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Spinoff:Your EPM Experiences

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    Spinoff:Your EPM Experiences

    I have a 8yo ISH mare that I took to the vet a few weeks ago to have a lameness eval., and to my surprise my vet is almost certain that she has EPM. (You can look at the original thread here) I had blood work sent off immediately to the lab that originally discovered the disease (advised by my vet, as it is the lab he trusts the most).
    Because we don't have opossums here, vets are thinking that we have a different strain of EPM, so sometimes it does come up on the titer scale as negative. Some people have elected to treat their horses when this has happened and they have gotten better. I on the other hand am still waiting for the second of the two tests to come back.
    My vet and I have decided to treat her for a month with Marquis and vitamin E, and see how she does. If she shows improvement, we'll probably treat her for a second.

    What are your experiences with EPM, and how did it turnout for your horse?
    Have any of you had a similar experience as the one I am currently having?

    Yes, I had a similar experience. It started out as a slight lameness RH, seemingly caused by a very sore SI on the rt side. Injected, got some improvement, but it always came back. My horse also had trouble putting on muscle on the topline, which in retrospect, was a huge sign. Vet didn't think EPM b/c steroid injections usually bring on worse symptoms of EPM, and we did not get that. Lameness eventually got worse, and then he became narcoleptic after a 3rd steroid injection. Treated for EPM, and he became sound.

    2 weeks ago we had our first EPM relapse (greeaaattt...). The same symptoms of the initial infection are usually present in a relapse. My horse went off again RH, and became lethargic. Supposedly, relapses are more common in the first year post treatment. We are 8 months out. Did another round of treatment, and are now coming back into work. We did Baycox, but I am doing a round of diclazuril as well this time.

    Good luck to you if your mare has EPM. It is a really crappy and unpredictable disease, but many horses come back from it quite well.


      No lameness, just all of a sudden poor performance ( pulled four rails in SJ and this horse rarely touched a rail), and sort of a failure to thrive deal. Horse suddenly did not look healthy and robust. Tested negative for EPM, but all the signs indicated otherwise. We treated with diclazuril, and another adjunct antibiotic, as well as a homeopathic med. Also did a month of gastroguard - all at the recommendation of my treating vet who saw a lot of this when she interned in Texas several years ago.

      Horse returned to full work (took about six months). I know at least one other horse, currently competing at upper levels who was very neurological, made a complete recovery and is competing successfully.

      What Touch of Grey said. Crappy disease, and a lot of misinformation/lack of knowledge about it out there. Internet searches will make you crazy.


        Original Poster

        Touch of Grey- Hope your guy makes a speedy recovery

        Thank you both, its good to hear some personal experiences. Those internet searches really have been driving me crazy!


          Expect a relapse, expect a relapse that is worse. It's a heartbreaking disease. My horse went from barely off one relapse, to unable to walk next.
          I see distances. Most times more than one. Sometimes I pick the right one, sometimes I pick the wrong one, and sometimes I close my eyes and let Jesus take the wheel.


            Eventingis my life, sorry to hear about your horse and epm. My thoroughbres was just diagnosed this week. I am on day 6 of Marquis and vitamin e. so far he looks the same, but i know it takes time. i have had many people tell me about their horses having a full recovery. i have also had many tell me about relapses. I agree if you search the internet you will drive yourself crazy. All the best to your horse for a speedy recovery.


              I started dealing with this disease in 1999-- so, here are the things that I have learned, for better or worse...

              1. There is no test, regardless of what you are told, that can tell you for sure that your horse does, or does not have EPM.

              2. You need to use a drug that is cidal to the parasite, at a rate that takes the drug to steady state, for as long as your wallet will allow- an absolute minimum of 45 days at this rate- sixty days is better. There is no data to tell us enough about the life cycle of the protozoans (yes, there is more than one type) to know when you have absolutely nuked them all, and, I believe that they can encyst, although my theory is merely anecdotal.

              3. You need to support the horses immune system with at least 10K of Vitamin E, per day, and whatever else makes you happy regarding immune boosters.

              4. Doing any kind of exercises that the horse is up to, that keeps their muscles active, and helps to rebuild their nerves (yes, you can) while not stressing or challenging them, is to your (their) benefit.

              5. Horses routinely relapse from Baycox (Toltrazuril) and Marquis- which is a metabolite of Toltrazuril. Use Dyclazuril- it is cheaper, and more effective.

              Best of luck- this disease sucks!
              When someone shows you who they are, BELIEVE them- Maya Angelou


                Hugs to you.

                I lost my guys just about 2 years ago to EPM.

                I think recovery depends on the age of the horse, how early you caught it, etc.

                My guy was 18 and was miss-diagnosed as needing hock injections, which, sent him into EPM overload. Marquis did nothing for him and I lost him 7 days later.

                There was a great Yahoo group for EPM as well, LOTS of info there!
                Never Ride Faster Than Your Guardian Angel Can Fly
                Way Back Texas~04/20/90-09/17/08
                Green Alligator "Captain"


                  I'm so sorry. EPM is such a devastating disease...for them and us.
                  Off Topic Discussion about Life, Interests & Politics


                    My gelding was 25 when he was diagnosed with EPM. Treated with Marquis. He was never back to normal, but was rideable for awhile. We ended up having to euthanize last summer due to relapse. He was 33....we were very happy he had those last 8 years. I think it depends on the horse, but treatment was defnitely worth it in my case
                    Good luck....the disease really does suck, but there are options for treatment!
                    Charlie Brown (1994 bay TB X gelding)
                    White Star (2004 grey TB gelding)

                    Mystical Moment, 1977-2010.


