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Rehabbing the EPM horse

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  • Rehabbing the EPM horse

    I'm helping a friend try to rehab her 10 yo gelding after an EPM diagnosis.

    Can anybody offer me some suggestions on exercises to help with his recovery? We're not in a rush -- just want to bring him back slowly and carefully...

    Thanks in advance!
    Last edited by Lulu; Nov. 2, 2010, 03:46 PM. Reason: grammar

  • #2
    The ground poles are good. Although I would personally start with lateral work and mild hills for rebuilding his back end and helping him relearn how to coordinate all four legs. For example if you've got a field to hack out in, at he's warmed up in a flat area, make several trips up and down a slight hill at a walk. On the days when you stay in the ring, integrate leg yeilding, shoulder in, haunches in, turn on the haunches, etc. into your ride. Again start with walking and then later trot and canter When he's successful with the lateral work and not struggling to trot up the hills, he should find it easier to work on ground poles and eventually back to jumping. Be careful not to drill him through the excervises; pay attention to his attitude and check his body for soreness before and after every ride.

    Good luck!


    • #3
      Barn cleanliness

      The last time I was in a barn with a case of EPM I left. There's no vacsine to prevent it, but it has a lot to do with cleanliness. I'm betting your barn is not clean. That's what allows the possum poop to get in the hay. Read this:

      Unfortunately, there is little horse owners can do to adequately protect their horses from infection with EPM. There are currently no vaccines to immunize animals against protozoal diseases. At best, good horse-keeping practices will discourage unwanted visitors such as opossums, other rodents and birds from contaminating hay, grain and bedding.

      Here are a few suggestions:

      * Keep feed rooms and containers closed and sealed.
      * Use feeders which minimize spillage and are difficult for wild animals to access.
      * Clean up any dropped grain immediately to discourage birds and other scavengers.
      * Feed heat-treated cereal grains and extruded feeds since these processes seem to kill the infective sporocysts.
      * Keep water tanks clean and filled with clean fresh water.
      * Maximize your horse's health and fitness through proper nutrition, regular exercise, and routine deworming and vaccinations.
      * Schedule regular appointments with your equine veterinarian.

      If your barn's standards are lacking, go find one that's better kept. If your barn is clean, I shut my mouth.
      Joanne, McLean


      • #4
        No. Not true. And not fair to the barns. Keep the barn as clean as a hospital ER and you will still be susceptible to EPM. Kind of irresponsible and inflammatory to blame the barn for EPM. Little misinformation there.

        The organism is carried by an intermediate host, Possums, who pass it out in their feces and it, apparently, is viable for some time on the ground. Horses ingest it as they graze.

        It is not passed from horse to horse, people to horses, horses to people and even from those Possums to horses unless the horse ingests the organism grazing. Additionally, a large number of horses will test positive for the presence of the organism and never show a symptom. Others go for years and then show them.

        If you want to avoid any barn with any case of EPM? I guess you need to move out west because it lives in the pastures in the east, mid atlantic and anywhere else with Possums cross the open fields.

        It has NOTHING to do with the barn and their practices and killing every Possum in the area is just about impossible. If they go out and graze, they can be exposed.

        Oh, and for OP and the rehab question? My barn does nothing but walk for awhile, starting at about 8 minutes each way. When they are walking 15 min each way, they add the trot starting with just a couple of laps each direction. After about a month of gradually increasing work time they will start adding in the canter, just a few laps to start then build.

        No way yours should be looking at ground poles at a week back. Go slow and figure about 90 days building back up to 40 minutes split between W-T and Canter. Then you can add the poles and jumps. It is very hard for active horses to lay up for months and they do loose alot of muscle and coordination. Remember, 90 days seems long but he was off for a solid 5 months. Take your time, he should be back where he was jumping around courses by summer.
        Last edited by findeight; Feb. 3, 2010, 10:50 AM.
        When opportunity knocks it's wearing overalls and looks like work.

        The horse world. Two people. Three opinions.


        • #5
          I used to take care of post-surgical cases referred from NCSU, and kept the barn immaculately and neurotically clean, and my horse got EPM anyway. It has very little to do with cleanliness (though I will admit that yes, if you leave grain all over the floor of the barn and it draws opossums into the barn you'll raise your risk).

