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Another EPM relapse - anything else I can do?

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  • Another EPM relapse - anything else I can do?

    Sorry, but this is kind of long...

    My heart horse, Winston, has been dealing with EPM since he was 4 years old. He's now 15. When he was first diagnosed (via spinal fluid test), we treated it pretty aggressively: sulfas and then marquis, then navigator. In the first couple of years, he improved and then relapsed a few times. My vet had been involved with some of the drug trials for navigator and thought that it was worthwhile to administer a higher than recommended dose. To maximize absorption into the spinal fluid, he tubed Winston daily (for a month) with a mix of the navigator and DMSO. Although a bit extreme, it seemed to work quite well and Winston improved dramatically. We kept him on sulfas a few months after that. But when he took him off the sulfas he relapsed, so we put him back on and he got a good deal better again.

    In the interim, I ended up moving a few times and I've had various vets suggest I take him off the sulfas. Whenever I've done that, he's ended up relapsing, sometimes soon after, sometimes months later. In consultation with my original vet as well as a local vet, we decided to keep Winston on sulfas, although it was suggested that I might be able to lower the dosage. So, he's been getting a "maintenance dose" of sulfas -- about 60% of the therapeutic dose. It's seemed to work well for the last couple of years. And at the beginning of February, Winston seemed to be going better than he had in decade. We'd be doing the low adult jumpers and were set to move back up to the highs.

    Fast forward a couple of weeks and everything started falling apart: he was refusing fences, bucking through lead changes, and swishing his tail around every turn. I wanted to think it wasn't the EPM, and the two regular vets at the farm where I board (not the vets previously mentioned) thought that it was either a stifle issue or an SI issue. When I suggested that Winston seemed to be dragging his left hind toe more than usual, one of them had the good sense to suggest that I repeat the IFAT test just to rule out the EPM possibility. The test revealed that his titers are up substantially from the last time we ran it (about 3 years ago). So... we're treating with the regular sulfa dose along with Marquis. Plus, I have him on vitamin E, an immune booster (SmarkProtect Ultra), and previcox to treat the inflammation. Any thing else you might suggest? Would you go with a different immune supplement? Someone recommended Uckele's herbal-mune to me, but I don't know much about it.

    The funny thing is that Winston was getting a lot better before the test came back. I had been tracking his neurological signs carefully and he seemed to be improving and was also getting a lot more comfortable under saddle (with just light riding). After about six days of treatment, he seemed a lot worse again. I know that sometimes they get worse before they get better, but I can't help but think that this might be the relapse he doesn't come back from.

    The other thought I had was that he's exhibited these most recent symptoms (to a lesser extent) a few times in the past couple of years and I didn't think it was EPM coming back, but maybe it was, and maybe his immune system fought it off then, but maybe I could have done something earlier.

    Any ideas you have would be greatly appreciated! Right now, I probably need to be patient and see if the new treatment works, but I also want to find out as much information as possible.


  • #2
    Worth a try. It has worked for my 10 year battle with EPM. Wish I had known about it for my other EPM horses.


    • #3
      Have you tried Oroquin 10? It's a different drug combo (levamisole and decoquinate) than others you have tried. It seems like if your horse does have S. neurona, and it's not responsive to what you've been treating it with, you should try something different. Additionally, treating him for that long with the same drugs screams drug resistance to me.


      • #4
        Yep my guy did a complete turn around on oroquin10. That would be the next thing I'd try. I did Marquis and epm cocktails before. Never fully recovered and was retired. Found out about oroquin10 on here and got him in the trial now he is starting to be a riding horse again. He is almost 20 so I'm not bringing him back to a show horse. Has some arthritis in his knee but on previcox for that and surpass when I ride him and he is doing very very well.
        Horses aren't our whole life, but makes our life whole


        • Original Poster

          Thanks for the suggestions of oroquin10. I looked into it before, and I think I've probably read every thread about it here, but my vets were pretty skeptical. That said, if this round of Marquis doesn't work, or if he relapses again, I'd really like to try it. I know the frequency of relapse from Marquis is really high, so there's a strong possibility that I'll have to try something else.

          Lauren12, since you're near me (Winston is boarded in Upper Marlboro, MD), can you give me the name of the vet you worked with for your Oroquin treatment?


          • #6
            My mare was diagnosed two years ago with EPM. We treated with 2 months of marquis. Last fall she relapsed, we treated with 2 months of Marquis and then the Oroquin 10. When the vet came out to do yearly lamenesses and joint injections he said her hind end has looked better than it has every looked. The Oroquin is really worth a shot.


            • #7
              I had excellent results with Marquis + DMSO. The addition of the DMSO improves the absorption of the Marquis a great deal, just as it does with Navigator. Are you already adding DMSO?
              "Absent a correct diagnosis, medicine is poison, surgery is trauma and alternative therapy is witchcraft" A. Kent Allen


              • #8
                Just an FYI - the Oroquin10 is not being manufactured anymore. It's now being made under the name Orogin.

                Does it work? Yes. *knock on wood* If you do a search for Orogin, you can see my posts about it that have a link to daily pictures of my mare on it.


                • #9
                  The Horse just published a brief (very) review article and funnily enough failed to mention Oroquin. They did mention the adjunctive use of DMSO with antiprotozoal drugs.
                  Click here before you buy.


                  • #10
                    So sorry, that sounds miserable! Just personal opinion, and I do think that individual horses respond differently to different things, but I would try a different immune booster if I were in your shoes. I had really good results with Hilton Herbs' immune booster. The other thing that made a huge difference for my horse when he had EPM was two acupuncture treatments - according to the Eastern view, he had a seriously malfunctioning immune system at the first treatment. That was my first experience with acupuncture for treating that type of problem, and I have to admit that I was pretty wowed - he had been on sulfa drugs (this was many years ago) for almost 11 months by that point, and had improved, but was clearly not "cured." Within days of the acupuncture treatment, I saw significant improvement in his symptoms, and he was off meds shortly after with no problems. I am always almost hesitant to tell people about that because I think way too many people promise miracles with EPM, but for this particular horse it did give us miracle results. Don't know that it would do the same for your horse, but with all you have invested already, it might be worth a shot.