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| Discussion on What are the sign of EPM? | |
| Author | Message |
| Member: Byerazz |
Posted on Thursday, Jul 28, 2005 - 1:46 pm: I have had two people in the last two days ask if I have had my horse tested for EPM. I have been having a weigh issue with him. |
| Member: Ryle |
Posted on Thursday, Jul 28, 2005 - 2:14 pm: Sarah,EPM is a neurological condition and can affect the function of any part of the body. Symptoms can include balance and coordination issues which can manifest as stumbling, tripping, falling etc, head tilt, difficulty swallowing, loss of muscle mass (generally along the topline and in the muscles of the hindquarters), seizures (though not common), abnormal reaction to touching and paralysis of facial muscles. If your horse is not showing any neurological symptoms, then I wouldn't be concerned about EPM. Have you looked at the more common issues that cause weight loss? Good quality forage? Balanced diet? Adequate intake of feed/forage to meet energy needs? Eating eagerly? Teeth in good shape? Good deworming program? If you haven't made sure on all of those issues, that's where you need to start. |
| Member: Shark |
Posted on Thursday, Jul 28, 2005 - 3:05 pm: Sarah,what I saw with my horse Big Ben who did have E.P.M. in March 04... (History) Ben is a 17 to 19 year old Appendixes Quarter horse who at the time I found him in March of o4 stood at 16 hands and weighed about 900 lbs. He had lost most of his muscle tone on his left side.. the right side was quickly catching up...when he trotted or canter he would always lean toward his left side..All so he would drag his left rear foot.. When I would put him in cross ties. after about 5 minuets or so I would see his hips start to sway back and forth..he was really starting to have a real problem with his balance.. He also was very touchy about having his left side groomed.. he would react as if it hurt.. I bought him in Jan of 04, at that time he just looked starved and somewhat weak.. Moved him out of the filthy stable where I found him at,( he and his pasture mare were forced to drink filthy water that was caught in a barrel coming off the roof of their run in shelter.) In March my vet did blood work that confirmed his E.P.M. The blood work is not as accurate as a spinal tap..but at the time the vet felt that it would stress Ben out more to load him up and take him to the clinic to have a spinal done. Ben was then put on a triple sulfate medicine that inhibits the parasites growth.. and is suppose to allow the horse to purge the dead parasite out of their body. He was also put on a put on a vitamin E and selium supplement.( this helps grow back nerve endings that are damaged by the parasite) The Nerve endings that are destroyed will never come back..Ben has a few (dead spots) on him. This all worked until it all stopped working.. in August of 04.. he was then put on the Marquis until Nov of 04.. Because Ben would drag his left rear foot in the early days, he damaged his hoof which makes him go (off) a little in his rear. My farrier has to do his feet every 4 to 6 weeks and he has to wear corrective shoeing until his left rear hoof grows out the damaged part..(2 more trimmings and the corrective shoeing will be done with.) Today when you look at Big Ben he stands at 16.1 hands and weighs in at 1,250 lbs..He is worked for about an hour to two hours 4 times a week under the supervision of my Vet ( I think I bought him a new car with paying my vet bills)..and my professional trainer.(Lesslie !! find your seat..DrOp those heels.. eyes foreword.) Have your vet check him out.. if he does have E.P.M. you must be aggressive with the treatment. The sooner you treat it the less damage the parasite causes to his nerves... I've always looked at E.P.M as the Equine version of Mad Cow Disease... Hope this helps and Good Luck |
| Member: Byerazz |
Posted on Thursday, Jul 28, 2005 - 3:08 pm: Cynthia,Thank you for your message. I have had his teeth done twice. Once last Aug and again this July. Last year they were VERY bad, this year my vet said they where not bad enough to make a difference. I have him on a Senior feed because we do not have good pasture/forage. My local grain company and the Michigan Rep. from Purina came to my house today and she is what that asked about EPM. She did pull his tail and then after said to just have blood work done by my vet first. He had lost the weigh over his topline, point of hips, and side of hips. I think he is just not getting enough fiber but I am not a pro. I had heard sometimes vet does some field test when vetting horses. Is this tail pulling think part of it? If so should the horse cross his legs or stand rock soild. Thank you for your help. |