          The most important thing with rehabbing a horse from EPM is that whatever speed you would normally use for a program, halve it. At each stage, you want to wait until the horse is really really solid and comfortable before pushing for more. You mostly need to focus on rebuilding strength, particularly hind end strength. So hill work is ideal, but if you don't have hills available, lots of transitions both up and down, backing up, etc will also help. Ground poles definitely help, although it does sound like it might be a bit early for them, to me at least. My horse was sick before Marquis was an option, and sounds like he was more profoundly impacted, but if it gives you any indication, I started back with just sitting on him and walking around the farm for 10 minutes, then gradually built up from there. Go slower than you think you need to, and just take your time. My horse started out being unwilling to trot, because he felt unsteady--I knew that he was going to recover the day that I asked for a trot and he almost bucked me off :-). Let him tell you how he's doing, and go slow, and you should have your old guy back before you know it.


          • #6
            Gosh did I hit a sore spot!

            Lulu: Did not mean to disparage your barn. I have no idea who you are or whether you have your own place as it seems you do. I did mean to give some good advice as a former vet tech to a prominent large animal Va. vet.
            To both of you: you're simply dead wrong about conditions for EPM. Yes, I know and have known for a long time that 50% of all horses contract EPM but most don't show symptoms. And even sanitary conditions can't completely prevent it. But the fact is, the cleaner the barn, the better the care, the more enclosed the feed and hay, the better-quality the feed (extruded, heated, etc.), the more grass turnout, the much less likely the horse is to come into contact with protozoa that cause it. AND the better the horses are kept, the less likely they are to exhibit symptoms because the stronger their immune systems are to fight it off.

            Fact is, in 4 years of vet-teching in the heart of Va. hunt country, the vast majority of EPM cases were at unkempt farms where other diseases/injuries were prominent. The only time we found an EPM case at a large, sanitary barn, where accidents and injuries were also infrequent, were when the barn had a tractor trailer load of hay brought in from the midwest. Somehow it got infected with the protozoa.

            But my vet's experience was similar to those of other vets: if the hay wasn't kept in a clean dry place (covered, to keep rodents out) and the grain wasn't properly secured, and the stalls weren't done right after 6the horses were grained (so as not to attract rodents) and the horses were on crappy hay and a lot of compressed food (beet pulp, hay cubes) which do not boost their immune systems like fresh grass and good hay, then the barn was a good target for EPM.

            Rant done. Your choice to learn from it or not.


            • #7

              perhaps there is a reason that you are a vet-tech and not an actual veterinarian. Plenty of knowlegeable and qualified individuals have disproven your "advice."
              Just saying! Your choice to learn from it or not


              • #8
                Hi LuLu!!!!!


                • #9
                  Nobody is advocating dirty barns here, that spreads just about anything. And you certainly would have trouble finding a larger barn that never had a case.

                  To suggest the barn is at fault for a horse that displays EPM symptoms condemns every training/boarding barn I know of, including the ones now at WEF and Ocala with impeccable horsekeeping conditions.

                  Those horses get turnout on large grassy fields and have at other times in their lives at various other barns and there are critters that also traverse those fields. Maybe cats too.

                  Say one thing just based on my experience...the imported WBs seem to get hit harder and younger. Maybe our native breds have built that immunity? Maybe just a coincidence? Who knows.

                  Otherwise I follow my own vet's advice and that of the State U he is affiliated with.
                  When opportunity knocks it's wearing overalls and looks like work.

                  The horse world. Two people. Three opinions.


                  • #10
                    I agree with you. I have been at two very large show barns with individual grass turnout that are basically sterile environments, no nearby wooded areas for possums to hide and have seen horses come down with EPM at each place. These barns were not in the same state, either. It annoys me that someone would claim that there is human error that contributes to this disease when so much REAL evidence proves otherwise.
                    At these two locations, it was always the newly imported youngsters that seemed to come down with this as well. It it very interesting how that works!
                    LuLu, I know for a fact that you know your horse and can read him well. I think the key to his recovery is listening to your gut. He will tell you when you are doing the right/wrong thing. Just take it slow!


                    • #11
                      Having grown up in the #1 county in the US for EPM cases and having dealt with it more times than I can think of, including working with some of the horses in the original test pools, Fontainbleu you are a bit off.

                      It's nice to think that WE can do something about contraction rates, and while clean barns are nice, and higher quality of care may indicate a stronger immune system but it could also indicate a weaker one through showing/racing/stress. We saw as many cases in pristine show barns as we did in backyard operations. My mare came from a stunningly gorgeous, hay kept in a sealed shed, you could eat off the floors TB breeding farm with acres and acres of well-maintained pasture. She probably contracted it out in the field.

