease, and building a detailed support plan. It does not cure shivers, but it may improve comfort, safety, and decision-making.
Consider: Highest cost range and travel or hospitalization demands. Even with advanced care, management rather than cure remains the goal.

Cost estimates as of 2026-03. Actual costs vary by location, clinic, and individual case.

Questions to Ask Your Vet About Shivers in Horses

Bring these questions to your vet appointment to get the most out of your visit.

  1. Does my horse’s movement pattern look most consistent with shivers, stringhalt, lameness, or another neurologic problem?
  2. What did you see when my horse backed up, and how severe do you think the signs are right now?
  3. Which tests are most useful in this case, and which ones are optional if I need a more conservative plan?
  4. Is my horse safe to continue riding, and are there movements or disciplines you want me to avoid?
  5. What turnout and exercise routine is most likely to help reduce episodes?
  6. Should we evaluate vitamin E status or make any diet changes based on my horse’s history and forage program?
  7. What is the safest plan for hoof cleaning, trimming, and shoeing, and when would sedation be appropriate?
  8. What changes would mean the condition is progressing and should trigger a recheck?

How to Prevent Shivers in Horses

There is no proven way to fully prevent shivers, especially because the exact cause is still being studied and a genetic predisposition is suspected. Still, good management may help reduce how often signs are triggered and may support long-term comfort. Horses with shivers often do better with regular movement, daily turnout when possible, and less time standing in a stall.

A consistent fitness program is one of the most practical tools. Long breaks from exercise can make episodes more obvious in some horses. Calm handling also matters. Stress and excitement can worsen visible signs, so predictable routines, patient hoof handling, and a farrier team that knows the horse can make a real difference.

Nutrition is another area to review with your vet. Some clinicians recommend attention to antioxidant support, especially vitamin E, because of its role in nerve and muscle health. That does not prevent every case, and supplements are not a cure, but diet review can be a reasonable part of a broader plan. If you are shopping for a horse, a careful pre-purchase exam and watching the horse back up and have all four feet handled may help identify concerns early.

Find a Vet Near You