[PrinceSheik325]

Well, this just isn't our year. First, my boy was diagnosed with hypercementosis, which required the dentist to pull 3 of his teeth. Then, he developed an unexplained swelling in his left hind that was determined to be a hole in his deep flexor tendon. I took him up for surgery, and thankfully, the surgeon said he didn't think it was necessary, but he's still been on stall rest since May for that. And guess what's happened now?! He has EPM! The vet came to ultrasound his tendon last week (which looks great, by the way), but noticed he was demonstrating ataxia. We had the blood test done, and he is 1 to 1000, so we're going to treat for a month and see how he does.

So, to all of you who have tread this path before me...should I start with the "EPM Shake" (sulfadiazine and pyrimethamine (SDZ/PYR)) or Marquis? Considering my horse is 21 and we're not trying to rush him back into work, my vet suggested starting with the SDZ/PYR shake as it's much cheaper. If that doesn't seem to be improving his symptoms, then we'll switch to Marquis. I know there's a pellet drug similar to Marquis out there, but my vet is not a huge fan of it. So, I'm really only interested in Marquis and the SDZ/PYR shake. Tell me the good, the bad, and the ugly of your experiences with each. Any side effects? How did your horse respond?

Also - I've seen threads on here mentioning Baycox. What is that and is it a preferable treatment?

THANKS SO MUCH!!

[deltawave]

Given the choice between one option that is approved, with solid evidence of efficacy and an option that is unproven, badly studied, with no solid evidence, I'd choose the former every time.

[AliCat518]

Marquis. It's approved to treat EPM.

[PrinceSheik325]

It's my understanding that the "EPM Shake" has been around for years, and it sounds like it's more effective at killing other, cyst-forming protozoa, as well.

http://www.epmhorse.org/Treatment/Treatment.htm

That aside, I'd really like to know whether anyone has experienced any side effects with either of these treatments. My vet says that Marquis, the shake, and the pellets are all around 60 - 70% effective; they just don't necessarily work in the same 60 - 70% of horses. As a result, if one treatment doesn't work, it's my understanding that it's worth trying another. I obviously want to do what's best for my horse, but other than certain side effects associated with the "EPM shake" that can be avoided if monitored, it sounds like the shake may be more effective (and much cheaper!) than other treatments. Am I missing something??

[betonbill]

The SDZ/PYR worked well for my horse years ago when that was the standard treatment. No side effects that I could tell--it just took a bit longer. I'd start with that and go from there.

[dwblover]

There is also IV Diclazuril

[mroades]

Yep, I would say neither and go with IV Diclazuril. Beyond that I would go with smz/pyr versus Marquis.

[nashfad]

I won't use Marquis----------I am in favor of the SMZ/PYR

[DownYonder]

I used Oroquin-10 from Pathogenes for my EPM horse and he is doing really well. It is cheaper than Marquis and side effects are usually much less severe. We are very pleased with the results. There is much info at the Pathogenes web site about EPM and Oroquin-10. Ask your vet to call them and speak to Dr. Ellison. http://pathogenes.com/

Also, as mentioned in the other recent thread - http://www.chronofhorse.com/forum/sh...d.php?t=369399 - stress can be a major factor in a horse's ability to fight off an s.neurona infection. Since your horse has been on stall rest for several months, his stress levels are no doubt elevated somewhat, resulting in a depressed immune system. How much longer will he be on stall rest?

[SLW]

Marquis.

When my TB mare developed EPM back in 1998 the "shake" was the only thing available. She was on it 4 months with no improvement so I stopped it. 2 weeks later she was down for good and we euthanized her.

[Colorado Eventer]

Well I am in the middle of the EPM battle as well. 5 yr old APHA mare, that in August tested with SAG titers of 8,4,8....she'd been being treated for several months for a severe ear infection with SMZ. She's never had any neuro signs, slight head tilt and twitch from time to time, but 100% stable on her feet. Have had her on Marquis, gastrogard, 10,000 IUI of Vitamin E and 10,000 mg of MSM for 5 weeks now, re-did her blood work yesterday. SAG came back higher, now she's has a 16,4, 32 (one 1, 5 and 6). So I am switching to Oroquin 10.

[thoroughlydaft]

My horse had a very, very bad colic episode that required surgery 3 days into treatment with the EPM "shake". There is no way to prove this was the cause, but I would never risk using it again. I have had great luck with Marquis though.

[Colorado Eventer]

My day 5 update on Oroquin 10.....my mare had been on marquis for 5 weeks and her symptoms starting coming back, re-did the Elisa test and her SAG numbers trippled...so I switched her to the Oroquin 10, the difference in only 5 days in incredible. She's never been super neuro, but she had a head tilt and twitch, eye blinking, soft tail pulls, etc. She looks remarkable. I've video's her entire journey since Feb of this year and finally posted all the video's on youtube to document. Dr.E is using her a test horse, in fact my son and her are on her blog right now. If anyone is intersted in seeing the video updated, drop me a PM. So far I am thrilled with the improvement.

