WWYD: Working the Neuro Horse

I have a 10yo warmblood mare who has received, following extensive diagnostics[1], a presumptive diagnosis of EDM. She has Grade II neuro deficits behind and Grade I up front[2].

She has a home for life with me. Fortunately, being very pretty, she is well-equipped to be a pasture ornament, and I know she won’t weep for her lost career; she is, in fact, overjoyed with what she views as a recent upgrade to shoeless, feral eating machine with 24x7 turnout. As well, I am fortunate enough that I am in a position to be able to support a second horse, though it hadn’t precisely been my plan to do so.

But she’s very fancy (gone Prelim, done the 1.30s, and casually hops the fence for giggles), and I’ve been reliably informed that there are some people out there going Advanced on horses with mild neuro deficits. Which to me seems more than slightly insane! But we all have different tolerances for risk.

So I’m curious, COTH: what would you personally be comfortable doing with this horse in her current state? She doesn’t have compression[3], so there’s no risk of a sudden, catastrophic downturn if she takes a wrong step. (And yes, I have discussed this extensively with my vet team and have my own ideas/plan… but am curious as to how others would handle it.)


[1]: Trips to VEI and New Bolton; bone scan, neck/back X-rays, myelogram, spinal tap, muscle biopsy. Open to suggestions if anyone has some, but there’s not much left to do!
[2]: Neurologically normal at PPE 18 months ago, current grading agreed upon by two different board-certified IM vets, one of whom is also board-certified in neurology.
[3]: Confirmed by myelogram.

I did not think that EDM developed in adult horses like that, I thought it almost always showed up by age 2. You don’t say what her symptoms are but obviously you did all this vet work and decided to retire her so presumably there were some and they were concerning enough to spend this money. Since this presentation is so atypical and possibly there is something else going on I would not ride her at all ever again. In my opinion almost all bad / injurious falls involved the horse and rider both falling and it’s really just not worth it. You say you don’t expect a catastrophic worsening of symptoms but I suspect this mare will not even stay pasture sound if she went from 1.3m jumper to retired in 18 months. I am sorry.

As far as competing: a lot of people get hurt on horses and when you go digging 90% of the time it turns out the people around them saw it coming. Eventing a horse with neuro deficits falls into that category for me.

ETA: did you treat for EPM just to see if it helped? How about Lyme? I’ve never heard of a horse this age, with a successful competition career and no compression or injury getting EDM.

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If that sounds insane to you, I think you already have your answer. Doesn’t really matter if you are running Advanced or Novice. The fall could be catastrophic either way. I personally would not put myself in that position. It’s dangerous enough on a perfectly healthy horse.

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I wouldn’t want to endanger her, either.

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Personally, I would let her be beautiful in the pasture. In 1998 I went to CA and bought a 3 year old Hanoverian mare. Left her at the breeder’s thru the summer. Had her shipped to FL

She got EPM. This was when there was not much known about it. The vet had to get the treatment drug from Canada

She was never wobbly after treatment but she was a big, old style mare. I never rode her, just let her be out in the pasture. I did get into breeding because of her. I had bought my own farm and had plenty of room. I just kept thinking I’d be killed if she fell on me.

Since then I’ve seen many horses that were treated for EPM and seem to have gone on to have careers

Again, that was my experience with EPM before much was known about it. I had to look up EDM (which showed me electric dance music :flushed: until I added in horses to the search) but from what I read, I wouldn’t chance it with your mare

Glad you can support another horse and sorry to hear this story

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My step up eventing horse wound up with EPM. My vet at the time had lost a family member in a fall off a horse with EPM. So, the diagnosis spelled the end of his career with me.

His former owner took him back, bless her, and he wound up on the track as a pony horse, which I thought was odd given that he might not be completely square ( you know, to have a youngster buffetting him on one side?) I don’t know if he lasted at that career or not.

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I opted to euthanize my 5 yo with EDM. Mostly the decision was because he had started to have explosive behaviors (that’s what led us to the diagnosis)…just with general handling as well as under saddle. He was also 18h. So, in my case, just walking him out to turnout could be a significant risk when one of the explosions happened. And, if my mom, who is in her 70s had to help bring him in…she could have gotten hurt really badly. And he wasn’t trying to be bad…it was the disease, so that made it all the more difficult…but in a way it made the decision easier. His neuro issues were also progressing very quickly. If his condition was more stable and he wasn’t explosive, I might have let him hang out as a pasture pet/companion (since I had the room). But the safety risk, especially if other people needed to handle him, was too significant.

