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EPM: Anyone ever had a EPM diagnosis where the only symptom was VISIOn changes?

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  • #41
    I feel your pain! My older horse just recently got the ok to be turned out again after months of trying to diagnose EPM v. neck arthritis.

    As it turns out, he has EPM, but initially, treating didn't help. Why? Because he also has Cushing, which we didn't know before all of this because he presents with zero symptoms of Cushing. Testing for Cushing was a last-ditch effort on my part, which was suggested to me by one of the vets who ran the clinical trials for Marquis. You see, the trouble with EPM drugs is that they assume an otherwise healthy immune system. If the horse's immune system is compromised by something other than EPM, treatment may not work. So, before you waste time and lots of $$$ on treating for EPM, make sure the horse is otherwise healthy. If so, DO THE SPINAL TAP!! It's expensive, but it's worth it.

    After I treated for Cushing for 2 weeks, the Marquis magically started working - pretty amazing. I'm using Protazil now, which I have found produces better results than the Marquis.

    Good luck to you!

    Comment


    • #42
      Following up on SuckerforHorses post, there was a horse at my last barn that was suffering from sleep deprivation. By the time the owner made an appointment at New Bolton, he looked so neurological it was downright scary. He was also in a lot of emotional distress. In anticipation of the visit, another boarder (a small animal vet who is New Bolton graduate) did a video and sent into the vets at New Bolton. Based on the video alone, the New Bolton could see that it was not narcolepsy. They immediately suspected sleep deprivation. The horse had arthritis and also ulcers, so the treatment was a combination of treatment for the arthritis, ranitidine, and a change in the horse's routine. Other than being on ranitidine for life, he seems to be doing fine.

      I don't necessarily think this is relevant to vfx111's questions, but thought I'd share since the issue of sleep deprivation came up.

      Comment


      • #43
        While you're at New Bolton, do your best to get your kiddo seen by an internal medicine specialist as well. You can call the secretary back and let her know. Amy Johnson is a boarded internist with a special interest in neurology; however, all of the internists there are wonderful and each could/will do a thorough neuro workup.

        I really think you need may to see both an internist and Dr. Utter to get to the bottom of this -- this may be what you end up doing anyway, but at least this way the medicine folks will have a heads up and you'll get on the schedule and may not be stuck waiting for as long. If Dr. Utter finds something in the eye, you can always cancel with the medicine folks.

        Comment


        • #44
          Originally posted by harnessphoto View Post
          I don't think it's impossible, but it would be UNUSUAL for vision loss to appear as a result of EPM without other symptoms appearing first. EPM, as you know, is a protozoal infection of the spinal fluid which, if not caught and treated quickly enough, CAN move to the brain. Usually, symptoms that are a result of the spinal infection can be largely reversed while symptoms that are a result of brain damage tend to be permanent. Vision loss with EPM horses tends to come with advanced cases that have moved up to the brain (since the spinal column doesn't control vision-- though, of course, optic nerves could be affected as part of the infection). That would imply that the infection has already moved from the spine to the brain. I would be VERY surprised if your horse had an active EPM infection so bad that it moved to his brain without displaying at least some telltale neurological symptoms.

          Best of luck with getting to the bottom of this. I hope you find the cause and that it's reversible.
          This makes sense on a logistics level.

          To follow up: anyone think that sleep deprivation alone could cause such spookyness in a horse?

          If we follow harnessphoto's line of thinking that other issues would present before an "eye issue", then let's assume EPM isn't the culprit here. You now have a horse that is still jumpy with seemingly healthy eyes. Would sleep deprivation alone (from constant discomfort from other things like ulcers, arthritis, etc) cause a horse to be so jumpy?

          I think it's possible.

          But, even when my mare's ulcers and arthritis were treated, she was still jumpy (with many less falling asleep while standing up episodes so....???) so didnt' seem really sleep deprived then, and still spooking at rocks
          "If you think nobody cares about you, try missing a couple payments..."

          Comment

          • Original Poster

            #45
            Originally posted by Ben and Me View Post
            While you're at New Bolton, do your best to get your kiddo seen by an internal medicine specialist as well. You can call the secretary back and let her know. Amy Johnson is a boarded internist with a special interest in neurology; however, all of the internists there are wonderful and each could/will do a thorough neuro workup.

            I really think you need may to see both an internist and Dr. Utter to get to the bottom of this -- this may be what you end up doing anyway, but at least this way the medicine folks will have a heads up and you'll get on the schedule and may not be stuck waiting for as long. If Dr. Utter finds something in the eye, you can always cancel with the medicine folks.
            This is the main reason I want to go to New Bolton. The ability to see all specialists/do everything at once.