[LauraKY]

Why has COTH turned into a promotional site for Oroquin 10? Are there any scientific studies yet to prove it works?

[dotneko]

My 25 yo presented with severe neurological symptoms last April. To the point of endless circling and almost falling. Vet started him on the shake - he said that the Marquis had a good chance of relapse. Also IV DMSO and something else (prednisone? - can't remember)
Within a week he was much better. About a month into it, the symptoms returned with a vengence. We continued to treat with the shake and he is now looking great. I plan to continue treating him another month (6 months is the regimen I read) and then we will see. He is also on 10000 IU of natural Vit E daily.
I pay $150 a bottle - so six months is about $900. Two courses of Marquis would have been something like $1400.

[Colorado Eventer]

Why has COTH turned into a promotional site for Oroquin 10? Are there any scientific studies yet to prove it works?

My horse...I have video's of her on Marquis for almost two months, SAG titers continued to rise....then I have a video of her on Oroquin 10 for 5 days...symptoms gone....Waiting on new SAG results, I'd bet my life, they are down...to me you can't get more obvious results than that. I tried the traditional route for 8 months (been doing this since Feb), I resisted Oroquin 10, as it wasn't FDA approved....but then I exhaused all other resources, tried dex, tried marquis, tried Sulfadiazine - Trimethoprim - Pyrimethamine Combination, tried top dress Protazil, nothing helped...I had nothing to lose...the difference of her on Oroquin is remarkable and the video document of the entire journey is remarkable, when you watch just how improved she is on the Oroquin.

Am I promoting it, yes and no, I am in no way associated with it, however.....it is working when not a single other medication has and I've tried them all. So I am a cautiously optimistic and for someone who two weeks ago, had about lost hope and exhausted all other options, I am eternally grateful that it's available.

And my insurance has seen enough cases that they supported my trying it and are covering 100% of it....(someone, above said it wasn't covered, and mine is covering it entirely)

[rabicon]

Yep my horse also. He is on day 7 of treatment and he is better than ever already. Went through 3 months of Marquis and 3 months of the "shake" treatment and he never really got better just stopped progressing. He started to progress again and we started the oroquin 10. Day 7. He actually pulls against the tail pull instead of falling over toward me. He has stopped dropping his feed while eating. He is talking like crazy to me again . His droopy eye has stopped and he is actually starting to cross his legs some while turning. He hasn't been able to do that in over a year. The drug is still in trial phases so not approved yet but I have to say I'm impressed and a lot more impressed than anything with Marquis.

[Colorado Eventer]

Yep my horse also. He is on day 7 of treatment and he is better than ever already. Went through 3 months of Marquis and 3 months of the "shake" treatment and he never really got better just stopped progressing. He started to progress again and we started the oroquin 10. Day 7. He actually pulls against the tail pull instead of falling over toward me. He has stopped dropping his feed while eating. He is talking like crazy to me again . His droopy eye has stopped and he is actually starting to cross his legs some while turning. He hasn't been able to do that in over a year. The drug is still in trial phases so not approved yet but I have to say I'm impressed and a lot more impressed than anything with Marquis.

Continued good thoughts to you and your boy....

[smay]

WOW, what a range of responses. Hard to tell what to do! Sorry for everyone with an EPM horse. Mine barely got through one month treatment on Marquis before his symptoms became so severe we had to let him go. So I didn't get to try anything else. But Marquis certainly didn't help him at all.

[Colorado Eventer]

Missy Update: Oroquin day 9.....well one more dose to go. I'd say she's 100% improved, with about 80% of the symptoms gone. Some slight right ear tremors, still some excessive blinking and the odd jaw and belly edema, but no obvious head tilt or seizure or jerking going on. And she is 110% more perkier and happier and alert! due to her long battle and her SAG levels increasing on the last test (which was
done while on the Marquis) we are going to start her on some oral levamisole, for 4-6 weeks and we'll re-do the SAG titers in about 4 weeks. That will determine how long she stays on the levamisole, but she'll be on it atleast a month. She'll stay on the gastrogurd atleast another 2 months, through the treatment and a solid 30 days afterwards as well. She's on an immune booster supplement, MSM and vitamin E supplements, which she will continue possibly indefinately...several months at the minimum. I'll try to get another video this weekend, before we start the levamisole. Just got a bit hectic the end of the week to get one done. Overall I am thrilled, I do not regret doing the Marquis at all, however, I am very happy I switched her to the Oroquin when I did.