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  1. #1
    Join Date
    Mar. 5, 2009
    Location
    Chicago, IL
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    406

    Default Oppinions on an odd lameness- vet thinking EPSM but I want more ideas?

    I have been dealing with some very strange lameness issues for the last 2 months and my vet and I are stumped. Started off looking lame in front, then moved to back (stifle and hip area), then it looked like there was something in the neck like a pinched nerve. Wasn't consistently off, just would take an odd step here and there. Most recently (Saturday), my horse tied up for no apparent reason. It was cold (about 28 degrees), I was on her for about 10 minutes total... worked in an unheated indoor, first 5 was just walk with a quarter sheet, then started to trot, she felt stiff. After about 2 minutes of trot, I asked for canter and I got what felt like a dead lame horse. I jumped off, and saw her left hind muscle twitching at the stifle and noticed she was dripping with sweat between her legs. I walked her back into the heated barn, so I could observe her vitals. Temp was at 100, breathing was double the normal rate (and we hadn't gotten through our normal warm up yet), gums were perfectly pink. I called emergency vet and asked her to come out; gave the mare banamine paste as the vet suspected colic even though I told her I thought it was a tie up. Mare refused to move her hind legs and was pawing with front legs. Once the vet arrived (about 30 minutes later), she confirmed it wasn't colic and did look like tie up, but was puzzled as the muscles were not hard, but mare couldn't move her hind end without becoming very unbalanced (looked like she was going to fall over). Her breathing was back to normal, as was her heart rate. Vet thinks it could be EPSM that is causing the odd lameness and most recent tie up. She didn't take blood to check muscle enzymes because of the holiday weekend and labs being closed, said the sample would degrade too much by Wednesday. She wants to give her a week off and see what happens (she has been on banamine (4 days), ace (3 doses since Saturday), and muscle relaxers (2x per day for 4 days, then once a day starting yesterday). I know I could do a muscle biopsy, but I don't really want to cut into her neck. She is already on a low sugar/low starch feed (Tribute, Kalm N EZ), so to me, this should have prevented anything related to EPSM, but maybe I am wrong? Vet said she really doesn't think it is neurological (EPM), but she said it isn't clearly EPSM either. Anyone have any ideas for me?
    Welcome to my dressage world http://www.juliefranzen.blogspot.com/



  2. #2
    Join Date
    May. 20, 2005
    Location
    Thousand Oaks, CA
    Posts
    908

    Default

    Could certainly be EPSM. Can affect either front end or hind end or both. Mine have sometimes looked like they got hit by a car... Pretty awful everywhere but not necessarily rock hard muscles. Another EPSM horse I knew seemed neurological, but never tied up. The diet made the neuro symptoms disappear. We do biopsies from the hindquarters. No big deal. Good to know how much your horse is affected.


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  3. #3
    Join Date
    Mar. 19, 2010
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    211

    Default

    Quote Originally Posted by Dressage_Julie View Post
    I know I could do a muscle biopsy, but I don't really want to cut into her neck. She is already on a low sugar/low starch feed (Tribute, Kalm N EZ), so to me, this should have prevented anything related to EPSM, but maybe I am wrong? Vet said she really doesn't think it is neurological (EPM), but she said it isn't clearly EPSM either. Anyone have any ideas for me?
    1) What breed is she, maybe you could do mane DNA test? If not, biopsy is usually taken from hindquarters, not neck.
    2) EPSM is rarely clearly diagnosable in 1 episode/1 vet visit.
    3) Diet is only 1 facet of controlling EPSM, excericise is the other. Did she have a change in work schedule at this time? Lactic acid can build up due to a combination of diet/lack of excercise. Just because the diet is low NSC, doesn't mean it is low ENOUGH, your "grain" diet is also impacted by hay/grass NSC which can fluctuate wildy.


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  4. #4
    Join Date
    Aug. 28, 2007
    Location
    Triangle Area, NC
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    My horse was on a 14% NSC diet when he became symptomatic. There's two elements to an EPSM diet: non structural carbs, and fat.
    I've found it easy to add oil to beet pulp while its soaking as the most appetizing form of delivery. Start with 1/4c per meal and gradually increase. Just adding 1c of oil per day made my horse's symptoms go away.
    www.destinationconsensusequus.com
    chaque pas est fait ensemble


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  5. #5
    Join Date
    Mar. 19, 2010
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    211

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    Quote Originally Posted by Petstorejunkie View Post
    My horse was on a 14% NSC diet when he became symptomatic. There's two elements to an EPSM diet: non structural carbs, and fat.
    I've found it easy to add oil to beet pulp while its soaking as the most appetizing form of delivery. Start with 1/4c per meal and gradually increase. Just adding 1c of oil per day made my horse's symptoms go away.
    What she said. and 14% NSC is considered low. As I remember, her horse became symptomatic after change in being stalled. Did I get that right Petstorejunkie?



