First off - thank goodness your horse’s case is minor! There is truly hope for a good recovery, so that’s definitely encouraging!
My now 24 year old developed EPM while on stall rest for a digital deep flexor tear. Looking back on it, it was probably the stress of stall rest that caused his immune system to become vulnerable to the protazoa. He’s not exactly an “easy keeper” on stall rest. He has a major case of wanting to be with “his herd” and will work himself into a frenzy during turn-out and bring-in times.
My horse’s EPM became SEVERE. By severe, I mean he could hardly walk without swaying a lot and collapsed several times while grazing. My trainer encouraged me to consider putting him down, but my vet said let’s give treatment a shot and then reconsider. It was terrible, and we literally tried everything (the shake, Marquis, Protazil, even looked into Oroquin-10 trials). His disease progressed so far that my vet started wondering whether he truly had EPM. The titers were there, but my vet indicated it could be a lot of things - including neck arthritis. So, in a truly desperate move, I contacted one of the vets who did the clinical trials for Marquis and Protazil. She told me she was not supposed to speak with individual owners, but I begged and pleaded and told her that my horse’s life might depend on what she had to say. Reluctantly, she told that there are only two reasons why the medicine would not improve his condition: (1) he didn’t have EPM, or (2) he had some other disease that was also suppressing his immune system. Given his age at the time (21), she suggested I test him for Cushing’s. What is SO crazy about all this is that when he first developed EPM, he tested negative for Cushing’s. After my many months of expensive treatment, when we tested him again for Cushing’s, it came back positive. Within two weeks of starting the treatment for Cushing’s, his EPM meds (Protazil at this point) started working like magic! He was nearly back to himself within two months. I could not believe it.
To answer your question, I don’t know whether he could have been brought back to full work had he only had the EPM. Because of his deep flexor tear, he was never going to be fully sound again. But, now he’s pasture sound, and I’m able to trail ride him occasionally. For me, the fact that he survived this terribly debilitating disease is reward enough. Knowing how horrible his symptoms were and how great he looks now, I would say your horse has a fighting shot at a really substantial recovery. Just remember, though, that it’s always lurking there, ready to resurface at a moment’s notice whenever your horse’s immune system is suppressed. To combat this, I keep my horse on 10,000 ius of Vitamin E a day (NOTE: contrary to what some others have told you, my vet said do NOT use Vitamin E with Selenium because the Selenium could actually make the EPM worse). We also start him back on Protazil two weeks before vaccinations and leave him on it for a week following vaccinations.
Best of luck to you and your horse!!!
