EPM Diagnosis

I have another thread detailing the odd attack Chanti had 3 days ago but wanted a new one to discuss EPM itself and the testing that was done, different treatments,etc.
The day after the attack she got in to see the vet and since Tuesday she has seemed 100% normal.
At the vet I had them do a chem panel which showed absolutely nothing wrong or abnormal.
The physical exam showed that her heart, lungs,etc was normal.
She noted lack of resistance when she lifted her tail to take her temp then she had me turn her in a tight circle each direction. Then she had me trot her while pulling on her tail. There was more weakness to the right, which is the side that is lame too. She also crossed her front feet over and Chanti put them back.
I just do not see how the vet could definitely say there's a strong suspicion it is EPM based on those few tests.
First off, Chanti was in standing heat the day we took her and even earlier that day any time I touched her rump or tail she'd lift it. I did the same test yesterday and she was much more resisting. In all the neuro exams I've seen or read about from EPM websites the vet does the tail pull at a walk, not a trot, plus they do a whole list of things.
Out of the long list of symptoms Chanti could possibly only have one. She's lame in her right shoulder that I think is due to toeing out and she also hit that leg when she had her attack.
She doesn't "hop" in the rear, she gets her leads every time, no problem going up or downhill, doesn't drag her toes any differently than she's always done, no back pain, no stumbling except when she has long toes and hits a rock or something, but it's all normal.

I have to go now but will add more later. I got a couple videos yesterday and pics and want to try getting a couple more videos.

The vet is probably noticing some type of neurological issue. Those were some of the same tests my vet did with Blue when I was concerned about EPM last summer. We did pay for the blood test with him and if I remember right, it was a few hundred dollars but we were able to rule it out.

CSF is a better sample for diagnostics. And the blood test (serum) should only be about $50. I would guess, Farmpony, that you had many other tests run as neurologic disease is so difficult to nail down which was what brought your costs up so high

CSF being the spinal tap, correct?

I got a week's supply of Bute to start tomorrow.
I called the Equine Center earlier and I was just going to ask them questions about EPM and if he could do a thorough neuro exam. First off he just says "Well do you question the diagnosis because you don't believe in EPM?" Ummmm....nooooo, I know it exists but I'd like to have a more thorough test done. He says right after that, "Well I think I gotta pass on that" Why the hell are you a vet then??? Jeez! So before I say anything I'll regret I simply hang up but I'm steaming. So hubby calls him back, and he's polite but wants to know why he won't look at her. He starts off by saying he doesn't think I would believe anything he says and I don't believe in EPM and I don't know anything about horses. Then hubby asked if he knew another equine vet and the vet said he wouldn't refer us to anybody and he wanted to know why we didn't just call them first, which hubby explained that we had tried calling when they colicked and didn't get ahold of anybody so we used the vet we could actually reach and the bloodwork and everything was cheaper with the vet we ended up using.
So this vet was pretty much like "well since you went to somebody else I can't help you."

So mad right now. This is the same vet who recommended right off that I put down a foxtrotter mare who had foundered 9 degrees in one foot rather than try to help her in any way, plus he takes his own Bute for headaches. He was just so rude and since he can turn down potential clients like that then I reckon he doesn't need my money and he sure isn't going to ever treat any of my pets ever.

Found out from the vet when we picked up the Bute they are going to try to get the EPM treatment in a compound form so it'll be a little less expensive. It'll be about $600 for a month's supply instead of 800-1000 for the Marquis.

I'm so sorry you had such an incredibly negative experience. That vet sounds like a crack pot and while it is within his rights to fire a client, that attitude is just appalling.

CSF = cerebrospinal fluid, which is what you collect when you do a spinal tap. I would definitely look for another vet and to be honest with you I wouldn't have taken anyone this guy recommended because he sounds like he has piss poor judgement!

It definitely ticked me off. He just didn't care at all and was so rude about it. I'm definitely not recommending him to anyone either lol. When I took the mare to him I had 4 years ago he said I should just put her down. He didn't even tell me what could be tried. I ended up donating her to a rescue across the state and they had their farrier work on her and tried different things and got her to the point where she was walking and moving without any pain at all.
It really irked me that he actually seemed mad at US for not taking Chanti to them. Helloooooo....umm, we couldn't get ahold of anybody and your prices are stupid high. Ginger, the vet I took her to is absolutely amazing. She really loves the animals she works with and you can see it in how she treats them. Not once has anybody there been rude and they are great at answering questions.
His whole attitude was like he was Mr Bigshot and I was a know nothing horse owner. He didn't even let me fully explain why I wanted a second opinion but since it seems the vet clinic there must be doing so well they don't need any more money then fine. I trust Ginger and I know if they colic after hours she'll get the message and call me back.
If I had known more about the neuro tests I would have asked her to do more of the tests, like lifting one hoof and asking the horse to walk 3 legged, holding the head high while walking, flexing on either side,etc.
I just have a hard time accepting it's EPM because all the results from the physical exam could have been caused from something else. I think if she was retested after she's out of heat the only thing that will show up is the shoulder lameness. She has no other symptoms and I know my horse. She never stands wide, she never wobbles, she doesn't have any trouble flexing around or raising her head high, she hadn't gone anywhere in 3 years up until that vet trip. She's fine at a lope, doesn't drag her feet, doesn't tap poles when going over them,etc. Nothing is out of the ordinary. Just that one odd incidence.

So sorry you have had such a negative experience with this vet. I think I am going to bake a cake for my vet...he is an absolute doll. He knows his business, is gentle with my horses and answers all of my endless questions.

My cousin's horse had EPM and we use the same vet. Doc saved the mare and came out endless times to give her meds, check on her, etc. and didn't even charge Kellie a farm call for that!

My cousin knows all about EPM and she has described it to me how Lady Dollar lost sensation on one side and couldn't feel her feet. She was on the meds you described that cost an arm and a leg.

Get another vet and I hope this one has better bedside manner.

There aren't any other vets nearby and I don't have any way of hauling her to one farther off. If we had a way I'd definitely take her and get a second opinion.
I just looked at the Mayhew Scale, which is used to grade the neuro symptoms and the only parts that would give her abnormal grades is the gait evaluation and I think with 99% certainty it's due to her shoulder issue. Her lameness hasn't switched sides, it's been that right shoulder. She also has an area on that same leg down by her fetlock joint that sometim es has heat. I can feel a hard little knot right around her sesamoid but I'm not sure if it actually is her sesamoid. After a workout it will sometimes have heat but I've noticed when I use the sport boots on her she's much better.
I am going to get video of us having her walk, trot, then tight circles, going up and down a hill, flexing her neck,etc.
She hasn't lost any feeling or exhibited any other symptoms. It was just one weird episode that is unexplained but she's been perfectly normal since then.
If there were more symptoms to make me think she had EPM, even if it was one clear symptom I'd have her started on the EPM treatment today, but for the results we got from the vet who didn't even do a neuro exam it just isn't enough to make me think EPM is the answer.