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OP - As others noted EDM is mostly diagnosed when horse is young. BUT there is this article from UC Davis that says it can show up between 5-10 yrs old. https://ceh.vetmed.ucdavis.edu/health-topics/equine-neuroaxonal-dystrophy . Wise to send to the clinics.
Also I’m just idly curious as to whether the diagnosis was EDM or EMD (equine motor neuron disease)- easy to confuse the letters, and EMD more often seen in older horses. Symptoms are quite similar apparently.
Another neuro story: About 18 months ago I imported a lovely 9 yr old horse. He passed PPE, was then gelded, seemed to heal slowly. When he arrived from Spain to Amsterdam it was notice that he had a funny eye, not really reactive, no recent trauma vet guestimated the problem was about 6 weeks old. I shipped him from quarantine directly to U-Florida. The rest of the very long story is he was also neurological, ultimately diagnosed with something called Polyneuritis Equi, was declining even while at UF and was put down after about 4 weeks.
This disease also presents similar to EPM and the others, but can also impact the cranial nerves; thus the eye problem, and other facial/head and finally neck issues. It is thought to be auto immune related and IMO I believe the gelding with general anesthesia and the recovery could have triggered it. ( A lot of seller ugliness in this story, put not relevant to this thread. )

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Does she stumble or take ‘funny’ steps? She was doing something to prompt all of this diagnostic work, I assume?

I have ridden known Wobblers and horses that have recovered from EPM. I never felt unsafe or worried about it. The work I did with them was far below what they were doing prior to diagnosis.

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Don’t ride her. Not worth it. I’ve ignored very subtle warning signs and been blinded by overall great performance, only to have the horse trip at the canter and me go flying. The hindsight is so clear. This was a leased horse, not mine, and baseline neuro workup afterwards showed some very mild symptoms. But I would bet you a million dollars that if we have chosen to invest in a full in-clinic workup we would have found something more neurologically damning.

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Firstly, my mare has no official diagnosis beyond it’s definitely mild neurological issues. She’s 21 this year, an actual diagnosis would be unlikely to have changed treatment and I wouldn’t have put her through any sort of surgery at her age, so we didn’t go further with diagnostics.

I’m still riding her. I’ve got a thread or two about her situation from over a year ago for further detail, but basically at its worst, she was totally unable to balance on three legs to have feet picked out, let alone trimmed. A month long course of anti inflammatories allowed her to recover somewhat, and I took it easy from there, at first just jumping on for a light plod once every couple of weeks.

She is now being worked on average 4x a week. One lunging session, 2x flatwork (training 2nd level dressage) and 1 trail, which may be a plod or may incorporate more fast work for fitness. she’s doing great, and keeping her in work seems to actually really be helping, I presume through maintaining fitness and muscle. She lets me know if she’s having a bad day, and if that’s the case we don’t do anything. The lunge sessions allow me to assess her movement from the ground regularly.

I accept there is an increased risk. My continuing to ride her is based on the fact that her symptoms are very mild, have substantially improved and she is also an incredibly sure footed horse. This is continually assessed and I am fully prepared to end her ridden career the second it needs to. She had a checkup just recently and the vet was thrilled with how she is going and agreed that continuing to ride at this stage was beneficial.

The mare i am training with to learn dressage is an EPM mare. One round of Marquis set her right. My plan of action is to not ride her outside of an arena. I won’t trail ride her, and right now, i don’t even ride her if i’m not in a lesson with my coach. Though she moves perfectly, i’m hyper vigilant for even the slightest anything abnormal. I wouldn’t jump her for sure. Just dressage.

It’s interesting to hear that some people won’t ride/jump/trail ride/whatever their horses who have been treated for EPM. Around here it’s so rampant that if every horse with a history of EPM retired, it seems like there would hardly be any riding horses left! I’ve had two horses with known EPM history. One was treated with Marquis at age 6, went on to be a successful GP dressage horse, and is now 26 and totally healthy other than Cushings. I would have missed out on a lot if I had retired him 20 years ago!

But this presumes effective treatment. As to the OP, no, I would not ride a horse with active neuro deficits. Horses are too dangerous at the best of times.

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Thanks to all for both the replies and for the kind words–I’m enjoying reading everyone’s perspectives. To answer a couple of questions:

Both EPM and Lyme were ruled out by spinal tap. (By the time we went to New Bolton for the spinal tap, she’d also had multiple months on first doxycycline, then minocycline.)

