Formal Welcome Letter to New EPM Horse Owners

There are some questions we always ask when someone joins the group because they have a horse diagnosed with EPM and it's not to be nosy, but to make sure that you really know what you are dealing with before starting a very expensive and lengthy treatment. There have been several people who joined the list because their horse had been diagnosed with EPM only to find out that it was something else after spending a lot of money on treatment.


How was the horse diagnosed? (blood test, CSF tap) Were tests done to rule-out other problems that can have the same symptoms as EPM?
What signs is the horse presenting?
If you are already treating for EPM, what drug OR drugs are you using?
Are you giving any other medications or supplements as supportive therapy?

EPM is a very difficult disease to diagnose, as the symptoms can mimic any number of other conditions that have a neurological component. Some examples are Wobblers, West Nile, the neurological form of equine herpes and Lyme disease. A good rule of thumb is if there is also fever present, it is most likely NOT EPM. There is no definitive test for EPM, so a big part of diagnosing EPM is ruling out these other conditions with appropriate tests.

A spinal tap is the best diagnostic tool currently available, and it is not 100%. Blood tests only indicate exposure to the EPM protozoa "S.neurona" ; it is not an indicator of active EPM. In some areas of the country, well over 50% of horses tested will blood test positive, while studies show only .14% will actually "get" the disease. The EPM vaccine completely eliminates using the blood test for exposure, as a vaccinated horse will test positive. Acupuncture "testing" is completely worthless.

If you tell us that you are using a "new" or unusual treatment, (such as colloidal silver, Texas red-eye) or some treatment that you don't know what is in it or you're told that the vet won't reveal the contents, BE PREPARED for tons of questions and comments. Here on this list we've heard about just about all of the oddball treatments and we are NOT attacking you personally, even though it might seem that way. Most of them DO NOT work and do nothing but waste your money and time. Some are actually harmful to your horse. Please remember that this list has years of collective EPM experience, more than most vets have, and we are trying to save YOU, the newcomer, some of the time, money and heartbreak that we have been through battling this horrible disease.

Please check out our EPM center at http://www.meadowherbs.com/EPMcenter.htm

There is some wonderful information there on EPM and how it is diagnosed and treated.

Attached an excerpt from the proceedings of the Nov. 2003 AAEP convention that gives the latest information on EPM and treating, though it's not as easy to read as the websites, it's great to have printed out and handy when the vet comes to talk about treatment. Also, check out these
websites:

http://www.xcodesign.com/aaep/displayArticles.cfm?ID=248
("EPM 101")
http://www.tufts.edu/vet/sports/neuro1.html
(complete description of a neurological examination)
http://www.bayerdvm.com/view/10152624767708267f00000198659109
(Bayer Corp's DVM Exchange/Roundtable (a long download, but worth it))
http://www.vetmed.ucdavis.edu/ceh/HR21-1EPM.html
(UC Davis report on EPM Jan 2003)
http://www.yourhorseshealth.com/epm/treat.html
(Bayer's webpage on EPM and Marquis)

If your horse is suspected of having EPM or recently diagnosed with EPM, you might want to print out some of this info to talk over with your vet at your next appointment. It's so easy to forget what you wanted to talk to the vet about when he's there having printed information, including a list of your questions, is a good idea. If you haven't had a full neurological exam performed, having a copy of the Mayhew scale for neurological exams printed up for your vet to fill out will also be helpful.

Most people here recommend treating with Marquis for a couple of reasons:
treatment only takes 1-2 months and it has fewer and less serious side effects than the other treatments. The current thinking is to either give two months of Marquis, or go 1 month at 1.5 or twice the recommended dose.
And you can add 1/2 cup of corn oil to increase absorption of Marquis.

The other two treatment options are: Navigator and a combination of Pyrimethamine and trimethoprim/sulfadiazine, but both of these treatments have downsides. Navigator can have some very serious side effects, including laminitis, and 30% of horses will run fever, show depression and lose their appetite on Navigator according to their published materials.
And the "trads" as they are called on this list (Pyrimethamine and trimethoprim/sulfadiazine) requires at the very least 6 months of treatment because they don't actually kill the parasite but in effect starve it out by keeping it from reproducing . The traditional treatment has been known to cause anemia in horses so they must be monitored very closely. Many are doing a 2 month treatment with marquis following with a 6 month treatment of traditional therapy .

