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Pattilou 12-09-2011 11:34 PM

Any EPM experience
My SSH was Dx with EPM ( Equine Protozoa Mylo-encephalitis ) back in September. We are still dealing with it. He has been on medication for the past few months. We have some good day, but more bad days.

Anyone out there have experience with this. I have a horse that has an unstable back end, he is depressed, can barely work 30-40 min before he is exhausted. AT this point I do not see an end in sight. Any encouraging words out there.


Cat 12-10-2011 01:19 AM

I'm so sorry your horse has been diagnosed with EPM. I know how it feels - I've been there with my haflinger. He got it when he was 4 and he is now 10 and we just completed a couple 5-6 hour trail rides this past summer in some very rugged terrain - something I was quite certain at one point we would never be able to do again. The best thing you can do right now is take a deep breath and read all you can on diagnosing, treatment and rehab of an EPM horse and realize its going to take time.

How did your vet diagnose the EPM? I'm asking this because it is sometimes misdiagnosed and people have gone through months of treatment only to find out their horses never had it to begin with and just had the antibodies to it.

Also, what medication are you treating with? There are several out there and some horses will respond better on one than another. Toby was treated with Marquis paste and responded well to it. I've heard that now in addition to Marquis they have a new med called Oroquin where they treat with a full round of Marquis (1 months worth) and follow it up with a round of Oroquin and the results have been drastically better. I only recently heard about this new med so I would look into it more before deciding that route but I've heard really good things about it.

The other thing I did with Toby is have him on therapeutic levels of vitamin E. I believe it was 18000 IU per day. This will help with the recovery of the damaged nerves that is already there.

The thing that concerns me is that you say he is being worked 30-40 minutes and then he gets tired. Are you riding him? I wouldn't be riding him yet! It took 8 months before I got on my horse to ride him and that was for about 10 minutes at a walk. It was a year before we moved up to a trot. They really need the time to heal. Hand walking is great for them! After a while I would start Toby stepping over poles and such too. But never worked him until he was tired until his back end was stable. Also circles are tough on them in the beginning. I would only lightly lunge Toby a round or two in each direction after about 3-4 months so that I could get a better look at his foot falls to gauge his progress.

There is a yahoo group called EPM that many owners who have been there, done that are on to offer guidance. I would highly recommend joining it.

You might also want to read up on Dr. Ellison's website if you haven't already:

Pathogenes Inc. - About Us

kitten_Val 12-10-2011 09:04 AM

Patti, I'm very sorry you go through that. My neighbor had a pony diagnosed with it just this passed summer. Lots of medications in for sure. He was all wobbly and unstable at first. Now (about 5 months later) he's just SO much better! The border's horse in barn I went to years back had EPM too (lighter form). I know she was able to continue trail riding him after he recovered. BUT in any case it takes time to recover. It's been just 3 months in your case so I wouldn't start panic.

hobbyhorse 12-10-2011 10:19 AM

Several horses down here have been dx with EPM. All different degrees of the disease. The one with the expensive treatment died. One ended up not rideable. She would sit down with the weight of a rider on her. One of them that had to struggled to stay on his feet. He'd wobble and he would lose his balance and fall down. This lasted two weeks. The owner did not start any treatment and the horse was back on the trails in less than 2 months.

Cat 12-10-2011 11:26 AM

hobbyhorse - do you know how they were diagnosed? The one that lasted 2 weeks sounds more like a toxic plant or an injury than EPM. There are tons of well documented EPM cases and there and none of them miraculously improved without treatment. Once staggering has started to occur that means the protozoa have made their way into the spinal cord and the horse can't clear it out themselves. But there are TONS of things out there that can look exactly like EPM.

Now I know many vets will just look at the signs and do a western bot test on the blood and if the titers come back positive they will diagnose EPM. This really only means the horse has been exposed to it and does not mean they have it. Approximately 70% or more of the horses in areas where opossums are located will come back positive on this test! But less than 1% of those will ever come down with the actual disease. I believe there is now an ELISA test out since my horse went through it that is more accurate but not all vets use it.

Pattilou 12-10-2011 11:32 AM

Thanks Cat for your reply. I am doing everything you mentioned. I had never heard of EPM before my horse was dx. I had to really educate myself. I am already on the EPM Yahoo group. I find it helpful, but hard to follow the way it is set up.

