Has anyone had success treating an aged horse for EPM? The horse is a 26 yo mare that was still in light work 3 days/week until two weeks ago when she started presenting with mild/moderate neuro symptoms and sudden significant muscle atrophy in the right hindquarters. I’m awaiting test results and considering my reasonable options. She is otherwise in good health, great appetite, and had an excellent overall body condition prior to this.
Thanks!
Bumping this for you - my 28 year old was diagnosed today with EPM, too.
The vet and I have agreed to treat him, but with the understanding that he basically has the summer to recover. He is ataxic enough that going through winter is not an option.
EPM is a strange disease. Some horses respond wonderfully and bounce back. Some don’t.
If he isn’t in immediate danger because of the severity I would take the same approach as Alex lined out
Horses do seem to respond differently to the different drug options, so don’t be afraid to make a switch after the first month if you aren’t seeing results.
I’d also add a good vitamin E supplement. I went thru this with my 20 year old horse last year. He did respond to Marquis but as knic said: different horses respond to different treatments. Wishing the best for your girl!
My friend treated her horse for EPM. He relapsed about 8 months later and she made the difficult decision to let him go. My vet has an EPM horse that she keeps on continual medication for life to prevent relapses. Not cheap but effective.
On the backside (hopefully) of EPM with my mare, but she’s 12. Doing great, we did 120 days of Rebalance that ended in January. She was still a bit neuro for a few months after the treatment ended, and I learned that it is important to note that you need to use a water soluble vitamin E. I did not know this at first, and when I switched her from the regular Vitamin E & Selenium crumbles to a water-soluble Vitamin E capsule, it made a huuuge difference.
We discovered my gelding had EPM at age 17. I’ll just share my experience as none of them are the same. Maybe you can take something from it, maybe not.
My geldings decline was slow at first, but then it was rapid. There was only 24hrs between NQR and scheduling and appointment at a lameness specialist. We treated him for 30 days with Marquis, immune boosters, and decoxx. He got about 90% better. I have to treat him every six months with Ponzuril. Plus many supplements and a low NSC/gut friendly/low stress diet and lifestyle. Frankly, he’s more than capable of showing again, very talented and is now a big, spicy horse now. But, he’s mostly retired now at 19, sometimes we trail ride or do baby dressage. He is just too big, 16.3h+ and ~1350lbs for me to feel safe riding him in less than perfect footing. Treating for EPM is so iffy. All of the treatments work, but none of the treatments work 100% of the time. I know that every time the treatment works, I’ve won the lottery. I’m mostly just enjoying spending time with my best buddy and letting him live the dream horse life. If that’s your goal I’d give it a shot.
I treated my 30 year-old with Protazil and he did very well living out for five more years. Occasionally he would show slight “crookedness” and I had a homeopathic remedy that would straighten him out in one treatment.
I agree that it’s a very individual thing. Try all options you have available.
And yes, water-soluble vitamin E.
I know that it’s important to supplement with natural vitamin E but this is the first I’ve heard that it must be water soluble as well? What did you use for supplementation?
Elevate liquid vitamin E, 10,000 iu top dressed on grain. There are a few other types but this is the one my vet wanted. I’ve recently after 6 months switched her to one scoop (5,000 iu) of Elevate concentrate powder. We did 60 days on Marquis and Elevate liquid and MVP Eclipse PM. Still gets the Eclipse PM as well.
Finding that the EPM PTSD doesn’t go away, for owner at least. This week pony is having reactions to spring shots and I’m so much more nervous about it than I would be had we not had the EPM history.
My vet also recommends Elevate. Was effective for the EPM horse and is now helping a different horse with head-shaking (long story for another thread).
Mine had a similar presentation and did very well with a 30 day course of treatment but never recovered enough to be safely rideable again. Agree with the Vitamin E. Unfortunately he relapsed 2 years later and didn’t improve retreating so I decided to send him over the bridge before the winter weather. Very sad but I was so afraid he’d end up down in the cold/snow. Hoping you guy does well. Such a hard disease to predict clinical course.
Ugh. This case is complicated by the fact that the mare is a school horse and has already stepped down to her present job of doing walk-trot, occasional canter lessons just three days/week. Funds are not unlimited. 
I would love to pour every penny into fixing her, but I’m also supposed to be the voice of reason in the equation.
From what I’ve read it’s something about the water soluble is more bioavailable for horses.
I use capsules. My vet recommended 3000+ IU so I give her eight 400 IU capsules a day. My mare is picky and doesn’t eat wet feeds; sometimes I give her soaked alfalfa cubes I could put the liquid in but I don’t give her soaked cubes year round so I’d rather use something I can give her easily all year. And it’s cheaper than the liquids.
https://www.amazon.com/Nature-Made-Vitamin-Soluble-Softgels/dp/B000EQ2E9A
I have a 27 year old gelding who has had EPM since age 5. Yes, it’s possible to have health with an older horse, even one with multiple other health issues. I’m always happy to talk EPM but it’s a funny disease and each horse is specific. I agree with medicating but the choice of medication each have positives and negatives. I also agree with natural vitamin e being necessary but I feed dry Santa Cruz natural E at 8,000 IUs a day and find it effective and less costly. Feel free to PM me, I’m always happy to talk more specifics. My guy also gets a custom herb blend in addition to a long list of other medications and supplements.
I’m not aware of any study that shows older horses with EPM do worse than younger horses when treated. Mostly that means some recover, some partially recover, and some go downhill despite everything you do for them.
What throws a monkey wrench into the situation is: are you sure her clinical signs are due to the EPM? EPM is an “easy” diagnosis in that you pull blood or (gold standard) do a spinal tap, find evidence of EPM exposure and call it EPM. The problem is plenty of horses live symptom free with EPM, get some other injury, get tested for EPM because any horse that’s “off” is an EPM candidate and then get diagnosed (correctly) with EPM, only to find that resolving the EPM still leaves you with an “off” horse whose real underlying problem is still unaddressed.
Once upon a time every horse that was the least bit off got diagnosed with EPM. Then we moved on to Lyme and now we seem to diagnose everybody with kissing spine. They’re all real illnesses but there are lots of horses out there with EPM, Lyme disease, and kissing spine all at one time that are totally asymptomatic. If one of those horses injured its psoas tomorrow, it would likely get treated for EPM and Lyme and kissing spine before it finally got it narrowed down to the psoas. These diseases are common (dare I say “popular”) findings and only require some blood or an x-ray that can often be done in the field, unlike more complicated issues like a pelvic fracture, spinal trauma, or nerve sheathe tumor.
Is the horse safe to handle still? If the horse returned to its prior level of work would you consider its quality of life good or was it already being nursed along with daily pain medication, etc.? If the horse is safe, has good quality of life, you’ve go the money, and you’re willing to try - you may get a full recovery. Or things don’t improve or they worsen and you may rest a little easier knowing you tried and now it’s time to gently say good bye.
Good luck. Whoever develops a crystal ball that helps me decide what treatment plans are worthwhile and when it’s time to give in to the inevitable earns my undying servitude.
Interesting that it’s called “Nature Made” but is in fact the synthetic version of Vitamin E.
Thanks. For now the horse is comfortable, eating well, and perfectly safe to handle. We have decided to treat her with rebalance and vitamin E and see how she progresses over the next 90 days. The muscle atrophy on one side is significant and occurred pretty much within just a few days, which is my biggest concern.
By submitting your email, you agree to our Terms of Service and Privacy Policy. You may also receive promotional emails from The Chronicle of the Horse. You can opt out at any time.
For Customers
Company
Terms of Use