Whatever treatment you are using, you need to have as accurate a weight on your horse as possible. Don't rely on weight tapes, they can be as much as 200 pounds low. Here's a pretty accurate formula for determining your horse's weight, if you don't have a freight scale anywhere near you can trailer your horse to:

[(hg X hg) X length]/330 + 50 = weight in lbs

Measure the heart girth in inches from just behind the withers to just behind the elbow and back up to the starting point.

Non-steroidal anti-inflammatories (NSAIDS) are also used as a supportive part of treatment because the parasites cause inflammation in the CNS which causes worsening of symptoms and can do permanent damage. I've seen more than one recommendation for the use of Bute or Banamine for 2 days prior to starting treatment and continuing for the first week of treatment and then as needed. Horses will have good days and bad days while being treated because the parasites release toxins as they die and this will cause more inflammation. Bute or Banamine can really help on the bad days.
If a horse is having severe symptoms, IV DMSO can be administered by your vet to bring down the swelling quickly.

Along with the drug chosen to actually get rid of the parasite and the anti-inflammatories, a lot of the members on this list have had good luck using an immune booster (Meadowsweet Acres) and supplementing with a minimum of 8,000 ius of Vitamin E (with no additives) to help the body repair damage done to the nervous system.

It is also recommended to keep an EPM horse as stress-free as possible due to the fact that stress inhibits the immune system in its fight against the parasite. This includes keeping him out of situations where he might overwork himself trying to keep up with other horses, going back in the show ring too soon, long distance trailering, vaccinations and deworming.
It is recommended to not vaccinate, if at all possible, during treatment, or if that is not an option then spacing out any vaccinations over a few weeks rather than all at one time. Many stay clear of 5 or 6 way vaccines.

It can also be helpful to give bute or banamine before any vaccinations are given. Spacing out vaccines is also highly recommended even when treatment is done, as people have reported relapses due to an overload of vaccinations given at once. Many people also opt to vaccinate only for fatal diseases, such as rabies and encephalitis. Deworming has also been reported by people on this list to cause a worsening of symptoms to , so deworming during treatment is NOT recommended . A probiotic such as FasTrack and anti-inflammatory supplements such as MSM are highly recommended

You may want to keep a journal. That way you can "see" any progress or setbacks. Expect setbacks, they just happen. Two steps forward and one step backwards has been most peoples' experience. And give your horse a year for recovery. Think of it like a stroke victim's recovery. Neural pathways have to reroute and this takes time. LOTS of time. Most just let their horses be a horse for a year or so. Once your horse is stable enough, hand walking for 5 minutes once or twice a day is good for them. Hand grazing, massage (if he doesn't mind being touched), and turn out for self exercise in a safe area is good for physical and mental rehab. Turnout with other horses is fine as long as it is safe ? if your horse isn't in danger from the others.

Hopefully all this information will get you started on your search for information about EPM.

Owning an EPM horse is sort combination of a trial by fire, and a labor of love. The animal that was once your active partner and perhaps took you to great glory, is suddenly a very big, incapacitated (often dangerously
so) dependent creature. You're going to be forking over huge amounts of money in an effort to diagnose and "cure" them in the hopes that you'll regain the status quo. Some do, probably more don't.

But probably a huge majority of the people on this list would tell you that while you may lose either temporarily or permanently your riding partner, you'll gain an insight into the psyche and spirit of your horse that you really weren't aware of before.

Try to look for the good in this.....it's hard sometimes, but it's there.

{This is a collective letter from the EPM Group and is in no way meant to replace veterinarian care and/or their diagnostic opinions)
 

Please be sure to visit our Support Group Center located at the Meadowsweet Acres Website. EPM Support Center.

Sincerely
Patti and Moose