Your experience with EPM horses?

[retrofit]

Just looking for anecdotes & advice. Obviously I’m working with my vet.

My horse was diagnosed with mild EPM 2 weeks ago. He was “NQR” behind and had 1 narcoleptic episode on the cross-ties. I started treating immediately and it was backed up by a “mild positive” on bloodwork. He’s been on Marquis for 2 weeks. I know that’s not long enough, but it’s still hard not to get discouraged when he has a bad day. Yesterday he looked pretty darn good in a very light lunging session. Today he looked like a crippled old plug (so obviously I stopped lunging) - also he seemed lethargic. sigh

How long did it take for treatment (I’m using Marquis) to start working? When was your horse comfortable to do some light work?

Did you horse experience soreness? Joint/muscle/overall body sore?

Did you do any therapies? What seemed to help the most?

Was your horse lethargic? Hyper? The same??

Did your horse have good days & bad or was it a linear progression?

In retrospect, what do you wish you had known when you started treating your horse? Any random advice??

Thanks everyone. My heart hurts.

[Pancakes]

If it’s any consolation, I am following this for the same information. I have to do a spinal tap (again) to try to get a positive diagnosis after our serum test was equivocal.

Have they ruled out other neurologic causes of this? Lyme? It must be affecting his brain if he’s been narcoleptic, but they still classify it as “mild?”

I’ve heard it can take several weeks to start working, but the majority are better within a few days. Have you supplemented with vitamin E or folic acid? I have a vitamin E level pending on my guy, and supplementation can help the muscles and nerves immensely, especially if they’re low.

Maybe don’t lunge him? It may have been too much? What did your vet tell you about the recommended amount of activity? I have been leaving mine out in turnout but no riding or lunging, on my vet’s advice.

I feel for you, though, and I encourage you to ask your vet too, and let us know what they say.

[retrofit]

I did a Lyme test. It came back equivocal so we are going to re-test in a few weeks.

Yes I am supplementing with Vit. E.

I am not getting specific guidance on how much work to do. I’ve been told by 2 vets he should be able to do “light work.” I’m playing it by ear and letting my horse tell me how he feels. Most of the time, he looks pretty normal (which for him, is a little fresh and exuberant) so I think the vets are having a hard time thinking he can’t trot around a little. But I also see his bad days …

[tabula_rashah]

No real advice- just wanted to say poor guy! and poor you- you’ve had way more than your fair share!!
Oh and this vitamin E supplement is the bomb- I’ve had awesome luck with it. I know I have at least 1 unopened bottle that will expire before I get to use it if you want me to send it to you.

[retrofit]

Thanks for the support, TR. Yeah he’s definitely had more than his share of bad luck. Thanks also for the offer of the Vit E. He gets very little grain and I already use one liquid supplement (U-7 which has been awesome for his tummy) so I’m just using the Smartpak pelleted Vit E for now. I swear half his calorie intake is from various Smartpak pelleted supplements! Nothing like havung a finicky yet easy keeper lol

[workin_onit]

I was told not to work my horse until treatment was completed. The only sign was falling down with me in transition from canter to trot.
We used the Marquis and he received ‘jugs’ of DMSO. This was followed by 90 days of Re-Balance. He was quiet during the treatment. I supplemented with Selenium/Vit E, Megasel.

[Lady_Eboshi]

If you did the UC Davis titer and it came back inconclusive or low positive, I wouldn’t throw more than 60 days’ worth of Marquis at it before looking for another cause if he doesn’t dramatically respond.

Other causes to investigate could be Lyme (treat w/30 days’ worth of Doxycycline and see if that clears it up) which is a cheap option, or X-rays of his cervical spine which are very expensive. It’s coming to light more often these days due to better imaging by more vets that a lot of what we always assumed were “EPM” horses actually have spinal stenosis pressing on the spinal cord. Mesentery artery damage, etc. can also throw similar symptoms, as can Wobblers’ Syndrome.

If it IS the genuine article EPM, according to my vet:
“33% of them recover completely, 33% arrest the progress of the disease with treatment but the disability remains, and 33% get worse until they have to be euthanized.” Bear in mind that EPM is VERY OFTEN overdiagnosed.

In any event, your vet should be telling you not to ride your horse, and to be extremely careful handling him, leading him in and out of the stall, and particularly having the farrier work on him. He may not be able to control his body, and may not realize this is happing. VERY DANGEROUS situation for handlers! EPM horses in the later stages can also have what act like “mini-strokes,” some resulting in blindness, confusion, inability to rise, or flipping over. I have dealt with two in the end-stage and it was dreadful.

Really hoping this is not what your guy has–Best of Luck!

[Frizzle]

The Smartpak vitamin e is only 2500 IU, while the recommended dose for neurological horses is 5000-10000 IU per day. There’s also some evidence that alpha lipoic acid can help neurological horses, and I also found that high dose MSM (20,000 mg/day) seemed to improve my horse’s symptoms.

