So you told a DVM that your trainer’s opinion and experience with a disease you can’t even name properly carries more weight than their schooling, experience, and continuing ed?
Frankly, I’d drop you as a client.
If you don’t value their professional expertise, you shouldn’t call them.
EPM in both horses at the same time, though? Of course it’s possible, as is Lyme, but having two horses with the same symptoms to me sounds more like mild laminitis from early spring turnout, as I said above.
I think two horses exhibiting new symptoms for Lyme at the same time is even less likely than both contracting EPM at the same time.
Yes, why not, if both horses are exposed to the opossum feces?
The infective stage of the organism (the sporocysts) is passed in the opossum’s feces. The horse comes into contact with the infective sporocysts while grazing or eating contaminated feed or drinking water.
Classic EPM symptoms
https://aaep.org/horsehealth/epm-understanding-debilitating-disease
I just re-read the OP to be sure I hadn’t missed something and this jumped out at me.
Yes treatment early is helpful for most diseases.
But what you’re missing is that by treating Lyme for thirty days* before you’re sure it is Lyme you may be delaying treatment for an equally bad disease that your animal actually has.
@Paks why don’t you use your trainers vet?
This may be going off track, but the more I learn about EPM, the more I would also consider Spring laminitis in this case as well. Horses are generally exposed to things like EPM/opossum poop but there’s something different with the ones that contract it. I’ve known two cases now where one horse has contracted EPM in a barn full of others that didn’t, and share the same barn/pasture. It seems like there is something underlying that messes with their immune systems that some aren’t able to fight it off as well as others. My understanding is that Lyme…Lyme could compromise the horse and make them more susceptible.
Anyways, off track and I’ve not experienced either first hand. Bottom line, the horses in OPs post could have one of many things going on.
to be fair the vet did pull blood to send off for testing. The problem is, if it comes back negative, the horse is now 5-6-7 days into antibiotics that weren’t needed 
Yes, thanks for making my point which I clearly didn’t make very clear.
Very small sample here, but I’ve tested my mare at least three times for Lyme. First two times were some years ago and were based on behavior. Did not do snap test. Both came out negative. Last time was because she had a fever. Did the snap test (knowing it’s not very accurate) and it had a positiv-ish result. Started ABX at that point. IIRC correctly, the diagnosis was anaplasmosis, so we finished out the ABX.
fortunately, the abx for acute Lyme, and anaplasmosis, is the same 
That poor horse is a saint.
It’s just very coincidental that they would both present at the same time. Even if they are in contact with the same EPM infected feces, it’s not a given that they would both actually contract EPM.
It could happen, of course. And, I think more likely that two horses get bitten by two Lyme infected ticks at the same time and present symptoms at the same time. Possible, but not that likely.
I am the exact opposite. Treating immediately is very common. Do vets resist …… yes. But over time my faith in vets has gone down, down, down.
Ideally, try to find a vet who is “on the same page” as you. Not always possible, I know. But it will make life a lot easier.
I’m really curious why you’d just automically treat, when 1) Lyme isn’t life-threatening in a matter of days, and 2) it doesn’t take many days to get test results back.
Do you still test? What do you do if the test is negative, wrt the antibiotics you started?
Here in Lyme Central, most of us wait for test results before treating. The tests can provide information that influences which antibiotic is used. Occasionally a horse will have classic Lyme symptoms and the owner and vet will agree to treat first, usually when time is important (like a show coming up in six weeks)
My horse just finished treatment on Sunday! The fact that he had a high titer in both chronic and acute parts of the tests determined which treatment protocol my vet suggested. Treatment was started less than a week from the blood draw.
What does that really mean though - treating immediately after what? Any sign of lameness? Finding a tick on the horse? Horse running a fever?
Fever of unknown origin is often treated as tickborne. Random lameness is not usually treated as Lyme without further testing or more definitive symptoms.
That they are both off, tripping, etc … suggests it could also be their trim/farrier/shoeing, or the footing … As someone else mentioned.
For me, I have had symptoms responds to Doxy or Mino in a few days. Even 48 hours. I had a vet who insisted “horses don’t get Lyme’s.” He eventually decided he was right, BUT if horses improved on AB then so be it. Thus far… I have not had a horse with suspected Lyme’s turnout to be EPM. Could be dumb luck.
I am talking about horses I was riding/training daily. And I could tell very well that their bodies were not ‘right.’ Though not exactly lame. I learned through time to ack immediately. I have known both animals and people who had bad outcomes because the Doc/Vet did not ‘believe’ in Lyme’s. So I don’t wait on these medicals professionals to agree with me.
And no, in several cases we did not test. As the tests did not seem to produce a reliable result. I have similar issues with Cushings. Horses looking very ‘cushy’ despite negative test results.
The “test results’ are dodgy, in my experience.
This thread is a fabulous example for why, starting this june, farm stores will no longer be able to sell antibiotics without prescriptions.
The Cornell test for Lyme disease is actually very reliable and sensitive, unlike some of the earlier tests or the so-called “snap” test.
Horses sometimes will do better (or seem to do better) once given doxy, whether or not they have Lyme, because doxy acts as an anti-inflammatory as well as being an antibiotic.
What’s interesting about the antibiotics we use to treat Lyme (no “s”) is that they have anti-inflammatory action. So, you start treating and the horse improves, despite a negative titer. That doesn’t at all mean the horse had Lyme and the test was “dodgy.” It probably means that the antibiotic is addressing an inflammation source, which is also supported by such a rapid response.
Sounds like you’re treating a lot of non Lyme as Lyme.
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