Epm - The Horse Forum
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post #1 of 6 Old 10-26-2009, 10:06 AM Thread Starter
Join Date: Oct 2009
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Hey guys,

My horse has just recently been diagnosed with EPM. He's an 11 year old TB gelding who I bought about two and a half years ago. He's had a couple of lameness issues in the past two and a half years but nothing that seemed to serious... but the wandering lameness, lack of muscle in the hind and occasional odd movement of his hind leg all seems to be explained by this disease. I was wondering if there was anyone else here dealing with this and what treatment you used... I've been doing lots of research and am trying to decide what is the best thing for my horse. I've been told once it has been established it will not get any worst, so I'm wondering what treatment options would even be worth wild. So what worked for you? Any supplements you would recommend? I've also been reading about an all natural Immune Booster supplement formulated directly for EPM horses, has anyone had any experience with that??
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post #2 of 6 Old 10-26-2009, 10:30 AM
Join Date: Jul 2007
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How was your horse diagnosed? (blood or cerebrospinal fluid? Western Blot or IFAT? neck x-rays?) What symptoms are you seeing in your horse now and have the gotten progressively worse?

My concern is that with the history you've given above--that this has been ongoing for 2 years---it's more likely that you are dealing with something else and not EPM. EPM tends to get progressively worse in a shorter time period than that. When considering EPM as a possible cause of neurological deficits, it is very important to get an accurate diagnosis. There are many other diseases/causes that present with similar symptoms to EPM so a full physical examination and appropriate diagnostic testing including blood tests for exposure to S. neurona, x-rays of the head/neck, testing for other diseases such as West Nile Virus, Eastern Equine Encephalytis, etc. With the symptoms you have described, I would consider arthritic changes in the neck, a chronic lameness from pain or possibly Lymes disease.

There are several treatment options including Marquis, Navigator, diclazuril and a combination of pyrimethamine and sulfadiazine marketed as Rebalance. However, Navigator is no long in production and Rebalance tends to be out of stock so vets and owners go through compounding pharmacies to have pyrimethamine and sulfadiazine compounded for use. Diclazuril has never been mass produces in a formula for treating EPM because the cost of doing so and the fact that an already effective treatment (Marquis) is on the market would likely lead to the same fate as that of Navigator---a product that doesn't sell enough to warrant production.
Marquis is labelled for use for 28 days and actually kills the parasite. This product is more expensive than the Rebalance but it requires a much shorter treatment time. Marquis also has a low incidence of adverse effects.
Rebalance (pyrimethamine/sufladiazine) prevents reproduction of the parasite and treatment must be continued for a minimum of 3 months to allow for the parasites that are present to all die without leaving new generations in the central nervous system of the horse. It is often recommended that this product be given for 6 months or more. Rebalance must be given on an empty stomach.
About 70% of horses recover with any of these treatments. Recovery is considered a 1 grade improvement of neurological deficits as graded on the Mayhew scale 1 month after treatment ends. However, horses who are recovering from EPM can improve for more than a year after treatment. But rehabilitation must be slow and cautious for the safety of the horse and the handlers.
Recovered horses also can have days when they appear to relapse and neurological symptoms reappear or worsen. This may actually be from a reinfection or it may be from an inability to compensate for neurological deficits left over from their initial infection. Horses will over time learn to compensate for neurological deficits and appear normal or at least more normal, but overwork, illness, injury, excessive heat and humidity or anything else which affects their energy level or concentration may lead to a reappearance or worsening of neurological deficits.
Other supportive care includes Banamine or DMSO to help with inflammation. 8,000-10,000 iu of Vitamin E daily, a good balanced diet, safe environment for horses with balance issues, free choice exercise.

Cindy D.
Licensed Veterinary Technician
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post #3 of 6 Old 10-26-2009, 06:52 PM
Join Date: Mar 2009
Location: Connecticut
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My horse was "diagnosed" with it last year. For me, the diagnosis was purely visual. The vet saw an OTTB who was moving strangely and decided it must be EPM. I was new to horse ownership, so I didn't know to ask for more definitive tests. We treated him with Marquis. It's not cheap, $300 per week for a month. It did clear up his symptoms, although to this day I only think it was Lyme.

Anyway, while he was recovering, I would hand walk him on uneven terrain to attempt to keep what muscle was still there, and to try to get more on him to get him ready to ride again. I did some research and read that vitamin E helps the body heal itself. I also found the selenium is low in my area. I ended up supplementing his diet for two months with SE-Mag from SmartPak. I was astounded on how quickly he returned to normal body condition with that stuff. You have to be very careful not to overdue the Selenium levels since they can cause toxicity, but I'd use it again in a second.
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post #4 of 6 Old 10-26-2009, 07:36 PM
Join Date: Jul 2009
Location: New York
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we treat our horses with Baycox. the good stuff comes from austrailia. you can order it online. drench them, or most likely have a vet drench them as most people dont know how, with the baycox. (if you dont know, drenching is when you put a tube up the nose, down the throat, and into the stomach. if you miss you go into the lungs and it will kill them immediately, so if you dont know very well what youre doing, have a vet do it!!!!) we have had excellent results with baycox. also use NO cortizone on them whatsoever. cortizone is a HUGE no no with EPM horses
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post #5 of 6 Old 10-26-2009, 08:35 PM
Join Date: Oct 2009
Location: arkansas
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i had a mini that the vet said may have it they also suggested vitamin e and selenium but you def need to be careful with that stuff my girlfriend said she just had a race horse of her diagnossed with it and she get s her stuff at cost cause she works at a vet but its still costing her 150.00 a week its usally 300 a week so its very expensive to treat best of luck to you
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post #6 of 6 Old 10-26-2009, 08:43 PM
Join Date: Oct 2009
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I took my first horse to a horsey hospital for EPM. We ended up putting him down because of other issues. if you dont treat EPM it will become worse/progress. if a horse truely has EPM they usually dont get "better" they just function as they are at that point. Its very dangerous in some circumstances, since the horses with EPM dont have normal motor function. I wouldnt feel comfortable riding a horse with it. You cant reverse the effects but you can prevent it from getting worse. Since treatment is so expensive have you vet run a blood test first, a spinal tap may also be needed.
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