Regarding “never heard of a horse this age”, unfortunately, it seems it’s being diagnosed more and more in older horses. You might find this article interesting. Excerpt:

"Although Nout-Lomas says she’s seeing fewer cases of EMND caused by vitamin E deficiency, at New Bolton Center Johnson reports seeing more—and she doesn’t know why. “In my case population, over the last couple years the number of EDM cases I’ve diagnosed surpassed the number of EPM cases or wobblers, and these are not young horses,” says Johnson, who adds that EDM has turned up in warmbloods of all bloodlines, Thoroughbreds, Quarter Horses, and other breeds. “These horses are usually in the prime of their career—between five and 15 years old,” Johnson says. In the typical case, “the owner first notices the bolting, spooking, rearing, bucking, et cetera, that is out of character for the horse. Later we start to detect mild to moderate ataxia,” she says.

Good question, but confirming I did mean EDM.

Less than you might think, actually. Full details would be a short novel, but she was NQR for most of 2021 (original symptom was bunny hopping in the left canter transition) and the breadcrumbs eventually led us here. I didn’t enumerate the non-neuro-adjacent diagnostics in my OP since they weren’t relevant, but I’m pretty sure the horse glows in the dark at this point.

She never fell under saddle and looks good at faster gaits save for a mild toe drag on the RH. The deficits are most obvious when you do the small circle and tail pull neuro tests. I was present for her PPE neuro exam as well, and the difference from then to now is… marked.

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The case I mentioned for me was over 30 years ago, when EPM was rather “new”. Not much was known about progression and treatment.

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Since the question is what am I personally comfortable with:

If I have the means to ride something else I won’t ride a neuro horse. The issue with neuro is you don’t know what day it will be when they become explosive or unsafe by way of tripping. My worst injuries have been on horses who stumbled (not neuro). So to me, it’s not worth it especially if you have another in the wings. If the horse needs work to stay healthy, I would go with long lining or longing. or find a treadmill you can rent 3x a week.

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well, i was rather shocked by the writeUp upon exam at the university. Which said to never ride the horse, never allow her to even be led by someone else! And to not sell her without full disclosure and a copy of their report. Needless to say, i AM riding her, but only in a ring in my lessons. I have lots of horses to go trail ride aboard, so it’s not like i’m depriving myself. Nor her, as she has 24/7 access to over 100 acres with the other 9 of her herd.
It was pretty terrifying watching her stumble around and seeing her eyeballs wiggle during the vestibular episode that one morning last Spring. I am amazed she has bounced back…it really was horrifying.

OP have been thinking about your original question. I had an older horse some years ago - 22 at the time who was diagnosed with cervical arthritis - very different situation but he was neurologic but pretty mild on the scale. Had injections done and saw enough improvement that I was comfortable riding him for about another 15-18 months. At that point, he was fine with free longeing (how do you spell this?) but clearly not so fine carrying weight. What I’m getting at is it seems you have to judge the horse in front of you and your vets’ diagnosis and what the progression might be. Riding doesnt mean necessarily back to cross country, but maybe a bit of walk/trot or even canter to provide some level of fitness. It does mean you need to look for each and every change in her - including behavioral changes - and consider the risks, because the whole situation is a moving target.

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This is pretty much how my mare presents too. As mentioned, we take it on a day by day basis. Just this weekend we did 7km+, probably nearly half at the canter and she still asked to gallop up the last hill to home! I’m taking her very obvious keenness at such activities to mean she’s feeling pretty good and is comfortable with what we’re doing.

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My gelding with EDM was similar…he was a grade I/II…mostly noticeable on tight turns and going up/down hills. He was not unstable that he was falling…though we did have a rather dramatic trip just trotting around the indoor where he completely ripped off a front shoe. That was before we realized the neuro/EDM. Actually, the mild neuro deficits made him an even fancier mover (right before we headed to NBC he did an extended trot in the field that made my jaw drop.

Had he not had the explosive components of the EDM/neuro diagnosis, I probably would have continued to ride him for arena work. His deficits were mild, and looked more like a low grade lameness than a really neuro horse. But…his explosions were the deciding factor. I had two rides where he had a complete explosion for no reason…my guardian angel did hazard pay those days and I stayed on. I should not have stayed on. Those were the last two rides I had on him. If those didn’t happen, I probably would have been able to continue to ride him, assuming the deficits didn’t progress.

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