unreal huh Jump but ohhhhhhhhhhhhh so typical of some on here. Some are well known for rushing to a thread that is getting a lot of hits just to put in their two cents as they are the members of the COTH know all and be all click. Would be comical if this particular subj did not claim a lot of horses usefulness if not lives. It would be one thing if I was claiming this treatment was a cure all for all horses but that they will not even email or call the vet/researcher is just very telling of their mindset. Thank God my vet called,read the website and went to the talks that were given. My horse and Sherri's would all be either in the ground or standing in a field.
I know this thread died off a while ago, but since it's searchable and may serve as a resource for someone looking for EPM treatments at any time in the future, I thought I'd update. I've finally had the opportunity to ask Dr. Barry David at EMCO in Ocala what he thinks of Oroquin-10 as an EPM treatment. As it so happens, I also have a horse in Ocala who just tested positive for EPM and guess who her treating vet is...yep. Barry. Will he be using Oroquin-10 to treat her? No. His words exactly, "[FONT="]No, the product may be good, but there is not good science behind it yet – and combined with shady marketing strategies, I have yet to jump on that band wagon. If it is a worth-while treatment, they will need to provide some valid data."
No surprise to me, but since TommyKnockers was insisting that Barry David is prescribing Oroquin-10 left and right, I felt clarification worthwhile.
I did want to point out a few things for those who are interested. I do know of other vets (one a DVM, PhD highly regarded around here) that uses levamisole in conjunction with even the current traditional EPM treatments. Can't say personally whether I know either way if it seems to help or not.
Also, just in case people are holding out until approval by the FDA- Yes, an administrative NADA submission review is 60 days, and a traditional one is 180. But, a lot of information has to be submitted and reviewed by the Agency prior to either one of those (well, they can do a traditional one and submit all that they have there, but it will likely not get approved that way). Most approvals are done through a phased review process, where lots of components have to be reviewed as they come in (safety studies, efficacy, manufacturing, etc). And, those take awhile- to conduct the studies, write reports, submit to FDA, and FDA to review. This will likely not see approval for quite a few years.
.like Olympians, Grand Prix riders, .....you can wait for FDA or get your horse on the path to recovery now
Or put them in a hyperbaric chamber. Safety? Efficacy? Pfft, who needs it? We have MONEY, GIVE us what we want!
Hoping this product is everything it is touted to be. Waiting for proof. In the meantime, recent events have shown us how there is always a down side to untested, unproven treatments, even down sides we haven't yet dreamed of. Yay research.
I'm glad to see some data being put out there, but I'd have to go through the study a few more times to make sense of what they were after here. It appears that the main thrust of the study is clarifying which sort of assay is best for diagnosing EPM. It is also interesting that nearly 60% of presumed "normal" horses tested positive by their standard serologies.
The response to the actual Oroquin therapy remains an unanswered question, IMO, since there was no control group, no strict diagnostic criteria except "ataxia" and there is no attempt whatsoever at blinding the observers. An improvement in one symptom cannot be called a response to therapy.
However, once more I am happy to see some evidence coming down the pipeline. If I get stuck in a hotel room somewhere with nothing to do in the next week or so I will go over it with a fine-toothed comb and try to comment further.
I'm off to read the paper posted above, but in the mean time, here are a few things re the ELISA test that I've compiled while dealing with my own EPM/Lyme horse (who's NOT on Oroquin-10, nor will he be - responding beuatifully to Marquis + DMSO).
The immunodominant surface antigen designated 1 (SAG1) ELISA (Ellison et al. 2003) was
validated (serum and CSF) using 6 experimentally infected horses. Based on this limited set,
the sensitivities were reported on marketing material as 94% (serum) and 100% (CSF) and
specificities as 86% (serum) and 94% (CSF). A serum titer of 1:32 is said to be clinically
significant. The same strain of S. neurona was used for both the SAG1 ELISA test
development and experimental infection. It is now well documented that a number of S.
neurona isolates lack the SAG1 gene and will test as false negative.
Johnson was involved in a diagnostic study to assess one of the newer diagnostic tests, the SAG1 ELISA test, marketed by Antech. This test checks for just one of the surface proteins. “I looked into the sensitivity and specificity of that test using clinically affected horses from this region—the mid-Atlantic area of Pennsylvania, New Jersey, Delaware, and Maryland. We found that very few of the horses that truly had EPM were positive on that blood test,” she says.
There are several different strains of Sarcocystis protozoa. “They all express proteins on their surface, called surface antigens. Horses exposed to the protozoa make antibodies against those proteins. This is what we are looking for when we run the blood tests for EPM. That particular blood test, the SAG1 ELISA, is looking for antibodies against the first surface antigen (surface antigen 1),” says Johnson.
