My vet recently came to the conclusion that my 7 y/o OTTB has EPM. Looking for some insight on others who have dealt with similar symptoms. On top of being unsound the whole 3-4 years i’ve had him and dealing with never ending SI issues… this EPM diagnoses is hard to digest and I feel that it’s very different from what others have experienced. My vet is very familiar with EPM and sees A LOT of it.
Got this OTTB as a 3 y/o from the track in Indiana. I realized that every single winter he deteriorates. He looses all muscle, has a bad attitude ,and looks like a 20 year old cushings horse. (He is known for being the most sane and sweet guy. He is a barn and summer camp favorite ) Every summer he blossoms. He’s the safest horse in the barn, looks amazing, and is able to keep his muscles. He’s had neurological exams done in the past and every vet has never even explored the idea of EPM. Every winter we have suspected other things ( treated for ulcers and thought he was unhappy where I boarded him.) but this winter it really hit me that something is still wrong.
I leased him to my barn to do summer camp this past summer and when I got him back in September he looked AMAZING ( as he always does at the end of summer ) I put him into a heavy work schedule from September-November (doing hillwork work, lunging with the equiband, everything I could to build muscle) so when November rolled around and there was absolutely ZERO muscle I questioned everything. He looks awful and granted he has had a few months off, a 7 y/o who goes out on 75 acre pasture everyday should not look like this!
After having someone out to do a magnawave session she looked at my horse and said she was not comfortable doing magnawave on a horse that looks like he has EPM. So, I immediately called my vet and he agreed and said there’s no reason for a 7 y/o to look the way mine does.
After a blood test, my Vet truly believes EPM is the only explanation. We are going to treat with protazil and I will begin giving vitamin e.
We ruled out cushings by testing hormone levels, he has a great diet and his weight is good, the barn we keep him at provides impeccable care. All I have ever wanted was a healthy, happy, and comfortable horse.
I wonder about his Vit E levels. I think most horses get what they need off grass, but as the grass dies (in the winter) their Vit E levels drop. I’m happy to see you are going to start giving Vit E. Make sure you are getting enough IU into him.
It may not hurt to run a Vit E blood test. I don’t think this is typically tested for in routine tests?
I am not a vet, and I am not claiming to be, but the degrade in the winter would lead me to believe something is off during those seasons - mainly looking at the limited grass. I’m pretty sure that hay does not have the Vit E of fresh grass.
Knowing his Vit E numbers would be worth knowing to me.
Is he on grass in the spring/summer/fall? It’s my understanding that horses on ample pasture in the nicer months will have a good store of vitamin E in their systems to get them through the winter months (please jump in if I’m wrong). Having muscle loss as early as November doesn’t seem quite right in this context.
With supplementation of Vit E; be aware if you are using Cal Trace or Cal Trace Plus, the Vit E isn’t shelf stable. Im one of multiple horse owners who had been relying on the guaranteed analysis that had a horse test below safe levels of Vit E (my gelding is dry lotted so no substantial grass intake year round).
My horse is fighting EPM right now. It took a long time to get a diagnosis because the symptoms were very vague and my vet missed it. He was slightly off on different legs, then refusing to go forward, better after being treated for ulcers, which can be related EPM. He was treated with Protazil for eight weeks and put on Vitamin E. After treatment, he was back to about 90%.
Last month, he went to my trainer and suffered a major relapse and was worse than he ever had been with ataxia behind. He is back on Protazil and I have seen major improvement in just three weeks. He’ll have another blood test in a few weeks to see if his numbers have come down.
My vet has suggested, because of the relapse, he may need to be on a reduced dose of protazil for a long time, maybe forever. He’ll stay on Vit. E and I will treat him for ulcers if he gets balky under saddle. The disease is insidious and awful.
My advice is to continue treatment for ulcers and keep him on Vit. E. Since he may have had EPM for a long time, it’s not certain treating him will clear the parasite. It’s difficult to get the medication through the blood/brain barrier and the parasite can form cysts that make it impossible to reach them. Stress can also cause a relapse, so that is something to consider. A relapse can happen surprisingly fast.
I am so sorry you are dealing with this. It is a heartbreaker and the most frustrating disease.