Like workin’onit, we also gave my horse several jugs of DMSO during the Marquis treatment. We did it to make him more comfortable (he was having trouble getting up), and it did help with that quite a bit. Since then, I have read that some vets believe that giving DMSO in conjunction with Marquis can increase the drug’s efficacy.

[candico]

To save a lot of $$, try this source for a natural Vit E supplement - http://www.scbt.com/datasheet-363242-ultracruz-equine-vitamin-e.html

Thanks to fellow COTHer JB for that find. Makes me sad I didn’t find it sooner! My vet also likes Karbo Combo for treating EPM. He also prefers the Florida test vs. the California test, FWIW…

[no.stirrups]

My horse also was NQR behind, which was his primary symptom. Plus, he’s a hot OTTB, but he’d been acting like an old QH. Within a week or so of treatment, he was perkier and more alert, but it was months before I noticed a significant improvement in his strength behind.

My vet told me to push him in his workouts, however I didn’t feel comfortable doing that. I’ve had nerve damage, and so I know first-hand that no amount of working out will bring the strength back before the nerves recover.

I’d also been warned that he might get worse before he got better due to the inflammation caused by the protozoa dying off, and the subsequent inflammation that caused.

If I had to do it over (god forbid!) I would add MSM for its anti-inflammatory properties.

Ultimately he came back better than ever! It was so worth the months of medicine.

[retrofit]

Thanks everyone. I should have clarified, I’m giving a double dose of the Smartpak supp so that’s 5000 IU/day. Didn’t want to go up to 10,000 without my vet’s say-so.

And he’s already on MSM.

I hope the odds for recovery are better than 33%. Shit.

[Zenyatta]

I bumped up my EPM thread for you.

[dotneko]

I use Puritans Pride for my natural Vitamin E. They sell 1000 IU tabs and my guy gets 10 of them a day. If you check their website, they often have ‘buy 2 get 3 free’ sales, so it is not very expensive. I like the gel tabs because I can see if they are going in or not.
Make sure it is the Natural Vit E not the synthetic.

[ladipus]

I too had a NQR situation with my guy and he tested mildly positive via bloodwork to UC Davis…We treated him with Oroquin and his response was almost immediately…like the next day his energy level went from zero to 10 overnight, and was bright and alert and was galloping, bucking, and zipping around the pasture after just one dose ! I also give him Health E - from the same makers of Heiro-it’s the most potent Vitamin E supplement on the market, as well as MSM

[outfoxem]

My experience with EPM was that the horse was mis-diagnosed. Blood tests only show that an immune response has taken place, not that the disease is present in the body necessarily. Here in Florida I have heard that 90% of horses will test positive to an immune response to EPM, even though most will not have the disease. My understanding is that the ONLY 100% correct diagnosis for EPM is post mortem. Deep subject. Make sure your vet has LOTS of experience with neurological diseases, otherwise EPM is the GO TO diagnosis for any neurological tendencies.

[Lady_Eboshi]

[QUOTE=outfoxem;8208092]
My experience with EPM was that the horse was mis-diagnosed. Blood tests only show that an immune response has taken place, not that the disease is present in the body necessarily. Here in Florida I have heard that 90% of horses will test positive to an immune response to EPM, even though most will not have the disease. My understanding is that the ONLY 100% correct diagnosis for EPM is post mortem. Deep subject. Make sure your vet has LOTS of experience with neurological diseases, otherwise EPM is the GO TO diagnosis for any neurological tendencies. :([/QUOTE]

This is true. The one I had who failed more on Marquis had a high titer, but I’d bet everybody in our area would. My regular vet was out on maternity leave that summer, and he was Dx by a colleague. When my regular vet returned after the horse’s demise, she told me she had heard about how it went and doubted EPM was what he had; she was leaning toward prior injury of the cervical spine. So you really never know; you just have to throw treatment at it and hope something sticks. My the Gods forfend I ever see another, but I’d be more inclined to try Oroquin than Marquis based on my experience and the others related here.

[quietann]

[QUOTE=Lady Eboshi;8208129]
… So you really never know; you just have to throw treatment at it and hope something sticks. My the Gods forfend I ever see another, but I’d be more inclined to try Oroquin than Marquis based on my experience and the others related here.[/QUOTE]

We are both in New England, and my vet strongly recommends Oroquin over Marquis. The EPM organism varies and the one that’s most prevalent in our area responds better to Oroquin.

[TBLover]

Have to second the vote for Oroquin. My guy (also located in the Northeast) has had an amazingly fantastic response to Oroquin.

[retrofit]

Thanks, Zenyatta. Nobody mentioned Oroquin to me. Vet #1 does injectible diclazuryl (sp?) but that scares me a bit (not that EPM doesn’t!) and vet #2 went straight for the Marquis. I’m 2.5 weeks into Marquis treatment and so far results are “meh.” If this doesn’t do it (and a re-test for Lyme shows no elevated antibodies) then I will definitely look into Oroquin.

[Frizzle]

Just want to point out that there are newer, better blood tests for EPM. Yes, most horses will test positive to the Western blot, which only shows exposure and not actual infection. The SAG & IFAT tests are much more targeted.