February 2024 - EPM

 

February 2024

 


I had ridden Angel in a lesson on Saturday, February 24. She was her usual sassy, spunky self - well-behaved but feeling perky, as we say! I turned her out Sunday morning. She was moving fine. I brought her in late afternoon on Sunday, and she was ‘crab walking.’ I recorded a video of her and sent it to our trainer. She told me to call the vet. After sending the video to them and talking with them on the phone, it was thought to likely be EPM - Equine protozoal myeloencephalitis.

 This video shows the "crab walking" that prompted the call to my trainer and veterinarian




 

EPM - Equine protozoal myeloencephalitis. (link to University of Minnesota article) A neurologic disease affecting the brain and spinal cord. Some symptoms are in-coordination, abnormal gait or lameness, muscle atrophy, drooping eyes, ears, or lips, and difficulty swallowing, among others. The opossum is the definitive transmitter of the disease through its feces, which contaminate feed, grass, hay, and water. There are other host/carrier animals; however, they do not pass the disease to horses. See additional links below for even more information on EPM.

 

This was my first experience with EPM. Angel went neurological fast, as there had been no other warning signs. I handle my horses daily, so the slightest difference in behavior, eating habits, manure, etc, is noticed.

 

On Monday, we did a blood draw (titer test) to check her antibody levels (which came back on Friday), which were almost non-existent, meaning she had not developed antibodies yet. While waiting for those results, we discussed treatment options, with me asking our vet which of the three treatment options she would go with. We began treatment while waiting, as the physical signs were quite obvious.

 

Her first treatment was on Wednesday. Diclazuril (an anti-protozoal) IV administration with DMSO, which is an anti-inflammatory. This treatment plan involves one treatment a week for three weeks, then once a month for three additional months. This treatment protocol is not yet an FDA-approved treatment. Diclazuril is FDA approved. I trust my veterinarian’s advice on treatments for my horses. We also began a liquid vitamin E. Three bottles as recommended, with her getting 10 ml twice daily on the first bottle and then once daily for the remaining two bottles. After the liquid vitamin E, we switched to a high-dose powder for the remainder of her treatment time. I continue vitamin E supplementation with her today but at lower doses.

 

She remained in her stall during this first week, with a daily check on how she was walking. On Saturday, just a week after she showed symptoms and four days after her first treatment, we turned her back out, and it was a lovely relief to watch her walk, trot, and canter out to the rest of her herd!

 

 Video of her first time back out in pasture.




The source linked above in the description of EPM provides good basic information on EPM. For more scientific reading on the disease there is this article from The Journal of Veterinary Internal Medicine and this piece from the UC Davis Veterinary Medicine Center for Equine Health


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