| Member: Byerazz |
Posted on Thursday, Jul 28, 2005 - 3:20 pm: Is it not true that most all horses with test positive from the blood work and some horses may not even have it? |
| Member: Ryle |
Posted on Thursday, Jul 28, 2005 - 3:46 pm: Whenever you suspect a neurological problem with your horse, the vet should perform (besides a good physical) a lameness exam and a neurological exam. The tail pull is just a part of a good neurological exam. For a more detailed description of a neurological exam, check this website: https://www.tufts.edu/vet/sports/neuro1.html And if you are going to have your vet perform a neuro exam, I would recommend having a printed copy of the Mayhew scale for judging neurological deficit so that the findings can be written down to compare with future exam findings. (Most vets don't tend to carry these around in their trucks *grin* https://www.meadowherbs.com/mayhewscale.doc)With the tail pull, if you can easily pull your horse off balance their may be a problem, but you have to keep in mind that some horses will just let you rather then resist. That is why the whole neurological exam should be performed and an overall rating of neurological deficit made. EPM tends to be one of those things that people have latched on to and want to diagnose on little or no evidence, in my experience. In the last 2 years, I've seen more then a dozen horses diagnosed with EPM with little to no testing and that were later determined to have some other condition when the owners decided that they did want better testing for whatever reason. EPM is hard enough to diagnose with appropriate testing and there is no way that someone can diagnose it without testing at all. The blood test simply tests for exposure to the parasites that causes EPM. About 50% of the horses in the US will test positive for exposure but only about 3% of horses actually contract EPM. The usefulness of the blood test is when it is negative, because that means that your horse has not been exposed to the parasites so doesn't have EPM. If it's positive, that means that EPM is on the list of posibble causes for neurological disease but that more testing is necessary to narrow down the list to a single cause. Sarah, I think I would increase your horse's forage with a good quality hay if you don't feel like he's getting enough. And if you decide to have your vet examine your horse, keep an open mind about what could possibly be causing the loss of muscle mass. And don't jump to conclusions, but depend on a systematic approach to reaching a diagnosis. Good luck! |
| Moderator: DrO |
Posted on Thursday, Jul 28, 2005 - 6:42 pm: The tail pull test is not absolute some healthy horses will give to it. Does your horse exhibit signs of weakness, incoordination, or lameness Sarah. The article on EPM explains about the blood test and you will find articles on horses loosing weight in Equine Diseases » Colic and GI Diseases » Weight Loss in Horses. But you should start with Overview of Nutrition when you are having trouble maintaining condition.DrO |
| Member: Shark |
Posted on Thursday, Jul 28, 2005 - 11:10 pm: If I may ask Sara.. how old is your horse? |
| Member: Rob10549 |
Posted on Tuesday, Aug 2, 2005 - 1:39 pm: Sara,My horse was diagnosed with EPM 10 mths ago. He first came up lame with a rear suspensory injury that, we now know, was caused indirectly by EPM. He was on Marquis for 2 months straight and relapsed two months later. I just finished treating him with a 28 day course of Navigator which had a 1% chance of killing the parasites....yesterday, less than a month from finishing the meds my vet did another neuro exam on him and found him once again failing neurologically. The Western Blot test is not a waste of money. My horse is disabled and barely able to be a horse. If I had known that this terrible disease could creep up and disguise itself as a lameness issue I would have had the blood work done the minute he came up lame with the suspensory. It's true, the sooner treatment is started the better chance you have of curing the disease. I believe that it should simply be standard of care, to test for EPM yearly. I realize that many horses will show titers for the disease but even if they are not high it's a good thing to know considering the disease can be instigated by stress. Depending on what you're doing with your horse it can only be helpful to know where you stand. I have talked to EPM specialists around the country since my horse got sick. I have done whatever I could to cure him. I am back to square one. There is nothing worse than watching your beloved horse fade away from this disease. I don't care what anyone says, get the blood test, rule it out before it gets any worse. |
| Member: Byerazz |