“We discovered that most horses in this area turned up negative on that test, even though they were positive on the western blot test and indirect fluorescent antibody test that UC-Davis runs. We deduced that in this particular region of the country, the protozoan strains that are affecting horses are not the ones that express SAG1. Some of the strains express SAG1 and some express SAG5. If you live in this area, it wouldn’t be wise to use that test because you will get a lot of false negative results, and that’s the last thing you’d want to do with EPM,” she says. You must properly diagnose this disease early on to successfully treat it.
“In this area we use either the IFAT (indirect fluorescent antibody test developed at UC-Davis) or the western blot test. No one has done much research looking at geography of protozoal strains. Until that is done, or unless you know that in your area most of the strains have SAG1 it would be unwise to use the SAG1 ELISA test,” she says. And only the IFAT EPM panel would also detect the other protozoan (Neospora hughsei) that can also cause EPM in horses.
“Researchers in Kentucky are working on a similar ELISA test, but looking at SAG2 and SAG4. Those proteins seem to be present across several protozoal strains. This may be a test that would be applicable across the whole country,” says Johnson.
“The best foundation for diagnosis is still a very thorough neurological exam. Sometimes EPM gets blamed for many things–poor performance, lameness, or other diseases that have other explanations. I encourage horse owners to get their veterinarian involved early in the process and make sure the horse has neurologic signs before deciding that the horse has EPM and starting treatment,” she says. There are many things besides EPM that can cause the horse to be a little off, or lame, and there are also many ways that EPM can affect horses, making diagnosis challenging at times. http://www.atlantaequine.com/pages/client_lib_EPMdx.html
An enzyme-linked immunosorbent assay (ELISA) is a test for detecting antibodies to surface proteins of the protozoa, and it is currently only available through Antech Diagnostics. The results are given as a quantitative titer as with the IFAT. Antibodies it detects are very specific, and some strains will not be detected, hence, leading to a negative titer in spite of a horse having an active infection.
The ELISA test relies on recombinant SAG1 (a specific protein) antigen to detect antibodies. However, it has been demonstrated that many S. neurona isolates do not produce SAG1. Horses infected with those strains will test falsely negative. Antibodies produced against S. fayeri, another common equine parasite, cross react with SAG1.
Apparently not much is new. The only thing published within the last 4 years is the messy, confusing paper cited above, which is (near as I can tell, I've tried to read it half a dozen times and it's nearly impenetrable) mainly trying to define the utility of the testing method/assay. It is put out there in support of the drug regimen, but I'm darned if I can make heads or tails of just what the therapy did.
I have used it over 2 years ago on a horse that I did Marquis and sufa mix drugs with for months. He never improved after Marquis and sulfa but didn't get any worse. 2 years ago did the orquin10 and he actually improved, quit dropping feed, not tripping around the pasture anymore and overall seems happier. He is still doing just as well 2 years later. Fingers crossed
Horses aren't our whole life, but makes our life whole
I treated my EPM horse 3 years ago, following Dr Ellison's protocol. He has had EPM for years and has had multiple courses of marquis and the more traditional cocktail. One of his primary symptoms was seizures. He had a seizure about 3 days into the protocol and that was the last one he has had. He is more normal acting and moving than he ever was before. I wish this had been available years ago.
Good luck to anyone dealing with this. Not an easy road.
I registered on this forum just to post this reply: Two years ago, my Paso Fino began to exhibit symptoms of extreme neurological distress. It came on in just two days. He was getting worse every time I went out to look at him. Luckily, the vet I use for routine shots and Coggins was coming by that evening. He examined the horse briefly and said it certainly looked like EPM, and did a blood test for it. He said that the blood test would come back in 2 days, and then it would take 2 more days for the medicine to be sent by courier to me. I called him the next day and said the horse was staggering around so badly and was getting worse by the hour, and I wanted to start something immediately. It very much looked as if my horse would be dead by evening. I learned that the vet had spent many hours the evening before researching what treatment he should authorize for my horse in case the bloodwork showed up as EPM. He admitted to me that he had very little experience with EPM and so spent hours researching what to do. He is mostly a small animal vet but will do routine things like shots and Coggins for people who live nearby.
As my horse was deteriorating so rapidly, I begged him to give me something to try. If I waited for the bloodwork and courier, he would be dead. The vet called a compounding pharmaceutical company and ordered Oroquin that hour. I drove several hours to the place where it was being made up and brought it home, immediately administering to my staggering horse. Within hours, the horse was walking better. Within days, he was almost normal. Within a week, you would never have known he was sick.
The vet came out to check him two weeks later and he was 100%. We gave him another dose just to be safe. That was two years ago. I ride him everywhere and he rides perfectly. Whenever I see that vet, I say, "You saved my horse's life." And he says, "No, YOU saved your horse's life by calling me and driving to get the medicine that very day."
So far, there have been no recurrences and the horse rides beautifully with as smooth and lovely a corto as he ever had.