This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Nervous System » Diagnosing Diseases of the Nervous System »
  Discussion on EPM Question
Author Message
Member:
Daryl

Posted on Tuesday, Jan 14, 2003 - 5:58 pm:

I brought my horse to the vet last night.He did a few physical tests and said he thinks it could be three things.EPM,EPM and EPM.The blood work will be back thursday I think.He said that treatment will cost approximately 700.00 and chance for recovery is between 80-90%.Does that sound about right? Thanks for any input.
Daryl
Moderator:
DrO

Posted on Wednesday, Jan 15, 2003 - 6:20 am:

Hello Daryl,
We have a rather involved article on EPM at » Equine Diseases » Nervous System » EPM, Equine Protozoal Myeloencephalitis. I really do not have a comment on the cost but I think the prognosis is a bit optimistic: more often you see published 70% respond by improving one to two grades of neurological deficits and reocurrence following treatment not uncommon.
DrO
Member:
Daryl

Posted on Wednesday, Jan 15, 2003 - 10:16 am:

I did read the articles and they are very involved.I understand that you are not able to comment on the cost.I guess I need help in making a decision with proceding with treatment.Actually I was being optomistic he did say 70%.I am concerned that I will be wasting very hard earned money at a time when money is a big issue for me.
But than what are my other options if she is not treated?My vet seems very positive about the outcome.But reading posts here it seems so iffy.
Oh well I don't know anything till the blood work comes back.Thanks
Daryl
Member:
Dres

Posted on Wednesday, Jan 15, 2003 - 10:49 am:

Daryl, this has nothing to do with your question but... like i told my daughter...

if you can't afford to take care of a pet PROPERLY when needed... then you should not have one...

sorry...

Ann
Member:
Jimhug

Posted on Wednesday, Jan 15, 2003 - 12:42 pm:

Ann, my question would be- who determines what proper care is? Daryl may be perfectly able to give his horse adequate feed, medical attention (shots, worming, etc), but may have a more difficult time when it comes to unanticipated items. Even though we all know that EPM, colic and other medical items may strike our horses, none of us plan for them.

I have 15 horses and if one of mine developed EPM, I would have to make a decision also. It would be based on the prognosis for recovery which , I believe, is what Daryl is asking. I didn't get the impression he was balking at spending the money, only that it would be well spent-in other words, a good chance for recovery.

Jim
Member:
Paul303

Posted on Wednesday, Jan 15, 2003 - 6:00 pm:

Yes, Jim, and we mustn't forget the many people who shower their horses with money, but are terrible horse people.
Member:
Daryl

Posted on Wednesday, Jan 15, 2003 - 7:53 pm:

Jim you nailed it.
Thanks
Moderator:
DrO

Posted on Thursday, Jan 16, 2003 - 5:58 am:

Ann, it would be one thing if he could spend $700 and be guaranteed he is going to cure his horse. But the situation is far different. He has a 70% chance of improving the horse, not cure him, and then a substantial chance the horse may relapse. Throw in the uncertainty of any EPM diagnosis and it is easy to see why Daryl or anyone may be slow to opt for expensive treatment.

What other choices?
1) You could opt for less expensive therapy (TMP and Pyrilamine).
2) If the horse is not in pain (and he should not be with EPM) you could be sure the horse has a safe place as long as he is able to get around.
3) Euthanasia. Although I would give the horse a bit of time to see if this problem does not improve on its own: some do.
DrO
Member:
1sally

Posted on Thursday, Jan 16, 2003 - 8:50 pm:

Dr. O,
There have been numerous posts, etc. on EPM, but none indicate what the life expectancy of a horse is if the disease goes untreated. Could you shed some light on this?
Moderator:
DrO

Posted on Friday, Jan 17, 2003 - 7:20 am:

There is no predictable pattern Sally. Some improve. Some go down hill quite quickly, being unable to rise in a matter of hours, while others may spend months or years slowly worsening. There is no doubt in my mind that one reason for this diverse prognosis is that we are confusing several diseases. Hopefully as we learn more we can answer this question more precisely.
DrO
Member:
Daryl

Posted on Tuesday, Jan 21, 2003 - 9:47 pm:

The test came back positive.Her white blood count is high.I am going with the treatment.I hope it works.
Thanks
Moderator:
DrO

Posted on Tuesday, Jan 28, 2003 - 11:35 am:

Good Luck Daryl. You do understand the high WBC count is not related to the diagnosis of EPM, right?
DrO
Member:
Lwillis

Posted on Thursday, Aug 11, 2005 - 11:55 pm:

Dr. O.,

Can you help me to better understand?

Is there a cure for EPM or can it only be improved?

