Wow, sounds like you are making some progress, but having been down this road, it sure takes a lot to get an answer. If it ends up being the neck, AFTER treating for epm, I would discuss steroid injections. Anecdotal evidence seems to say that (unlike hocks, etc) they dont work as well after the first time. But depending on severity you might get a fair amount of mileage out of them. Much like people: my neuro surgeon said that for my personal back issues: injections might work. maybe for a week, maybe for a year. Dont work as well over time.
My older dressage horse, diagnosed at 20+ yrs with cervical arthritis, did well for over a year. He wasn’t a tripper, but had issues with canter leads and a “slippy” stifle - like it got left behind. That showed up again around 14 months post injections and I decided it had to do with spinal compression from rider/saddle. He would go naked around our round pen like a rock star. So I quit riding him. When he was rideable, long and low was his preferred place. They are all different, so best advice is to know your horse and read his reactions every time.
Hugs,
Edited to add: from back in my Ohio days, I’m familiar with OSU and the couple of times I was there, they were very good at their jobs.
@Ziggy793 or anyone in the know; I’m reading that many people give an anti inflammatory like bute along with Marquis? I’m prob going to wait to start treatment until I can call the vet to see exactly what he wants me to do. So far I’ve got some Elevate Vitamin E coming tomorrow and am going to pick up oil of some sort as that seems to be recommended when administering the Marquis as well. I also ordered one of those Easy Wormer bit/halter contraptions just in case.
Anything else I need to be thinking about? I’m considering giving him access to a little more hay while we see how he tolerates the meds so he’s got something to buffer longer in his stomach.
Thank you for sharing @2tempe Once we get through this month I may have more injection questions. There was some concern from the vet due to his metabolic predisposition and steroids so the risk there would definitely need to be considered. Ugh. One day at a time.
I think your response was supposed to be directed to 2tempe, not me, I’m twotempi.
Edited it, sorry about that!
Wait and see how he does, but this was a hard line for me after my horse’s neuro diagnosis. He generally didn’t trip much under saddle, probably because I was very attentive about making him use all four legs properly. Before diagnosis I would have dismissed a bigger trip as him just not paying attention to his feet. After diagnosis I kept riding as everything the vet saw was how my horse had always moved, but with the decision already made that if he started to trip more, not even big ones, just more, then I would stop riding. Because it would only take one catastrophic trip to seriously injure one or both of us. While true of every ride on every horse, a neurological horse showing a decrease in proprioception vastly magnifies that risk.
I hope the EPM treatment gives you many happy, healthy years to come.
Yes my vet often does banamine for the first week or so to help with the die-off. We actually failed to do it when my gelding started on the marquis and that probably contributed to his pretty intense reaction. And anything to help gut health when you’re pumping a lot of meds in is great.
Ok good to know, thank you! Did you do a full dose or half doses of banamine? I have 2-3 tubes of that handy so good there for now.
Still planning to start him with the loading dose of Marquis tomorrow morning since I am off work and full staff will be at the barn.
I started him on the higher dose of vitamin E this morning and am picking up some oil today. He’s already on a couple gut supplements for FWS (pre/probiotics and Tractguard) already so I think I should be ok there.
I’m stressing out more about any reactions to the meds vs anything else at this point 
For the nuchal ligament issue, a shockwave series could help. I would wait to do anything on the lower neck until you see how he responds to the EPM meds, since steroids would not be the best for this horse.
Loading dose of Marquis, banamine, and oil administered with a bigger than normal hay bag. I’m going to deive out late late to check on him just in case so he has some eyes on him before morning.
Fingers crossed 
Sending some healing jingles along!
Our 1AM check this morning was just ducky. He was lying down and hopped up bright eyed and bushy tailed when we got there. His neck muscles were actually soft, presumably because of the banamine.
Day 3 of Marquis (yesterday). All seems normal, still tripping intermittently above the walk. We are getting better a bridleless riding though!
@FjordBCRF -
My experience with injecting the neck was that I got the greatest benefit from IRAP and from the first round.
I initially did cervical Adequan injection right after diagnosis. We saw some benefit but a lot. After consulting with another vet, I did IRAP. Mostly because he was still insured and they paid for it. I got 18 months out of the first IRAP rounds. I only got 8 weeks out of the second (I had enough vials left for a second full round). I retired him when that didn’t buy me a lot because tripping under saddle was an unacceptable risk for me.
Just adding some perspective on the benefits I saw and the risks I evaluated.
Thank you so much for sharing, very much appreciated.
No major updates. This was day 11 of Marquis and the tripping is still intermittent. The longest we was 4 days in a row without tripping and no real trends in the data I’m tracking so far. Slight trends that he does better in his boots on all fours AND if I trim him every 1-2 weeks vs 2-4 weeks. Still hard to really tell though.
I’m really enjoying the liberty work with him and bringing our neck rope riding along though. Hes pumped to be doing it too which is awesome. He had a good day today so after all that we walked the farm roads and got a nice sunset picture!
Go Charlie!! This picture is gorgeous 
My gut says not EPM but what do I know?!
Mine does too. I’m glad we’re treating the titer to be safe, but I don’t think it’s causing the tripping.
In effort to keep things fresh in keeping Charlie at least baseline fit with not much riding going on, I got Jec Ballous new book 33 Strength and Fitness Workouts For Horses. It. Is. Awesome. Very prescriptive, 30+ unique workouts, basic fitness schedules. It’s great.
We did our first workout last night which included hand walking/trotting/backing/step ups/step downs and up and overs. He was engaged and seem to enjoy it and it’s a good human workout too!
We have the perfect place for step up/step downs. Each side of the pad is a different height too so we started on the lowest side.
He has also decided he is a Marquis fan 
IMG_5578
I love Jec Ballou’s exercises! I have two of her books. She also has some online programs you can do as well.
Charlie’s looking good! His weight seems especially nice. Keep up the great work.
Thank you!! His weight is still slowly going down. I’m very thankful I’ve been able to keep him active even with less riding.
The Jec Ballou book is just lovely and put together so well! I’m going to have to pick up her others!