  6. #6
    Join Date
    Mar. 5, 2009
    Location
    Chicago, IL
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    Default

    Thank you everyone for the comments. This is great input! Vet mentioned adding Vegetable oil to feed yesterday.

    Now the horses with EPSM, are you still able to work them comfortably after managing diet and exercise?

    I will also add the answers to outfoxem's questions

    Quote Originally Posted by outfoxem View Post
    1) What breed is she, maybe you could do mane DNA test? If not, biopsy is usually taken from hindquarters, not neck.
    2) EPSM is rarely clearly diagnosable in 1 episode/1 vet visit.
    3) Diet is only 1 facet of controlling EPSM, excericise is the other. Did she have a change in work schedule at this time? Lactic acid can build up due to a combination of diet/lack of excercise. Just because the diet is low NSC, doesn't mean it is low ENOUGH, your "grain" diet is also impacted by hay/grass NSC which can fluctuate wildy.
    My vet told me muscle biopsy in neck was the way to find out for sure... I guess, just the mere idea of cutting into her muscle scares me. We took blood yesterday to run a full panel bc the mare started urinating and drinking about double of her normal intake after the tie up (or at least that is when I started to notice it!).

    She is a warmblood; registered Oldenburg, dam is Westfalen (with TB (dam) and KWPN (sire) lines), Sire is KWPN.

    You are correct about diagnosis not being complete, we are just getting started and I am just hoping for nothing that will be career ending for her... I want her to be happy and comfortable in work.

    The biggest change has been her exercise... She went from constant 5 days a week for the last 4 years to inconsistent work. I got pregnant and couldn't ride, trainer came 3 days a week for the summer but has since left for Florida. Now that I have had the baby I am struggling with balancing trying to work, take care of baby, small farm duties, see my husband and work riding in during the week. The other major change is our hay. With the drought our hay is way more alfalfa than I would like- but I don't have much of a choice where that is concerned!

    Please keep the suggestions coming, I am just learning about this disorder, so it is all really appreciated!
    Welcome to my dressage world http://www.juliefranzen.blogspot.com/



  7. #7
    Join Date
    Jan. 9, 2012
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    From the sound of it, her going from regular exercise to inconsistent, that could certainly have triggered symptoms if she does indeed have EPSM.

    I hope you can find out what's wrong with her!



  8. #8
    Join Date
    Mar. 19, 2010
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    211

    Default

    [QUOTE=Dressage_Julie;6763810]
    The biggest change has been her exercise... She went from constant 5 days a week for the last 4 years to inconsistent work. I got pregnant and couldn't ride, trainer came 3 days a week for the summer but has since left for Florida. Now that I have had the baby I am struggling with balancing trying to work, take care of baby, small farm duties, see my husband and work riding in during the week. The other major change is our hay. With the drought our hay is way more alfalfa than I would like- but I don't have much of a choice where that is concerned!

    QUOTE]

    MANY WB are affected by EPSM. Many are also Asypmtomatic when exercised and fed a "correct" diet, which is often elusive but keep after it, each horse is different.

    Although alfalfa is not a problem generally, any stressed forage is bound to be VERY high NSC.

    Combine the lack of excercise with the stressed grass and VOILA, your EPSM shows itself.

    Kudos to your vet for being savvy enough to recognize it!



  9. #9
    Join Date
    Mar. 19, 2010
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    211

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    Just one paper that has good info forage NSC content on it, I am sure there are others. If anybody has other stuff, PLEASE post a link!

    http://www.extension.umn.edu/forages...d_pastures.pdf



  10. #10
    Join Date
    Jan. 29, 2002
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    1,623

    Default

    Julie, the muscle biopsy is not done on the neck. It is done on the thigh. Excerpt from Dr. Valentine's site:

    Muscle Biopsy
    Muscle biopsy is not a difficult or dangerous procedure, and may be performed by your veterinarian at your barn. The best muscles to biopsy are the hamstring muscles, which are the muscles that run up and down on the back of the thigh on both sides of the tail.



  11. #11

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    I have a horse with EPSM and he did the very same thing. There were days he couldn't even move before I found out what was wrong with him. I changed his diet and he has no problems anymore. Good Luck!



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