Is there any way to prevent relapse? It seems that it is very common.
Member:
Ryle

Posted on Friday, Aug 12, 2005 - 8:32 am:

Lauren,
There are treatments for EPM that will get rid of the parasite that has made it's way to the central nervous system. However, there may be lasting damage to the brain and/or spinal cord after you treat your horse and this may leave him with permanent neurological deficits.
EPM (the disease) is actually not very common. Exposure to the parasite is fairly common in areas where opposums are found. Approx 50% of horses will test positive on blood test for exposure to the parasite, but only around 3% of horses actually contract the disease. It just appears to be the "disease of choice" lately and is being diagnosed frequently without appropriate diagnostics or even any diagnostics at all. And this is sad for owners and horses because several times when I've seen this happen the horse did NOT have EPM so they were wasting time and money on treatment that wasn't going to help their horses. Most notable was one last month where the man's vet diagnosed EPM with an exam and a Western Blot test on blood only and did no other testing of any kind. They treated the horse for 3 days before the owner learned enough about EPM to realize that he didn't have a diagnosis and took his horse in to the nearest vet school where he found out that his horse had a broken vertebrae in it's neck that was causing the neurological deficits.

Prevention of exposure to the parasite is hard since your horse can be exposed even while grazing because the parasite is passed in the feces of possums. But keeping your feed and hay stored where possums can't get into it can help limit your horse's exposure.
Moderator:
DrO

Posted on Friday, Aug 12, 2005 - 9:41 am:

Hello Lauren,
We answer both of these questions and many others in the article, Equine Diseases » Nervous System » Incoordination, Weakness, Spasticity, Tremors » EPM, Equine Protozoal Myeloencephalitis. Start there and then post any questions you have in the forum there.
DrO
New Member:
Jackiea

Posted on Monday, Aug 14, 2006 - 4:36 pm:

Dr. Oglesby,
My 19 Year old mare was diagnosed with EPM last August. She tested moderate positive with the blood test. She had weakness in her hind quarters, swaying at a stand and turning her foot inward when walking, this would shift from side to side every 5-7 days. We treated her with Marquix for two successive treatments and she seemed slightly better, with less swaying at stand and less problems with her feet turning in. Several months later, she started having more swaying/foot turning again and it seems to just be a constant occurrence with 4-5 days of problem, several days of seeming to be stable and then switching to the other leg again. She has lost a great deal of muscle/muscle tone in both her hindquarters,but can get run if excited, with not much obvious problem. It seems worse at a slow walk. I know that amount of recovery depends on damage done by the parasite, but what causes her to keep switching from side to side? Is this what it means to have a relapse or should I expect this to occur from here on out? I don't hand walk her much, but she is kept at pasture and grazes 24/7. Several times a day she will rest against the barn/fence. Should I try a treatment with Navigator now? Thank you for your advice.
Member:
Ryle

Posted on Monday, Aug 14, 2006 - 10:12 pm:

Jackie,
What are the temperatures like where you are?
Is your horse showing any other symptoms beside the balance issues? Is she around other horses who have been sick lately?
Horse who recover from EPM can learn to compensate for the permanent damage that they have due to the disease, but often you will see a relapse of symptoms when they are stressed by other conditions--illness, hard work, pregnancy, etc. And extreme heat tends to really be hard on them...many of the people I know who have horses who have been treated for EPM (some even several years ago) often see their horses start showing neurological symptoms again when the heat and humidity are high. The best thing to do is to remove the stressors as much as possible. If heat is the problem then cool baths, fans and shade may lead to an improvement in symptoms.
The other thing to remember is that it may not always be a relapse of EPM or an inability to compensate for permanent neurological deficits. You have to be cautious not to just assume without making sure that you aren't missing something new.

Good luck.
New Member:
Jackiea

Posted on Tuesday, Aug 15, 2006 - 6:52 am:

Thank you Cynthia, She has not been around other sick horses and shows no other symptoms, but it has been hot and humid here. However,she had been doing this before it got quite so hot and it cycles every 4-5 days from side to side with several good days inbetween. I guess what I am trying to figure out is if this the way she'll always be or if it is a sign that she has relapsed and I should treat her for it. I know I need to try to rebuild her muscles up, but feel as if I might do more harm when her foot is turning in badly.
Member:
Ryle

Posted on Tuesday, Aug 15, 2006 - 7:54 am:

It's so hard to say whether it could be EPM rearing it's ugly head again or not as the symptoms can be variable, but since it started prior to the onset of the hot/humid weather and the symptoms "move" I would consider having her re-examined to see if there is something else going on.

I guess the real question becomes: do you want to just spend the $700-$800 to go ahead and treat her again or do you want to spend some money on diagnostics and still maybe have to spend the money to treat again? Getting your vet to come out and perform an initial exam will help give you more of a basis for making that decision.
Moderator:
DrO

Posted on Tuesday, Aug 15, 2006 - 8:15 am:

It remains uncertain this is EPM and because of the lack of firm diagnosis it is very hard to make judgements about cause and possible results of specific therapy. The bilateral symptomology certainly makes EPM less likely in my mind. The up and down nature suggests this is variation within the disease rather than progression of a disease process. This variation is possibly proprioceptive in nature but considering the muscle wasting more likely weakness. It is normal for weakness secondary to chronic neurological problems should vary from time to time but I cannot account for the specific rhythmicity you describe.
DrO
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC