|
|
Discussion on EPM - "Weak Positive"
|
| Author |
Message |
Member:
Mpurdy
|
Posted on Monday, Feb 10, 2003 - 4:53 pm:
Hello!
I am continuing the discussion of my mare, "Penny", which appears in the Lameness Diagnosis Forum under the post called, "Progressive Problem with..."
Her blood test for EPM came back weak positive. From what I understand from my vet and from extensive reading, this could fit with her mild symptoms and her situation. I have constructed a time line that supports a diagnosis of EPM; however, I realize that some of my assumptions could never be proven and I expect that some of you can find fault with my reasoning-- bring it on  !
Sept. 15 she moved to a new barn, a trip of about 45 minutes. New place is in a area which can be considered a bit more likely to have exposure to infected possums. Penny is quite adaptable and
not high strung, but nevertheless, a move can be stressful.
Next stresser was on Oct. 25 when she had 6 month booster for Rhino/Flu and 1st West Nile Vacc. The 2nd WNV was given several weeks later.
Sometime during the first week of November I started to notice the beginning of problems while riding in the arena, as noted in my post about lameness.
Each time I rode after that there was a subtle decrease in my ablility to get her to do certain things and/or my ability to do things such as post on the correct diagonal.
Currently Penny is undergoing treatment for EPM --she began it on Feb. 7. I decided to do this because:
1. EPM is my vet's first choice of diagnosis.
2. Her blood test, mild symptoms and timeline above are not inconsistent with EPM.
3. I don't want to ignore the chance to treat for EPM at its earliest stages.
Margo & Penny
|
Member:
Suzeb
|
Posted on Tuesday, Feb 11, 2003 - 12:39 am:
Hello Margo,
Sorry to hear about Penny's troubles. One thing that comes to mind is did the vet have a good look at her feet. Does she have long toes/underrun heels or low heels? A lot of quarter horses do have this condition. Did your vet do any hoof testing for sensitivity or any nerve blocks to rule out foot problems? What does your farrier say about the condition of her hooves. The sandy arena may have been just the thing to bring on these symptoms. Is it very deep/heavy and uneven in places? I too have a quarter horse who travels better on firmer ground. The deep sand footing that he had been ridden on was enough to make his joints more sore which can lead to a sore back. Been there, done that. I did get a second opinion because I was dealing with something serious although different from your vet's diagnosis. Hope everything turns out well for you.
Susan B.
|
Member:
Mpurdy
|
Posted on Tuesday, Feb 11, 2003 - 11:19 am:
Susan, thanks for your input. The vet used hoof testers and found nothing wrong and also described Penny as having very good hooves for a QH. Since I moved, the new farrier has been shortening her toes and bringing heels down, but I don't believe that her hooves were extremely out of balance in this regard-- just needed a little improvement.
Yes, sometimes the area is uneven and deep, sometimes not. She did not move differently/better for the 2 days she was on Bute.
Margo
|
Member:
Mpurdy
|
Posted on Wednesday, Feb 12, 2003 - 10:25 pm:
Hi,
Since I am a new user of the Horseman's Advisor, I don't know if Dr. O. responds to all posts or just selected ones. I was hoping for his input on "Weak Positve" as well his opinion on my answers to his question on the thread from the Lameness Diagnosis Forum. I suspect that there are quite a few of us who were unaware that there were more "choices" for the results of the EPM blood test besides "positive" or "negative."
Thanks,
Margo
|
Moderator:
DrO
|
Posted on Thursday, Feb 13, 2003 - 9:10 am:
I did not see a question in your first post above Margo nor anything that really needed comment on but I am glad to reply to the question in your second post.
Since I have not seen the test itself I really do not know what your lab or vet means by a weak positive. The test is thought to be quite sensitive yet specific for exposure (but not disease) to S. neurona so I would presume a weak positive is still a positive.
Which questions and answers are you wanting for me to comment on Margo from the other page? I read every post made to these boards and if I do not comment it means I see nothing I disagree with. But if you have some questions you think I can help with by all means ask!
DrO
|
Member:
Mpurdy
|
Posted on Friday, Feb 14, 2003 - 10:43 am:
Happy Valentines day to all!
DrO,
Thanks for clarifying your routine of not posting when you see nothing that you disagree with. That makes sense. Since I didn't elicit a response from you on the post (in lameness diagosis) where I tried to answer your concerns about the veterinary evaluation of my horse, I now believe that you are more comfortable with what was done and the conclusions.