Posted on Tuesday, Aug 2, 2005 - 3:02 pm: Robin,Thank you for your message. You e-mail can right in time. I was just at my vets office this morning about have blood work done to check liver, kindey, red and white blood cells etc. I was considering The Western Blot Test but There is so much I do not know about EPM that I thought that I first would have the other blood work done. My vet said the testing has came very far in the last two years. HE said normally he get horses that have high numbers or low and not much really in the middle anymore. I am going to read Dr. O article on this site but I think I am going to have the blood work done. Thank you. My horse does not show any signs that EPM horse do expect he is thin over his top line and near so I guess if he does have it I am catching him earlier on and can give him a better change. Thank you |
| Member: Lwillis |
Posted on Thursday, Aug 11, 2005 - 11:41 pm: My horse was just diagnosed with EPM, so I am trying to learn as much as possible.What are titters? What is the Western Blot test? |
| Member: Ryle |
Posted on Friday, Aug 12, 2005 - 8:16 am: Lauren,I would highly recommend that you join the EPM group on yahoo. You'll find lots of practical experience and support there. https://groups.yahoo.com/group/EPM How was your horse diagnosed? The Western Blot test is a specific type of test that tests for antigens to S. neurona. It can be run on blood or spinal fluid. When run on blood it only shows exposure to the parasites not active disease. When run on spinal fluid, it is diagnostic for active disease so long as the sample is not contaminated and the horse hasn't been recently vaccinated with the EPM vaccine. A titer is a measure of antibody levels to a specific disease causing agent. |
| Member: Lwillis |
Posted on Friday, Aug 12, 2005 - 9:07 am: Hi Cynthia,My horse is currently at an Equine hospital in Ca. We were trying to solve an intermittent lameness issue and found a bone spur behind the knee which we had removed. When my horse got there they noticed some nuerological symptoms that made them suspicious so they did a mylogram (sp?). Originally they thought that there was damage to his spinal column, but the radiologist so no. Next day they kind of as a side note mentioned that he tested slightly positive for EPM and I could treat for that but it was very expensive. The more I read about EPM the treatment sounds like a must, not a choice. I'm also unclear as to whether or not it can even be cured. |
| Moderator: DrO |
Posted on Friday, Aug 12, 2005 - 10:07 am: Hello Lauren,We answer 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 |
| Member: Ryle |
Posted on Saturday, Aug 13, 2005 - 9:01 am: Lauren,Was the test on blood or spinal fluid? If it was on blood, then it's NOT diagnostic for EPM. It just means that your horse has been exposed to the parasite that causes EPM. Only about 3% of exposed horses actually contract the disease. And there are many other conditions that can cause neurological symptoms, so if you just have a positive blood test I would spend my money on getting a good diagnosis of what is causing the neurological symptoms and THEN treat when you are sure of what you are dealing with. |
| Moderator: DrO |
Posted on Saturday, Aug 13, 2005 - 4:08 pm: Hello Cynthia,Important to remember is that the CSF test is not diagnostic either as explained in the article referenced above. DrO |
| Member: Lwillis |
Posted on Sunday, Aug 14, 2005 - 4:00 pm: Dr O.I have read the article and have a couple of questions. 1. When did you wright this article? Is there any new news since 2004 with regard to the Fort Dodge Lab vaccine? I have heard that some people are using a vaccine, would you recommend it? 2. If Navigator kills the organism rather then just stopping it from growing, why doesn't everyone use this as opposed to the other treatments available? 3. Since Marquis doesn't kill the organism, is the treatment effective? 4. Since relapse is a common occurrence which is the preferable most long term treatment? Is it possible that an affected horse should stay on treatment indefinitely ? |
| Member: Ryle |