Here is some good information about ulcers in EPM horses.
IME, EPM isn’t usually cyclic or seasonal. If they have it, they have it. Periods high stress have been known to cause a relapse in some horses, but again, they relapse and it doesn’t go away until they are treated.
What does the horse eat in the summer and what does he eat in the winter? Does he turn out in the big field all summer and winter or does the turnout change at some point? I’d be wondering about PSSM.
The only was to accurately diagnose is via a spinal tap …many horses have positive blood tests for epm due to the high incidence of exposure …however I would recommend having your horse evaluated by a neurologist…check the neck and go from there.
OP, your experience is very similar to an OTTB at my barn. He tends to relapse every winter even though he’s dry-lotted year around. He’s a stressy type of guy who will often stall walk, etc. when he’s kept in, and will do the same (although less) when outside. It took a while for him to be diagnosed and then set upon a regime of treatment as his symptoms were vague cyclical. Also blood test numbers didn’t change much during treatment (Marquis, Orogin then Protizil), he responded to a large degree. A new vet recommended putting this guy on Protizil twice a year going forward and not waiting for the telltale signs. Vit E @ 11k IUs is also being given.
Another survivor of EPM and ulcers. And also polyneuritis. My vet had me treat with both omeprazole and carafate fot the ulcers and I used oragen and lavamasol for the epm. We had to treat twice and for an extended period. The mare responded better to the oragen.
Her symptoms were also vague. Hypersensitive to touch, girthy and irritable. Maybe nqr behind but not neurological at all.
She’s better now, but I still manage the ulcers despite being out 24/7 with almost constant forage.
What is the EPM titer?
Yes he is on grass during those months. When I brought up the possibility of a lack of vitamin e in his diet my vet said that quality hay should not be lacking vitamin e and a vitamin e deficiency would not be the cause for my horse to look as bad as he does.
We are going to try the nano liquid vitamin e
He eats the same and goes in the same turnout winter & summer. Only change is he gets no grass in the winter.
The E dissipates once the grass is cut, I wouldn’t count on that and I would honestly question the vet on that one too. You cannot count on hay for vitamin E.
“When feeding a hay-only diet, the vitamin status of the horse should be considered and addressed accordingly with appropriate nutritional supplementation,” said Catherine Whitehouse, M.S., a nutrition advisor for Kentucky Equine Research. “Over time, horses offered hay-only diets may become deficient in vitamin E, which impacts antioxidant protection, immune function, and neuromuscular health.”
This may not be a popular opinion but IMHO some vets see a lot of EPM bc they over diagnose it. Or at least over diagnose it as the source of a problem.
At one point I had horses in an area where 99% of the cases were in one vet practice.
It does get tricky bc there are areas where a high percentage of horses will test positive with most being asymptomatic.
I recommend listening to the podcast titled something like Does Your Horse Have EPM? by Straight From the Horse Doctor’s Mouth.
Yes, a vast majority of horses exposed to EPM will test positive, but not display neurological symptoms. However, a positive serum test with high titers, along with neurological symptoms, point to a positive diagnosis of EPM. Vets can also test for PSSM 1 & 2 to rule that out.
It’s true it was the disease of the day back in the 1990’s and maybe still today. However, the range of Virginia possums has expanded, especially to northern states, causing more horses to become exposed.
Of course, there will be horses misdiagnosed with EPM. However, I wouldn’t dismiss it if all the factors are positive.
In my experience EPM isn’t seasonal. So it wouldn’t be the first thing I’d jump on.
How rapidly is he declining?
With seasonal issues I generally think the following first:
ulcers
colitis and/or digestive issues related to not being able to process hay as well as grass
PSSM
low grade laminitis
Others have a point that the Vit E is essential; can you test his values? I would be surprised to see such a drastic change for the negative just because he lost grass – usually takes a few months but… it is horses, there’s an exception to every rule.
I would think something management wise is changing in the winter. Typically turnout in the winter is much shorter due to shorter daylight hours.
Is he shod, and does the ground freeze?
What exactly does “look as bad as he does” mean? Is he getting enough hay in turnout…? Is he getting any at all?
