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  Discussion on EPM Question
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Member:
Ginger1

Posted on Friday, Apr 8, 2005 - 11:36 pm:

I have a 15-18 yr. old TWH mare that has been diagnosed with EPM. We had only had her for a few months when she fell when I was riding her and we had the vet out to test her. Blood work was done to confirm EPM and she has been getting 30 cc of the EPM Suspension (Sulfiadiazine & Pyrimethamine) daily for nearly 60 days now. After 30 days on the meds the vet said I could start walking on her in the ring. I did this a few times and was working on building up her exercise time, but after only walking with her a few days ago she fell again. I am now thinking that I'll never be able to ride her but was wondering if anyone could tell me if this is a realistic thought or have we just not given her enough time on the meds. Since the fall I have just longed her in the mornings before turning her out for pasture time. ** she always seems to get around fine in the pasture with no rider. She has also put on about 200 lbs. since we purchased her back in November as she was quite underweight. Currently we feed her a mix of a supreme & golden years feed, hay & pasture grazing. Although she is not progressing with a rider, she looks like a new horse. Nice shiney coat and so much more healthy looking. I would love to hear your thoughts on our situation. Tried to attach pic of her from yesterday.. hope it works.

Thank you,

Gigi
Member:
Ryle

Posted on Saturday, Apr 9, 2005 - 10:40 am:

Gigi,
I hate to say it but many vets just don't understand how slow rehabbing an EPM horse goes, especially one that is on the slow treatment regimen that your horse is on. Your horse isn't safe at this point and you shouldn't be riding.
Generally with an EPM horse, you are better off letting them self exercise in a very level, safe paddock or arena until they are much more stable on their feet. Many EPM horses improve for several months to a year after treatment and you are looking at needing to treat for probably 6 months at the very least with the drug combination that you are using. There is a book out called "Rehabbing the EPM Horse" that you really ought to consider buying. Please go slowly, it's not worth risking your health or your horse's to get back up on her now (or probably anytime in the next few months). Many of the people I know who have treated EPM horses have waited more then a year before starting to ride again because it has taken that long for their horses to become stable enough that riding was safe. Recovery from neurological damage is very slow. And rushing an EPM horse may lead to relapse or accidents.
In case you don't know, the drugs you are using don't actually kill the parasite but prevent them from reproducing so that they eventually die off. Why did you choose to go that route rather than Marquis which is only a 28 day treatment and actually kills the parasite?
You said that blood work confirmed EPM, do you mean that you had a blood test done for EPM or that you ruled out other diseases via bloodwork.
Because if you are basing your whole diagnosis of EPM on a blood test that was positive, you really don't have a diagnosis...just a possibility. More then 50% of horses will test positive on a blood test--it only shows that they have been exposed to the organism that causes EPM not that they have EPM. The blood test is valuable in that if it's negative then you can cross EPM off your list and if it's positive EPM stays on your list and you need to keep testing to determine what is causing the neurological deficit.
If you are interested, there is an EPM support group on yahoo. https://groups.yahoo.com/group/EPM

Cindy D., RVT
Moderator:
DrO

Posted on Saturday, Apr 9, 2005 - 4:44 pm:

Hello GiGi,
Your post does suggest you have not read the article on EPM, you will find it at Equine Diseases » Nervous System » Incoordination, Weakness, Spasticity, Tremors » EPM, Equine Protozoal Myeloencephalitis. It has an in-depth discussion on the diagnosis and probable outcomes of your case. It also compares the different treatments available.
DrO
Member:
Vickiann

Posted on Saturday, Apr 9, 2005 - 8:32 pm:

As in the prior posts, bloodwork does not determine an EPM diagnosis . . . only exposure to it. In Florida (or wherever there are plenty of possums) bloodwork concludes a majority of horses show EXPOSURE to EPM but that does not mean they suffer from it. You must have a spinal tap to definitely determine this. . . unless you believe in the holistic diagnosis, which is hugely (and shown in research to be) questionable and shown in studies to be more than inaccurate.
Member:
Ginger1

Posted on Sunday, Apr 10, 2005 - 1:23 am:

Thank you for the responses to my inquiry. To answer a few questions; we chose the longer treatment for economic reasons. When we made the decision about treatment, we had only owned the horse for approx. 2 months and believed the longer treatment would be just as effective, but just take a bit longer. Additionally, the vet who is treating our horse conducted what looked like a pretty extensive series of coordination tests in conjunction with the blood work. He told us that the spinal test used to be deemed necessary for a diagnosis, but that he didn't believe it was. So this is what we based our information on at the time.

I am 43 years old and until this past November when we I purchased Ginger, have not had a horse since I was 17. I was so excited about finally having a horse again after all these years, and in January she was diagnosed with EPM and we have been dealing with this since. My first clue that something was not right with Ginger was when she fell to her knees when I was leading her out of cross ties. Others told me she was just getting used to her new shoes (she had been out of shoes for at least 3 years)but I had the vet come out and look at her anyway .. I was told she was fine. Then a few weeks later I was riding her; we were just walking and she fell to her knees. Again I called the vet out. This time he did the coordination tests and blood work.

After reading that many people don't ride their horses for a year, I would tend to believe that my vet was not really aware of the amount of time involved in recovery with EPM. Although after Ginger had been on the meds for 30 days and a second series of coordination tests was administered, it was obvious even to my untrained eyes that there had been a noticable improvement. Of course I was heartbroken when she fell again though.. but reading your posts I feel better knowing that it's probably just way too soon for her. I don't have a problem with waiting a year or more if necessary. In fact, even if I am never able to ride her, she'll always have a home with us.

Also, thanks for the info about the Yahoo support group. I went to the link and have applied for membership.

Gigi
Moderator:
DrO

Posted on Sunday, Apr 10, 2005 - 9:13 am:

Vicki, the CSF tap with either the Western Blot or the PCR test run show a high incidence of false positives similar to the blood tests. There use in the diagnosis of EPM is explained in the article referenced above. Gigi can you tell us what coordination tests where performed and what the results were?
DrO
Member:
Vickiann

Posted on Sunday, Apr 10, 2005 - 8:42 pm:

Thanks -- that is very good information to know!
Member:
Ginger1

Posted on Sunday, Apr 10, 2005 - 10:58 pm:

DrO,

My vet spent a good 20 minutes moving Ginger's legs into various positions, moved her around by pushing on her hind end and sides, crossed legs, extended legs, etc. to test her response. The first time he did this she did very poorly. He would cross her legs and she would just stand there and not move them back. All of her responses seemed to be dulled. But when he did this the second time after she had been on the meds for a little over 30 days, she showed a marked improvement and responded quickly to having herself placed in precarious positions.

Gigi
Moderator:
DrO

Posted on Monday, Apr 11, 2005 - 7:51 am:

How about while being trotted in hand Gigi, did the horse show weakness, unusual and varying tracking of the legs, or interfere with one leg running into the other?
DrO
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