I think I’d pursue EPM.
1 Like
Yep. EPM would be my guess. They don’t have to be obviously neurological to have it.
1 Like
My mare had a lot of body soreness and reactivity. Between a diet change and changing farriers she is significantly happier. Her angles behind were not good and it was definitely causing soreness over her hind end and back.
1 Like
He’s been on Ponazuril for about three weeks now with no change.
Lyme makes my horse very back sore and I think has made him permanently hypersensitive in some ways. Sorry if I missed if it was already mentioned.
1 Like
Yes, they tested for it – he was negative, but was on Doxy anyway for a month I think?
1 Like
For EPM, I’ll assume. If he’s got a stronger case that probably isn’t enough time for change. But … I’m not a vet, just someone who treated a horse who I think had a far worse case, for far longer, than anyone realized.
It took a couple of months before real change showed up, but it finally did. And then he became a new horse. In movement, and in outlook and personality. I think it was the first time he had felt really well in years.
2 Likes
Have you considered or ruled out EPSM/PSSM? For me, I would start there.
EPM presents in different ways in different horses and could also be a culprit here.
And has any vet done a good blood work up on this horse, to look at kidneys, etc.? It’s a long shot, but perhaps the infection in his hock became more systemic and he hasn’t been able to fight it off completely?
Just my experience - my TB also has kissing spines. It didn’t show up on an X-ray for many years but he was symptomatic. He had almost all of the symptoms you’re talking about. The vet thought he was neurological at first too, but it turned out he had KS in T10-11 and T15-16. He also has suspected ECVM, with remodeling at C5-6 and probably 7, although it’s hard to see C7 on X-ray. (Both are being seen with some prevalence in TBs, according to my vet.) He has a very hard time walking with his head raised or walking down steep declines.
He has days where he hates to be touched, particularly on the left side. My vet thinks that it’s likely just general discomfort from being in pain (we scoped and treated for ulcers, but symptoms persisted.) I take him as the horse he is every day; he has good days and bad days.
The treatments that have worked for us include mesotherapy 3-4x per year, heat packs before and after rides, PEMF therapy, and weekly massage work. He does not like Chiro - vet said it’s likely because of his arthritis. We tried shockwave and it didn’t seem to do anything. Most important is fitness to keep his core muscles strong, as someone else mentioned before. Riding in an Equiband has been helpful for that. We do not jump anymore, as most of his explosive behavior was occurring during jump schools.
Another thing that is important for longevity with KS is making sure the palmar angles in the hind feet are not negative. I have my vet come out to X-ray when my farrier is here to keep an eye on this. It can make the problem much worse, and it’s not always visible from the outside of the hoof.
Many people are frightened of this diagnosis, but I try to embrace it as an answer. Many horses have it and never get diagnosed. Good luck!
4 Likes
How long ago? The first thing that went thru my head was “what drugs was the horse on?” Because if he truly had NONE of these issues “not that long ago”, then that’s a glaring red flag to me…
ETA: went back and re-read your first post. My thinking…sometimes when in “full work” - first the track then u/s to be sold, then was okay with you all until the stall rest incident…the adrenaline and what-all that goes thru your system when you are consistently working, can mask a whole boat load of NQR. Then, it just takes ‘one last straw’ to break the camel’s back, so to speak. Maybe, just maybe, this horse was hanging on by a thread, and the stall rest and injury forced it to the front.
5 Likes
My horse was on stall rest and controlled exercise for about 11 months before he kicked me. But it was rolling one day and trying to get cast for a minute that kissed off his back enough to change the behavior. I was not brushing his back at the time. And second kick I was actually giving him a scratch, which he asked for and normally loves. So yes, short layup and lots of meds could potentially trigger something that horse was doing ok managing before.
But I also do wonder how long into ownership this happened also.
3 Likes
I unfortunately have more experience with EPM than I would like and from everything I’ve researched and experienced firsthand, some horses just respond to one active ingredient better than the other. I would try switching to Protazil for a month after you run out of the ponazuril. My trainer’s horse saw no improvement after 3 months of Marquis and 10cc a day of Nano-E, but a vast improvement after a month of Protazil. I was lucky and both have worked for me (had to use Marquis while waiting on Protazil) and I also have had luck with adding an extra month of compounded diclazuril/levamisole (more cost effective). It might just be one of those things where you have to try a few options, which sucks when it’s all so expensive!
2 Likes
Thanks to everyone for the input!
I’ve been forwarding the posts to the owner…Interesting about the EPM and the various drugs being more (or less) effective; something to run by the vet, perhaps?