                      ---"the more grass turnout"--- = More grass for chance of infection ie: Bigger 'possum potty.

                      ---"The only time we found an EPM case at a large, sanitary barn, where accidents and injuries were also infrequent, were when the barn had a tractor trailer load of hay brought in from the midwest. Somehow it got infected with the protozoa."---

                      Riiight... So now we aren't to buy hay from the midwest 'cause that's where EPM comes from? All of the hay that they'd purchased from Virginia was safe? EPM can have very long periods between infection and symptoms, how can you possibly pinpoint to ONE load of hay?

                      ---"But my vet's experience was similar to those of other vets: if the hay wasn't kept in a clean dry place (covered, to keep rodents out)"---

                      Opossums... ugly rat-like marsupials. No rodents cause EPM, (although Lulu mentioned that cats might be a vector, and we had a cat named Mouse once...)

                      ---and the grain wasn't properly secured, and the stalls weren't done right after 6the horses were grained (so as not to attract rodents) and the horses were on crappy hay and a lot of compressed food (beet pulp, hay cubes) which do not boost their immune systems like fresh grass and good hay, then the barn was a good target for EPM.---

                      I'm not sure what stall cleaning after 6 and EPM have to do with each other. Maybe possums are like Gremlins, no cleaning after six or ELSE! And "fresh grass/good hay" how do you keep the 'possums out of either of these? Good hay or "bad" hay, they have traipsed through both. A 'possum isn't going to think: "Wow! That field looks like it has a really nice 2nd cutting timothy/alfalfa mix growing in it, I'm going to go poop in this weedy nasty field instead."

                      ---Rant done. Your choice to learn from it or not.[/QUOTE]

                      You have a good point, better immune systems help prevent symptoms, but a lot of the other stuff seems to be a bit off. It's a new disease and there are a lot of old wives tales and information that gets adjusted as we learn more. The truth is, it's a crappy, horrible disease, and it sucks.


                      As I write this the aforementioned mare is having her 3rd relapse. 14 years after infection and having lived in the desert for over 11 of those years, she on immune boosters out the ears, on the proscribed diet and carefully maintained. It's just sad, it's just the nature of the disease.
                      Last edited by propspony; Feb. 3, 2010, 03:10 PM.
                      The ninja monkeys are plotting my demise as we speak....


                      • #12
                        Ah this thread is hysterically funny!

                        It's so much fun to learn from neurosurgeons and infectious disease specialists, esp. the pony neurosurgeon.


                        • #13
                          To bring my gelding back post-EPM I did a ton of groundwork. In-hand up and down hills, over poles forward, backward, and sideways. The sidepassing is really hard for them - you may see that your horse doesn't properly cross-over to one side or another. When we started he would just shuffle his feet instead of stepping.

                          Once he'd built up some muscle and strength, longeing over raised poles and a million transitions on the longe to make him use his back end. I also longed him in a sloping section of field so he was constantly changing from uphill to downhill. You have to be careful to work very very slowly.

                          I'm not sure what rehab diet you have him on, but my vet had me feed 16% Mare&foal grain, alfalfa, and 10000 IU/day vit E. The high protein content is because it's such a wasting disease, they need the extra protein to rebuild the muscle.

                          Good luck with your rehab, and I do hope he comes back well. Just be patient - it took my guy almost a year to fully recover.


                          • #14
                            My horse was diagnosed with epm last year showing the same symptoms you described. It's been such a long haul but a year later he's going even better than before the disease & he's finally ready to show again! (Some positive outlook for you

                            As far as rehab I was lucky that he went out on lots of hills even during treatment, then getting back on him we did trail rides & such til he was ready for more actual work. We did lots of transitions, circles, figures & lateral stuff at the walk & trot til he was ready to canter- which was about a month. Around then is when I started with the poles too. We also took some dressage lessons which has helped us both in the long run

                            I think it was about 2 months or so in when we were allowed to do little crossrails & we started with gymnastics once a week after that. The gymnastics helped all of his gaits tremendously.

                            Good luck with your guy, it's so time consuming & at times so frustrating, but totally worth it!


                            • Original Poster

                              Thanks so much, ToughEnough! You made me feel a lot more optimistic!


                              • #16
                                Lulu, I can't offer you any advice that hasn't already been given, but just to add some more hope - my horse tested positive and was treated for EPM a few years ago and is now successfully showing in the 1.40m jumpers... just keep swimming!!
                                Proudly blogging for The Chronicle of the Horse!