My specific question on the weak positive relates to my assumption (and think my vet's as well) that those results imply a recent exposure. This was a key to my timeline rationale. Now it is not necessary to know the timeline in order to treat my horse, but as an intellectual/educational exercise I am curious, as are my friends who know about the situation.
Thanks,
Margo
|
Moderator:
DrO
|
Posted on Thursday, Feb 20, 2003 - 8:30 am:
There could be many reasons for a weak positive. Recent exposure is one explanation, but exposure a long time ago, very low exposure, or a weak response to exposure are all also possible. To better support recent exposure as the reason a second test 21 days later with a significant increase in reaction is indicative of recent exposure. Treatment should not effect this continued rise.
DrO
|
Member:
Mpurdy
|
Posted on Sunday, Mar 2, 2003 - 10:11 am:
Hello! A progress report on Penny:
Two weeks after the beginning of treatment I was suppose to evaluate her progress or lack thereof. I noted mixed results and reported them to my vet, who felt there was still good reason to continue the medicine and it was re-ordered from the compounding pharmacy. It is Sulfadiazine, Pyrimethamine, Trimethoprim -- not Marquis.
Yesterday, three weeks after starting treatment, there was a significant milestone! I was able to get Penny to trot in both directions of the arena, and I was able to post on the proper diagonal; and I got her to take the right lead on the second try!!
Margo & Penny
|
Moderator:
DrO
|
Posted on Monday, Mar 3, 2003 - 6:12 am:
Thats great Margo, thanks for the update and keep us appraised.
DrO
|
Member:
Mpurdy
|
Posted on Wednesday, May 14, 2003 - 5:07 pm:
Hello,
An update on Penny: She is very much improved in all respects. A sore back on the right side is really the last problem that lingers and the vet noted a great deal of improvement in that in the past 4 weeks (happened to work out for her to check Penny yesterday and compare to exam of last month).
She has been on meds since Feb. 7, and I expect to use another bottle (month's worth) of medicine before we stop. Should I supplement Folic Acid and if so what dosage and product? Should I pursue massage therapy? I have a friend who does equine massage so that option would not be difficult to arrange -- trying to decide if it would be contraindicated either from any possible harm or as a waste of money is my question.
Thanks,
Margo & Penny
|
Moderator:
DrO
|
Posted on Thursday, May 15, 2003 - 2:32 am:
Folic acid supplementation may actually be contraindicated while on oral antimicrobials. For an explanation of this somewhat complicated problem see the table insert entitled "Important" in the article » Equine Medications and Nutriceuticals » Antibiotics and Antimicrobials » Trimethoprim -Sulfa. It gives suggestions for dealng with the folic acid problem.
I am not sure how massage might help as this is a neurological problem but if you feel there is muscle soreness, it might help that.
DrO
|
New Member:
Emp9002
|
Posted on Saturday, May 31, 2003 - 7:58 am:
My walking horse mare has been preliminary diagnosed with EPM by two vets. She has been rated
on the scale as a "close to 3 grade". Most of her symptoms are in her hind quarters, very weak. I have decided to treat her with Marquis and not do the additional testing as it all is very expensive. My question is what is the best conditions for her at this time. Her paddock does not have grass but she received plenty of hay, is
not having access to grass going to be a problem?
Will the summer heat interfere with the antibiotics or accelerate the disease? Are there
supplements that she should be on while she is
taking this medication? After? Should she be
exercising during treatment, lunging , round pen
etc. or kept quiet? thanks for your help
|
Moderator:
DrO
|
Posted on Saturday, May 31, 2003 - 11:40 am:
Hello Jeanette,
You may have not read the article on EPM which discusses the essentials of treatment, see » Equine Diseases » Nervous System » EPM, Equine Protozoal Myeloencephalitis. As to whether the horses should be made as comfortable as possible the answer is yes, and good green grass is more nutritious than hay, and forced exercise should be considered a form of stress.
DrO
|
Member:
Ryle
|
Posted on Monday, Aug 30, 2004 - 4:18 pm:
I came into this discussion late, but for future reference there is a yahoo support group for people who are dealing with EPM. https://groups.yahoo.com/group/EPM
There is wonderful information and support available to help you in dealing with this awful disease.
Cindy D.
|
|
|