                      Do your best to keep the horse from hurting herself by falling. I had a big TB that tore a muscle in his "armpit" by falling and doing the splits and the muscle injury was permanent. In the end, we don't know if it was the EPM relapsing or a secondary injury in the spine that was the last straw.
                      Sometimes the die off from the medication can make the horse worse for a bit so just be prepared.

                      My experience is the relapses after being on medication were much worse than the original problem. I have wondered whether the organism goes into hiding and when the medication is stopped it has a huge population explosion that provokes a huge inflammatory response and thus the really alarming symptoms.

                      Honestly, it would have to be a very special horse for me to try to treat EPM again. Months of worry and $$$ and heartbreak and the horse it buried on the hill in the paddock.
                      "The mighty oak is a nut who stood its ground"

                      "'ll never win Olympic gold by shaking a carrot stick at a warmblood..." see u at x


                        Got my TB when he was 5 in 1992. For some reason his right side always looked different from the left--muscle atrophy. Knew nothing about EPM, so it was about a year or so before he was diagnosed. Treated with the sulfa med that was available at that time and he was rideable. A year or so later there was an EPM trial at the University of Florida vet school so he went in that and was treated, then we finished up with another 90 days of the sulfa med ( I think he was 8-9 at that time).

                        He was very rideable until he was 18, then apparently had another relapse. Treated him again with the sulfa meds and he got somewhat better, but no longer rideable. Another year or so later I think he had another relapse, but did not treat it this time. Let him have a nice summer out in pasture and then put him down at 20.

                        Not a nice disease at all. He was always stiff in the right hind and always had atrophy on the right side, but at least we had some good years in between the attacks.


                          I was not caught up to speed on all this EPM stuff until my mare I just got back, maybe (hopefully not) positive for the disease.

                          From what I have read and from what I have heard from my vet, a test will never confirm the disease, because it is estimated that over 50% have been in contact with the disease, but never develop the disease, but would still test positive for it.

                          My vet was trying to talk me out of the test for EPM, because of that. But I went ahead with the expense and had it done because IF it does come back negative, you are pretty much guaranteed that they don't have the disease.

                          My vet said if he were to pull blood on any horses in the barn that around half would come back as positive for EPM.

                          That being said, I have also come across articles where some vets, when they cannot come up with a diagnosis, will just go for EPM- because it fits the bill. And it is costly to treat. There are so many different things that could be going on with a neuro horse, unless you do diagnostics, it is just hard to get a 100% correct diagnosis.

                          But just bare in mind that just because your horse comes back as positive on the EPM test, doesn't necessarily mean the horse has it.

                          If you do not have the funds to treat for EPM, please contact me. Also, do not put your horse down right away if you do not have the money to treat, unless it is a medical emergency of course. There are other things that can be going on, that could be fixed either with something simple, or with time.

                          For instance, west nile. Horses can and do recover from west nile. In the beginning, they need supportive care but if it is already too late for that, they need time to recover and let their immune systems do its' job.

                          I suggest reading a lot on each disease that it could be. Post here for other's experiences. Ask your vet a lot of questions.

                          As they always say, you ask ten vets for a diagnosis you will get ten different answers. What I mean by that is, not every vet is right, nor are they God.. Be open minded to different suggestions.

                          I would also recommend putting the horse on a low starch diet. It won't hurt anything and if the horse improves, you know it could be something along the lines of not processing carbs/sugars right.

                          Good luck. Sorry you are having to go through this with your horse.


                            Originally posted by Blondyb View Post
                            IF it does come back negative, you are pretty much guaranteed that they don't have the disease.
                            On there is a story about a horse called Piaff who repeatedly tested negative for EPM. After a long battle and lots of diagnostics, in desperation they treated for EPM, too (this is at Rood and Riddle). It was too late. Horse was euthanized and at the necropsy they found lesions in the CNS with LIVE protozoa in them.
                            So anything is possible.
                            "The mighty oak is a nut who stood its ground"

                            "'ll never win Olympic gold by shaking a carrot stick at a warmblood..." see u at x


                              The IFAT test definitely has false negatives. Ask me how I know... Did eventually get a weak positive.


                                It looks like you've got a lot of input here already, but I'll throw my two cents in for what it's worth. Twelve years ago my five year old gelding was diagnosed with EPM, and we treated it. At the time, there was only one drug my vet was aware of for treating it, and I can't recall the name of it. He showed virtually no improvement after the first month, but after the second month he was much better-walking down hill without tripping, able to turn in tight circles etc. We did three months, if I recall correctly, of treatment and two spinal taps. We were lucky to have a vet that was very interested in our case, as it was the first EPM case he'd seen first hand. He went out of his way to contact "experts" in the field to get the latest research results and be sure he was giving us the most accurate advice possible.

                                Luckily, the treatment was effective and he never relapsed. He is currently 17 years old, and we recently retired him from eventing, where he was doing prelim and schooling intermediate. It is an awful, devastating disease there's no doubt about it, but don't give up hope, lots of horses do recover and continue to compete at high levels.


                                  Original Poster

                                  Wow! Thanks for you all on sharing, its has been very helpful. Way to go COTH