            On the sleep deprivation theory... I've seen my horse sleep. In the pasture lying down and in his stall. And he's been in situations before where he had injuries that I imagine hurt (tore deep digital flexor tendon) and he was his happy, non-spooky self-- just 3 legged lame.
            ~Veronica
            "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
            http://photobucket.com/albums/y192/vxf111/

            Comment


            • #46
              Originally posted by vxf111 View Post
              On the sleep deprivation theory... I've seen my horse sleep. In the pasture lying down and in his stall. And he's been in situations before where he had injuries that I imagine hurt (tore deep digital flexor tendon) and he was his happy, non-spooky self-- just 3 legged lame.
              Then I am definitely interested in the results here, because it sounds like in yours case it would NOT be sleep deprivation causing the skittishness, and must be something more. In my case, I know my mare is sleep deprived, but maybe there is more to her than that...your results will be very interesting to me.
              "If you think nobody cares about you, try missing a couple payments..."

              Comment


              • #47
                I apologize if you've already covered this... but has the horse been tested for Lyme? My guy's entire personality changed when he had it in 2010. He looked neurological behind and my normally bomb proof horse was suddenly seemingly making excuses to spook. He was also cranky and mean, which is very unlike him. If you didn't specifically do a Lyme test, it could present in blood work as an infection. As I learned the hard way, Lyme can frequently settle in other parts of the horse's body. In my guy's case it was his heart, but in some horses it could just as easily be vision.

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                • Original Poster

                  #48
                  Yes, negative for lyme. And we had a "baseline" as he's been tested several times and was treated last fall. Test was through Cornell.
                  ~Veronica
                  "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                  http://photobucket.com/albums/y192/vxf111/

                  Comment


                  • #49
                    Damn... what a mystery

                    Comment

                    • Original Poster

                      #50
                      It was a good idea and one of my first thoughts. And would have given a clear answer
                      ~Veronica
                      "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                      http://photobucket.com/albums/y192/vxf111/

                      Comment

                      • Original Poster

                        #51
                        I promise to keep you updated SFH
                        ~Veronica
                        "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                        http://photobucket.com/albums/y192/vxf111/

                        Comment


                        • #52
                          A good idea to have it checked into further, interested to see what they say

                          EPM horses can be only affected by vision and general spookiness. Mine was for many months then the physical ataxia signs started. I had no idea at the time it could have been caused by EPM. He is now 9 month post EPM Drug treatment and 6 months Post VivaStem treatment and is totally normal in every way including non spooky like he was before. His spookiness and ataxia went away post drug treatment (oroquin 10) then he relapsed at 90 days post at which time the vet treated him with the Vivastem ( stem cell fluid). He improved to normal and has continued to be.

                          The Pathogenes -- ELISA SAG tests, test for antigens that are specific to the proteins on the protozoa. SAG 1. 5 and 6

                          This tells you of exposure and your horse’s response to exposure

                          It will be up to your vet to decide on treatment and course of action

                          I just wanted to pass on that the horses can relapse post drug treatment for the Protozoa. Some do not but many do. Many never recover fully post drug treatment. I do know of 2 that recovered fully but the rest did not or relapsed.

                          Something that surprised me in my research is that conventional drug treatment is considered successful if they improve one grade on the mayhew scale. So from spinning and falling to stable but still ataxic is considered successful, leaving a lot of horses stuck in an ataxic state and not improving.

                          There is an option with stem cell fluid that can help the horses fully recover

                          We have one acute case we are studying now that relapsed 3 weeks post drug treatment to his original condition of being unable to stand on his own and spinning till he falls. Post VivaStem, He is now on his way to recovery improving daily.

                          Most we have studied have residual ataxia post conventional EPM drug treatment. Stable but ataxic in some way and all have or are recovering. The amount of horses though is small so far only 15 known cases with more being added .

                          Having personally dealt with EPM, several times, I just want to pass this information on there is another treatment option.

                          Please feel free to contact me mariehorse@aol.com

                          Good luck with your horse and will watch to see what the vet says

                          I am the clinical Coordinator for Vivastem Laboratories LLC - Pioneer of Stem Cell Fluid and have been studying stem cell fluid therapy for EPM. This is my passion to help horses that would not have hope.

                          Comment


                          • #53
                            It's interesting that you cite Pathogenes when talking about Vivastem, Mariehorse. When we asked about your new product, she didn't have a whole lot of faith in it.

                            Comment

                            • Original Poster

                              #54
                              SFH- today Somserset was diangosed with corpra nigra cysts in both eyes. 3 vets missed this, including an ophthalmologist. The cysts are treatable with laser surgery, which I have scheduled. Perhaps you want to consider a second opinion on you horse's eyes?