Posted on Sunday, Aug 14, 2005 - 5:07 pm: Lauren,1. There is nothing new on the Ft. Dodge vaccine. If it were proven effective, then I could see vaccinating against EPM but it's not and it interferes with the only tests available to aid in the diagnosis or ruling out of EPM. If you vaccinate, those two tests become useless. 2. Navigator does kill the organism, but it has a higher rate of adverse reactions and has much more serious adverse reactions then Marquis. Navigator must be dosed very carefully and should not be given for longer then 1 month. 3. Marquis DOES kill the protozoa. It is an effective treatment and much safer then the Navigator. There has been some concern that maybe people are under-dosing with Marquis, so several of the university vets are recommending either giving a higher dose of Marquis or continuing treatment for 2 months to ensure that the parasites are killed. They can do this because Marquis has a wide safety margin. 4. There is a lot of talk about relapse, but the truth is we really don't know what is a relapse and what is just a reccurance of symptoms caused by an exacerbation of whatever permanent damage was done to the central nervous system. We just don't have the technology to determine new infection as opposed to antibody levels from previous exposure/infection. Many EPM horses will start exhibiting symptoms again if they are over-worked, sick, injured or if the environmental temperature and humidity are high and then the symptoms cease once the stressor is removed. So, treatment can kill the parasites, but your horse may have permanent neurological deficits that become more noticeable with stress. If a reccurance of symptoms occurs, you can watch and see if it passes or you can choose to impliment treatment again. For repeat treatments, Marquis is the safest and most effective of the three but it's expensive. Navigator would be on the bottom of my personal list for treating any horse for EPM. Lauren, did the "slightly positive" for EPM show on blood or CSF tap? If it's blood, that is far from diagnostic and you should look at getting a better diagnosis before starting on treatment for anything. If it was on CSF, then I would opt for treatment with Marquis as it's a shorter treatment and is safer then Navigator. Check out these two links and pay particular attention to the Precautions and Adverse Reaction sections: https://www.idexx.com/equine/pharmaceuticals/navigator/navigatorvetinsertletter.p df Navigator Pkg insert info https://www.meadowherbs.com/marquis.htm Marquis pkg insert info Dr. O is right, the CSF testing is not 100% accurate, but it's still the best diagnostic we have. |
| Member: Lwillis |
Posted on Sunday, Aug 14, 2005 - 5:41 pm: Thanks Dr.O for your quick response!I'm glad to hear that Marquis does kill the protozoa. I'm not exactly sure which test my horse got as I am having a hard time communicating with the vet, but I will be getting some paperwork on Monday that I hope will clarify. My horse was at an equine hospital last week due to a strange intermittent lameness issue. We did a bone scan and milogram (sp?). They did find a bone spur behind his knee that we had removed and in the meantime they told me about this "weak" or "slightly" positive for EPM. I am assuming that they tested the CSF tap, but hopefully I'll get more clarification on that tomorrow. My trainer picked my horse up on Saturday and the clinic had already started him on Marquis. We never even suspected that my horse had EPM and the only neurological symptoms that they found were un coordination. I've owned this horse for 4 years and he's always been uncoordinated , but it has never interfered with his ability to successfully show in western pleasure and western riding. So, could a horse have mild symptoms of EPM for 4 years? Is there a way to tell if my horse is in the early stages or not? |
| Moderator: DrO |
Posted on Monday, Aug 15, 2005 - 8:11 am: Concerning the articles Lauren, they are not static documents but are constantly updated as new information comes in with the EPM article updated in the last 30 days. Though possible, EPM is usually a progressive disease, often rapidly progressive. There is no way to be 100% sure and the article explains the best diagnostic criteria has.Concerning the CSF tap titers and PCR results Cynthia, they may improve the diagnostic accuracy over the blood tests alone but the improvement is not great enough for me to strongly recommend the CSF procedure, particularly when you consider the possibility of Neospora myeloencephalitis. However there is no doubt that other CSF findings do help rule out other diseases of the spinal cord and it could be the ratios between the blood and CSF fluid titers could have more significance (new information currently in editing of our article) than either alone. DrO |
| Member: Shark |