She got the horse in April, but didn’t start riding him until a month later. The BM has a rather rigid quarantine policy for all incoming horses (no matter where they come from): they all have to go into a field (separated from the barns and all other horses) upon arrival - and are not allowed to leave the field for 30 days - so no exercise or work other than the pasture. It’s about half an acre/acre and is a little hilly so they are able to move around at least - but the separation from seeing any other horses is a bit hard on them. I know, I know. Everyone there HATES it (and thinks it’s Draconian) and I agree - but it’s her policy.
Anyway, when she started him (back) into work, she did groundwork and very light riding; some walking hacks, a little ring work - 3 or 4 times a week IIRC, with one lesson a week where we did a little more. Mostly walk, trot, a little lateral work, some brief canters (owner was trying to get her sea legs back after riding sporadically, her previous horse had been unrideable and had to be euthed earlier in the spring), so no hard work per se.
We do think the injury, stall rest (a week/ten days, maybe?, because the wound was slow to heal), and all the antibiotics were very stressful to his system.
After that (early fall) he started to show some resistances under saddle - didn’t want to circle right (we had been working on this issue previously and it had improved), fussy in the bridle, not wanting to go forward - so we checked saddle fit. The fitter said it was okay if not perfect, but he was unreactive to back palpation - and had a body worker work on him who said he felt pretty good. He also started becoming girthy (this was before he went full on “don’t touch me ANYWHERE or I will kick you!”, and obviously we stopped work at that point and had the vet out to check for ulcers (he had numerous SMALL ulcers), Lyme (negative to SNAP test and blood test), the usual suspects. I don’t know why the treating vet didn’t want to treat for hindgut just in case - but they did do an ultrasound and said he was fine. Blood was taken at that point (no abnormal results but the owner wants to redo the blood test), and when his behavior did NOT improve after the full round of Gastroguard (re-scoped and they were gone), he went to VEI for a full workup.
As mentioned, the vet there recommended the above treatments for his (mild) KS - shockwave, Osphos, PRP I think? (would have to go back and read the report), but despite the owner trying to schedule this, she has been unable to because the treating vet has been under the weather.
So that’s where we stand.
5 Likes
Sounds similar to my epm ulcer mare. Sweet kind horse that gradually presented with weird behavioral symptoms. Crabby, girthy, sensitive to touch. Seriously tried to bite and kicked so bad at the chiropractor that we had to sedate her and she still tried to kick him under sedation. She was also xrayed for kissing spines. I finally treated her for EPM a second time with oragen and lavamisol and I think we dosed her twice as long last winter. Just the lavamasol for her polyneuritis helped, but didn’t quite get it all. Then she was treated for both hindgut and foregut ulcers this summer which seemed to finally get her back to normal.
Apparently the EPM protazoan can have different “versions” (I can’t think of the right word). Marquis only treats one. The other drugs treat the other types. It’s frustrating disease
After your last post and more of the history…was the neck imaged at all? I see that they looked at the thoracic in the report and legs but didn’t see anything on neck. I would image the neck if that has not been done.
It’s funny - I was thinking about this recently and thought it might be a good idea.
The thing is that the owner is going to give birth in a couple weeks and is now having issues with her BP 
She would have to arrange to have him hauled back to VEI (she doesn’t have a rig), and unfortunately this is just not a priority ATM!
Well…it can be done in the field pretty well. Especially ultrasound. I’d be inclined to do that before spending more on Marquis if it’s not working so far at all.
3 Likes
Don’t know if this is an acceptable suggestion … If the owner is on her own ‘layup’ with childbirth, new baby, relatives & friends, etc. & so on … (and the favored vet is in somewhat the same situation) …
On the one hand it seems efficient that if the horse needs treatment for something, he’s getting it during this period.
On the other hand this could also be a chance to just leave the horse alone for a month or so. Nothing but good basic nutrition and normal farrier and winter care. No work. No interventions. Nothing. Let him chill and see what happens. It might clear up some potential side issues that need rest to heal.
I don’t know what is the right thing to do here, of course. Just a thought.
5 Likes
The owner just gave birth today! Healthy baby girl - thank goodness 
(first child, she’s 40, came a few weeks early.)
Anyway, the horse has basically been left alone for the better part of the past month - since he went to VEI for his check up. No riding, occasional grooming, a couple of blanket changes, regular feed (which is high-fiber/fat, hay and a vitamin E supplement – turned out as usual.)
My other student – who was riding him a couple days a week before all of this started getting progressively worse – just bought a horse of her own, so is pretty busy with that.
He’s going to get even less attention now, but trust me – he has been pretty much getting a minimum of “attention” lately and has been left alone for the most part. (There’s not an option to just put him out in a field at this boarding facility; it’s only 12 in and 12 out - but more and summer and less in winter.)
7 Likes