                              To everyone-- thank you all for your brainstorming and support. Even though some of the theories were wrong, they helped me figure out paths to go down and eliminated issues. Now I have a diagnosis and a path forward. Thank you again and I'll post after the surgery and update again.
                              ~Veronica
                              "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                              http://photobucket.com/albums/y192/vxf111/

                              Comment


                              • #55
                                Originally posted by vxf111 View Post
                                SFH- today Somserset was diangosed with corpra nigra cysts in both eyes. 3 vets missed this, including an ophthalmologist. The cysts are treatable with laser surgery, which I have scheduled. Perhaps you want to consider a second opinion on you horse's eyes?

                                To everyone-- thank you all for your brainstorming and support. Even though some of the theories were wrong, they helped me figure out paths to go down and eliminated issues. Now I have a diagnosis and a path forward. Thank you again and I'll post after the surgery and update again.
                                I think this is a positive update -- you have a diagnosis and a solution, rather than no answer at all. Best of luck with the surgery and recovery! How long until surgery, and how long is the recovery? Hopefully you have your horse back to normal soon!

                                Comment

                                • Original Poster

                                  #56
                                  Originally posted by horsepoor View Post
                                  I think this is a positive update -- you have a diagnosis and a solution, rather than no answer at all. Best of luck with the surgery and recovery! How long until surgery, and how long is the recovery? Hopefully you have your horse back to normal soon!

                                  I am THRILLED. The surgery takes a few hours and then he stays for observation through the next day. Then a few days back home of steroids and then he goes back to work. Of all the things it COULD have been this is the MOST innocuous and I am very very thankful!
                                  ~Veronica
                                  "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                                  http://photobucket.com/albums/y192/vxf111/

                                  Comment


                                  • #57
                                    How were they previously missed? I'm glad you have a diagnosis and I hope this helps your guy!
                                    As Peter, Paul, and Mary say, a dragon lives forever.

                                    Comment

                                    • Original Poster

                                      #58
                                      Originally posted by CrowneDragon View Post
                                      How were they previously missed? I'm glad you have a diagnosis and I hope this helps your guy!
                                      Interesting question. The New Bolton doctors did say that without dilation and a dark environment/slit lamp they understood how the two sports medicine vets missed the cysts. Basically they didn't have the right tools. Why the eye specialist didn't see them? That I don't have an explanation for. He did dilate the eye and look with a slit lamp. It wasn't perfect pitch black like at New Bolton but it was dark? Your guess is as good as mine? That declaration that they eyes looked clinically normal sent me down a bunch of futile (and expensive) testing rabbit holes that I wouldn't have gone down, otherwise?
                                      ~Veronica
                                      "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                                      http://photobucket.com/albums/y192/vxf111/

                                      Comment


                                      • #59
                                        THANK YOU for updating as promised!

                                        My vet also had a dark area and dilated the eye and had the slit lamp. Its possible he missed this as well.

                                        I will pursue this further! Thanks again!

                                        Originally posted by vxf111 View Post
                                        Interesting question. The New Bolton doctors did say that without dilation and a dark environment/slit lamp they understood how the two sports medicine vets missed the cysts. Basically they didn't have the right tools. Why the eye specialist didn't see them? That I don't have an explanation for. He did dilate the eye and look with a slit lamp. It wasn't perfect pitch black like at New Bolton but it was dark? Your guess is as good as mine? That declaration that they eyes looked clinically normal sent me down a bunch of futile (and expensive) testing rabbit holes that I wouldn't have gone down, otherwise?
                                        "If you think nobody cares about you, try missing a couple payments..."

                                        Comment

                                        • Original Poster

                                          #60
                                          Partial update: Somerset had the laser ablation July 11th. He came home and within days seemed back to his normal self in terms of ground handling. He tolerated the after-surgery medication very well and had no side effects. He is now back in work and slowly building fitness up. He isn't fit enough to really jump yet, and that will be the final test, but as far as I can tell from riding on the flat-- his vision is 100% back to normal. He is back to the confident go anywhere, do anything horse I know. No spooking, no looking at invisible things, no fear of passing jumps, no changes when he goes from a shadowy area to a well-lit one. He also just seems back to his happy, non-nervous self. So far, I am thrilled. I only wish I would have known about the cysts earlier so we could have done the surgery right away. But so far, so good (knock on wood). I am aiming to get him fit enough to go to a show in early September at the venue where this whole thing came to a head in the first place.
                                          ~Veronica
                                          "The Son Dee Times" "Sustained" "Somerset" "Franklin Square"
                                          http://photobucket.com/albums/y192/vxf111/

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