Posted on Tuesday, Aug 23, 2005 - 5:06 pm: Attitude: Lauren...cop an attitude .. with this parasite it is your foe..Did I think I was beating a dead horse back to life... you bet....did I have professionals tell me... you can get him sound as a pasture buddy.. you bet.. Dr. O and Cynthia can and will give you all the info on E.P.M Bless their hearts and thank god there here. BUT.. you are the lead Mare.. Dr O. and Cynthia well tell you what medicine to give, when to give it... but you as the lead Mare have to explain to your horse that he or she will be fine... your horse will believe you..If you believe they will be fine...It's a matter of faith.. Dr.O and Cynthia have Given you the weapons of information now use it and fix your horse... YOU ARE THE LEAD MARE. BE THE LEAD MARE.. LEAD YOUR HORSE TO SAFETY..because he or she will simply follow.. you are safety.. you said it will be alright so it will be.. Money and time...mmmmm that blows about six grand later and 18 months of waiting...I can ride him , but what I got out of him..was simply my soul.. what does that really cost... Give him his meds and tell him he'll be just fine .. because he will be...You just got to believe that..(I will repeat this many times) Foot note I have every E.P.M. web site bookmarked including this site.. There is a reason why Lance Armstrong beat testicular cancer.. to win the Tour de France seven times in a row..Lance has a sever attitude problem.... Lance never said poor me once and I never allowed Big Ben to say poor me even once..because I'm his lead Mare AND I SAID HE WILL BE SAFE...and that big horse really believed me... So later on today..I'll saddle Big Ben up and will go for a ride down by the creek where its real cool and he can get a drink of clean creek water and graze some new grass that came up.. I'll sit a spell have my sandwich and read a bit of my new novel,then Will ride around the hay Field and then head on home. It all about Attitude Lauren... Also I really do think that all English saddles should be equipped with a horn so that the average English rider has something to grab on to right before they fall off of the horse again.. |
| New Member: Angie18 |
Posted on Thursday, Feb 2, 2006 - 3:42 pm: I recently had a horse pass that was 20 years old over a one week period of noticing signs of a problem. We moved him from a pasture into a barn area/ large stable area in a temporary move. He was going to be let out in a different pasture when he started showing signs of problems. He stopped eating, was losing weight, & seemed very depressed. Towards the last day it appeared that he had lost feeling in his lips & facial area that morning but was acted better later that evening. It seemed like he couldn't smell his food or anything. I thought to myself that his eyes where changing. He laid down a lot on his side with his head on the ground. He would get up if you made him. A month earlier the Vet diagnosed him with arthritis in all of his legs. I thought he was laying down because of this legs hurting. We gave him the medicine the Vet gave us for the arthritis and then we gave him some penicillin. Two days later he died. Unfortunately, I could not get a vet to see him in the area at the time. We've never lost a horse before and we are looking for answers as to why he might have died so suddenly. We have 7 other horses. I need to know if I should get them tested for something? |
| Member: Mrose |
Posted on Thursday, Feb 2, 2006 - 7:43 pm: Angela, I'm so sorry you lost your horse. It sounds to me like your horse could have had a stroke, or aneurysm, at least towards his last day. A lot of things could have caused the depression and loss of appetite, pain from his arthritis being one of them. Dr. O will, I'm sure, have more information for you, but imo he didn't have EPM.Again, I'm sorry about your loss. How long had you had him? I have several older horses that I know I'll have to watch die someday; I love them all and am not looking forward to it. |
| Member: Ryle |
Posted on Thursday, Feb 2, 2006 - 9:06 pm: Angela,I'm very sorry to hear about your horse too. But the symptoms sound so vague as to have been any number of things and EPM wouldn't be high on the list. Without some diagnostics and a necropsy, you will probably never know exactly why your old man died and even then you might not find answers. |
| Moderator: DrO |
Posted on Friday, Feb 3, 2006 - 7:41 am: I agree with Sara and Cynthia, EPM is not likely and the symptoms could cover lots and lots of possibilities, including rabies. You need to discuss this possibility with your doctor. Is there any more information? Did he have a fever? Whenever there is a suspicious death it is important that a necropsy be done to confirm the cause of death.After such a dramatic episode I can understand your worry about the other horses. I want you to thoroughly check all the areas this horse came in contact with to check for unusual substances that might be toxins. Any suspicious stuff should be checked by your vet. Next I would like you to check all your other horses carefully including their temperature with a thermometer. If all that checks out you have done all you can other than maintaining vigilance. DrO |
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