Seeking input on the different EPM treatment options

[Iride]

Our horse was recently diagnosed EPM, muscle wasting and weakness behind, plus mid-level ‘lameness’ or rather, weakness, in a hind limb, and did not block sound all the way up the leg.

I’ve been trying to research the treatment options, and what I’ve come up with so far is:

Orogin (by Pathogene) - tablet, levamisol/decoquinate

Diclazuril IV injection for 4 or 5 days

Toltrazuril Sulfone Sodium, tubed (possibly with 10cc DMSO)

Marquis, which I’ve already decided against (relapse history and $$$)

Protazil (top dressed pellet) - I don’t know much about this one

Cur-Ost EQ-Immune and Repair -from Nouvelle Research (Mushroom Beta-glucans)

Please, if anyone with knowledge and experience with regard to the modern options, I’d like to hear what is most effective. Thank you!!

[mroades]

Over the last 20 years, I have definitely had the most success with the Orogin, followed by diclazuril. I also found Marquis to be too much $$ and almost always a relapse.

[Iride]

Mroades, thank you for your reply. That is exactly what I was steering towards… the Orogin followed by IV diclazuril, followed by Protazil (pelleted diclazuril). Accompanied by increased protein for muscle building. I want to also do something to build his immunity (exercise yes but perhaps a supplement that won’t break the bank)…I’ve heard natural vitamin E 10,000IU ?

[Huntin_Pony]

I treated my then-30-year-old gelding with Protazil four years ago. He was in a bad way - could not even balance long enough to eat his grain. I had to follow him around with his bucket. I was distressed and then some.

The one 30-day course of Protazil did the trick. He’s just fine with very occasional subtle relapses (e.g., not standing square) treated easily with a homeopathic remedy. He lives out in a hilly pasture and does very well.

We celebrated his 34th birthday last month.

[Iride]

Huntin’ Pony, wow. That’s a pretty amazing result. You did the Protazil pellets, and nothing else? Were they palatable? Kudos on your sweetie’s 34th birthday. You’re a great mom.

[beowulf]

I have not had a horse personally with EPM, but have been involved in the care of horses with EPM… The best results I’ve seen have been with Origin/Pathogenes… I wrote off Marquis years ago after an absolutely horrible case and relapse with a lovely old QH gelding… BTW… he underwent treatment w/ Pathogenes 3+ years ago and is still doing well. My neuro-vet prefers to use this exclusively in her practice and feels it is the most consistent in delivering results.

Good luck OP. Jingles for you and your horse.

[Huntin_Pony]

Thanks, Iride. I’m glad I still have him and he’s happy. He deserves it.

Yes, we did the Protazil pellets. He is seriously picky about new things in his feed but he ate the pellets okay. (I don’t remember exactly what it took to get him going, but it was not difficult or I would remember!)

We started him on Vitamin E early on and he still gets 5ml of liquid Elevate per day.

I also work with an exceptional homeopathic vet and she gave me a remedy that she has found to be helpful. I don’t remember how soon we used that, but I keep some around and give him a dose whenever he shows any indication at all of wobbliness. It seems to resolve the problem in hours for this particular horse in this particular situation - really remarkable. I doubt that I used it more than twice in 2016, so very rarely.

I suspect that the results vary widely, but that’s our story.

ETA: He trots, canters and bucks whenever he feels like it, too!

[Iride]

Beowolf, thank you. Did the treatment consist of 10 days of giving the horse one tablet? I don’t know much about the product. I’m hoping it’s not something he’ll spit out when we’re not looking…ask me how I know!

[Iride]

Huntin Pony, good to hear!! Was it Dr Ganser that provided the homeopathic? (If you’re in the NY area, I assume it’s a possibility it was her)

[Huntin_Pony]

Not Dr. Ganser but I know she’s great.

[mroades]

One tablet, once a day for ten days…it melts easily in water and I never had one turn up its nose at it

[Zenyatta]

Oroquin, hands down.

[Iride]

Zenyatta, thanks. I assume you mean Orogin?

How did you feed the pills? Melt the two in water and mix in feed (risky if horse turned its nose up to the taste)? Or dosed it? Or hide in a treat? (I assume the latter would be risky because if the pill(s) dropped out as the horse was chewing, you may not notice, or even find the dropped pill if you did)…?

Also, what size are the pills? Would you say smaller than a dime, or larger?

[mroades]

its both meds in one pill the last time I got it. About the size of two tums put together

[Iride]

@mroades

its both meds in one pill the last time I got it. About the size of two tums put together

Mroades, they must have changed the formula, because it’s now 2 pills per dose (2 pills at once, daily, for 10 days total). Both pills are to be fed at the same time…

[AKB]

My horse had mild, long standing, EPM signs (crooked tail, low energy, stopping at fences) that was finally diagnosed last spring. Three days after starting Orogin, his tail was straight and he was energetic. His followup titers and CRP were still high, so even though he was normal, we next gave Neuroquel, then Protazil pellets. His titers finally started dropping 3 months ago. I was pleased with how easy it was to do the treatment, and how well it worked. He ate the all of the meds in his grain. The pills must have been tasty as he gulped them down. Read the Pathogenes website. If you have questions, you can call Dr. Ellison at Pathogenes. She is good about answering the questions/anxieties that you don’t want to ask your regular vet.

[Iride]

AKB, that’s great to hear about your boy.
I actually did talk with Dr Ellison this evening. She was great. She didn’t recommend putting the pills in feed because she said they are very bitter! lol. I’m willing to try it, I guess whole (if I grind them the bitterness will be throughout the feed). She said the best bet would be to dose him, which I think we’ll do. (But I’m tempted to try it in his feed anyway… or stuffed in a treat).

Edited to add… I was going to do the Protazil pellets after finishing the Orogin pills… but, now I think we’ll do the diclazuril shots instead. Same drug (diclazuril)… shots MUCH cheaper… and only 4 intravenous injections vs. 30 days of Protazil pellets. Anyone here used the injections?

[AKB]

Interesting that the Orogin is bitter. Admittedly my guy is a good eater, but he loved the tablets mixed in his grain. He also chomped down the Neuroquel. I would do some reading about the dicazuril. I am not convinced that injectables are better than oral, if it is a med that is well absorbed and if you can get the oral into your horse. I was happy with the Protazil, and would have been reluctant to rely on a short course of meds from the diclazuril/ponazuril family. I think the 30 day bucket of Protazil was $800 on line. That is expensive, but not out of reach.

[quietann]

Had good results with the Orogin/(something else) powder on my mare when she was mildly neurologic. We were not 100% sure she had EPM (positive but not high blood test results, and mild symptoms, like Grade 1 1/2) My vet at the time said that in our area, he got better results with that than with Marquis, and that Marquis is very hard on the system.

[Iride]

Quietann, thanks, I’m pretty sure I’m going to stay away from the Marquis since I’ve heard a lot about relapse with it. I’m sure there are horses who have not had that experience, but I’m going to avoid it for now. If you can find out or remember what the name of the ‘other’ med was that you used, I’d be happy to hear it.