Beau was dx by clinical exam and the Davis IFAT and Dr Ellison's ELISA. He has finished Oroquin he has been on Levamisole for 6 wks and was doing really well ( hence the riding we do 15 min of walk and 15 min of light trot, we had walk over pole. I do not lunge, for my horse it is very uncomfortable for him) He was done with the Levamisole last week and I noticed a drastic downward turn. In energy and mood. So Dr Ellsion said to restart the Levamisole .... which I will start today.

The exercise is a hot topic on the forum. I think the inactivity has made my horses back end worse. Since he is gaited its hard to determine what back end issues are EPM and what are breed related. But I may have pushed it a little since he seemed to be doing so well the past several weeks. I will back down on the exercise while he is back on the Levamisole.

I find it so tiring, my horse use to be my stress relief .... now it is the biggest stress in my life :( Patti

Cat 12-10-2011 11:50 AM

Patti - I know exactly where you are coming from. I know the frustration, the heart wrenching pain watching your horse improve and regress and all the added stress. Its a long process, but really 3 months isn't that long at all and considering your horse had shown improvement on the levamisole that is heartening! Like I said - I don't know too much about the new treatment method and since I had such a good experience with Marquis I would head for that first, but if your horse is showing improvement I would continue to use it.

Excellent that you are talking with Dr. Ellison!

Now my personal experience I found light exercise in hand worked way better (and eventually light flatwork undersaddle) than anything else as I would find my boy would regress if I pushed too hard. Sorry to say that my horse had problems with the canter for years afterwards. Some of it may be the breed as haflingers tend to prefer the trot to the canter, but he cantered undersaddle before EPM but wouldn't even canter out in the field for a couple years afterwards and he fell apart if asked for the canter under saddle after the EPM. Its now 6 years out and this past year was the first time I was really able to work him at a canter under saddle. The summer before was also the first year that he didn't have mini-regressions in the high heat of summer. He was never bad in the heat, but a slight unstableness made it obvious that if the mercury was climbing, I wasn't climbing on his back. Now I have been told if oroquin-10 was available to follow up after the marquis paste we probably wouldn't have had such a long haul to get back to 100%.

Also I never stalled him when its wasn't necessary. I found any time he was stalled, even for a couple hours, he be worse right afterwards than when he was allowed to move in pasture or even a dry lot. Movement is very important, but I think its finding that balance between too little and too much that is so tricky in the rehab of these horses.

hobbyhorse 12-13-2011 08:45 PM

Cat- I agree with you that there are other disorders that looks like EPM and I told my friend I think his vet is wrong. I don't know what tests the vet did to determine the EPM dx. I know one was blood test. I know my friend had to wait a few days for the results. Prior to this, same friend had another horse that was kept in the same stall and it had a horrible death. The same vet treated him for colic. I have never seen a horse act the way this one did, it was so violent...

Lakotababii 12-14-2011 12:34 PM

An arab cross at the therapy barn I worked for was diagnosed with it early this year also. We ruled out just about everything before the vet diagnosed EPM. He normally ran all over the place in the pasture, but would just walk. He could not keep track of his back feet, lost all muscling in his rump, and couldn't back up. He was also very depressed and lethargic, but still friendly and happy to see everyone at times. He also had good and bad days. There was a time when, after treatment, we thought we would have to put him down. Vet came out and told us to keep trying,and gave us a stronger medicine.

Smokey is now fully recovered, he has his muscling back, can easily back and definitely knows where his feet are. He runs like the wind when he sees humans, or horses, and is generally back to his normal self. He is now back into riding and training, and is an awesome trail horse. We w/t/c with him all the time now.

That said, we did not work him at all, minus ground work (brushing, grooming, leading) when he was ill. We let him rest and fight off the disease. His hind end did get weak, due to the disease, but he got it back after it was cured.

Pattilou 12-14-2011 09:56 PM

Thanks for the good new on the arab.... I am hoping the same for my boy. He turns 5 in a few days, so I was hoping for a long relationship with miles of trails !

It has been so hard not riding for the past 4 months.. but I am trying to realize I have to take things at his speed and give him the time he needs.

Thanks for the input

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