EPM treatment & itching?

[Simkie]

I have a horse that was started on Marquis following an EPM diagnosis a week ago.

She’s overall doing well, but is MASSIVELY itchy, to the point of rubbing or chewing holes in herself.

It doesn’t seem bug based…we really have no flies, she’s sprayed with fly spray daily, and I added Equispot last week.

I’ve tried Benadryl (doesn’t help), Zyrtec (doesn’t help).

Gabapentin might be helping, a little, or it might just be so sedating she’s itching slightly less. I’m really not sure.

Has anyone else seen this with EPM treatment? Any other thoughts on what to try to make her more comfortable?

[Critter]

I’ll let you know as my gelding started EPM treatment 2 days ago. Although we are doing the Protazil.

Could it be the Equispot? My one gelding is very sensitive to it, if I apply too much in one spot it causes some mild hives or skin reaction. This week I was trying to figure out why he had this rubbed spot on just his left cheek right under the halter…when he’s not been wearing the halter…that’s one of the exact spots I rub the equispot. So either he reacted or he was itching when I had too much applied. Not sure how you would remedy that though.

[Simkie]

That’s an interesting idea, but I don’t think so. She’s had equispot before with no issues, and where she’s rubbing holes in herself is about as far away as the application areas as we can get.

Good luck with the protazil! I hope your horse doesn’t develop this itchy issue

[Knubbsy]

My only thought is that because EPM targets the nervous system, it may derive from that. When I went on medication for nerve pain a side effect was intense itching everywhere, like my hands were raw from itching for the first two months it was so intense. But I’m not sure how Marquis could cause that since it’s meant to form a barrier, not impact the nerves themselves.

[Simkie]

Yes, that’s the idea behind the gabapentin–the EPM, or the die off of the protozoa causing the EPM, is causing neuropathy. Gabapentin treats neuropathy.

I’m not sure what you mean about Marquis forming “a barrier.” Marquis works by inhibiting an enzyme in the protozoa, which prevents it from reproducing.

[Knubbsy]

@Simkie

Marquis works by inhibiting an enzyme in the protozoa, which prevents it from reproducing.

Sorry that’s what I meant by a barrier (against the reproduction), not a terribly precise way of describing it.

[sparkygrace]

My horse can’t kick EPM, so he is on a low-dose of Protazil forever. I have never noticed any itching, but EPM is a very frustrating and strange disease. Symptoms are all over the map.

[joiedevie99]

Super interesting. Medically I see how it’s possible, although we’ve probably treated 40 horses in the barn over the last 10 years (basically every horse that’s wintered in Wellington unfortunately) and never seen itching.

[Simkie]

I guess it is par for the course that this horse in particular pops up with a bizarre issue

That’s interesting you’re seeing EPM only in the horses that travel. Do you think they’re picking it up down there?

Thankfully, the gabapentin does seem to be helping, and I’m not seeing such a big sedative effect as when we first started. She’s still itchy, but not bonkers itchy.

[js]

@Simkie

That’s interesting you’re seeing EPM only in the horses that travel. Do you think they’re picking it up down there

EPM is in FL or anywhere in the Deep South. We lived in the AL for many years, never had an issue with EPM; however, when we moved out West, one of my horses developed EPM (even though it doesn’t exist out here). He probably carried it in AL for many years but only became sick from it when we moved.

[Simkie]

@js

EPM is in FL or anywhere in the Deep South. We lived in the AL for many years, never had an issue with EPM; however, when we moved out West, one of my horses developed EPM (even though it doesn’t exist out here). He probably carried it in AL for many years but only became sick from it when we moved.

EPM has a much wider distribution than Florida or the deep south…

Equine Protozoal Myeloencephalitis (EPM)

This horse has never been south at all.

[js]

I realize that, was just commenting to your question about picking it up in FL and relating my own experience for what it was worth, which apparently wasn’t much.

[sparkygrace]

EPM is becoming more and more prevalent in the west as possums have expanded their territory. I am in Oregon and know many horses, including my own, that have been infected.

[Simkie]

@js

I realize that, was just commenting to your question about picking it up in FL and relating my own experience for what it was worth, which apparently wasn’t much.

Joie is nearish to me. I was wondering why it was popping in the horses that travel vs the ones that stay home, because there’s certainly plenty of EPM here to infect horses. Curious, no?

[sparkygrace]

Stress from travel and showing could be the reason. My horse relapsed when I sent him to my trainer’s. A relapse can happen quickly; the horse is fine one day and then shows symptoms the next.

https://aaep.org/horsehealth/epm-understanding-debilitating-disease

[Simkie]

Yeah, I was curious if it was something along those lines.

It’s amazing how “fine one day and definitely not fine the next” even applies to primary infection. My horse was a-okay one morning and really abnormal the next. Thankfully it didn’t keep progressing at that pace!

[sparkygrace]

I’m so frustrated with this disease. For the last year, which coincides with his infection, he has been muscle and foot sore after shoeing. I rode him today and he was not forward, a bit ouchie, and refused to canter. I used the massage gun on his croup where he palpated really sore.

Before his feet were done on Monday, he was fine. I’ve used the same farrier for ten years and never had problems; he’s very good. I had his feet x-rayed a year ago and he had quite a bit of sole. Now his sole has thinned. My vet is skeptical about EPM contributing to this problem, but they missed the diagnosis for over five months, so there is that.

I’ve learned so much about EPM. The symptoms can be almost anything. I’m afraid my horse is part of the 1% that can’t shake it. I have no idea why. At some point I may have to decide what to do with a horse that is so inconsistently on and off and costing $500/month to treat. He can’t be sold, so the other option is difficult to think about. It’s so depressing.

[sparkygrace]

Another thought. You probably caught the EPM infection early. What were your horse’s titer evels? Mine were 2560 and only came down by about half after being treated for two months.

[pony_baloney]

Just throwing this out there----check out Silver Lining Herbs. They have a mix called EP Minus that may help. My previous horse developed EPM but was pts during treatment. (At 34 his hocks weren’t great and couldn’t get up after losing his balance and falling.) My current pony is at a barn where several horses have been tested and treated for it. I’m going to try that herbal blend after building up his immune system with another blend. He occasionally takes a strange step or two with his hinds and I’m wondering if he may have a minor case.

EP Minus (Best EPM Supplement for Horses) -

Give them a call; they’re great. I haven’t even started using them yet but I’ve heard nothing but great things about their products.

[Critter]

Not to derail the OPs thread…but did your vet have recommendations about when to retest and how long to treat? My guy was just diagnosed (and everything I’m reading is all over so it’s hard to find consensus)…plus my guy is in training quite far away, so I am relying on the vet the trainer uses and not my vet (who I have 100% confidence in).

My guy had a titer of 1:8000…but the vet down there and my vet are only recommending a month of treatment. We are also dealing with a Lyme acute infection (and on doxy). He has some mild ataxia and mostly behavioral changes.