Does anyone have experience with EPM?

Question

I'm waiting for test results for my horse who I had tested for EPM. He's showing almost every sign of the disease, and I know diagnoses can be difficult, but I'm wondering if anyone has dealt with EPM or Wobbler's Syndrome before? About how much is treatment for EPM? I hear it's expensive, I'm wondering if anyone has any round about numbers. If it is EPM, I definitely want to treat him and keep him comfortable as long as possible. He's 21 years old now, and I will retire him if that's the only option. And does anyone have experience with Wobbler's Syndrome, and is there any treatment for it?

Answer 1

EPM is terrible. I'm sorry to say it usually ends up for the worst. It is very expensive to deal w/ b/c it is a lengthy proccess. You just want to keep your horse comfortable. You will definelty need t retire him.  

Answer 2

I've had a horse with EPM.

It's actually caused by a protozool parasite. It's carried by possums, and horses generally get it through possum poo, either in grain or pasture.

Horses are not a definitive host, just an accidental one. The protozoa can live in the horse, but not reproduce, so horses can't spread it.

The disease is progressive. It attacks the nervous system and the brain, and manifests in multiple ways. Muscle wasting shows a high degree of involvement, but is almost certainly not the only tissue damaged. They'll colic, they'll have brain lesions, you never know what'll happen next.

These horses can be dangerous. Mine never showed any symptoms I saw until he was pretty far along - he lost control of his hindquarters while I was trail riding. Sat down, flipped over backwards on top of me, rolled completely over me, flailed around on top of me trying to get up... then put his head down and calmly grazed like nothing happened.

Two years of treatment. Two more years of pasture. At least the first two years we only did light riding, a little trail riding, because he was never entirely sure where his back feet were. Two years later, the vet said if she didn't know his history she would just have thought he was a little stiff. He's doing great now, even some low level eventing, but it's been a long, long road.

Fortunately, treatments are much better nowadays.  I've been interested since my horse had it, and try to keep up with the research.

The treatment of choice is Marquis (ponazural) given for 30 days orally.  It'll run you $750- $1000, depending where you get it.  If that doesn't work, they use Navigator ($1800-$2000) for refractory cases only due to side effects.  Some places will do Marquis for a month then the old stuff (sulphadiazine pyramethamine) for 6 months ($150 a month).

You may have to retire him for a while, but then he may come back like mine did.

Wobblers is caused by compression in the spine, usually the neck.  I've never had that, but I understand sometimes steroids and antiimflammatories help, and in dire cases they can sometimes be fixed surgically.

Answer 3

I don't have much to add to Zephania's very good answer, except to tell you that one of my students had a horse whom they'd rescued from an auction who was subsequently diagnosed, based on clinical findings only, to have EPM.  He was treated for 9 monthes with Rebalance (Sulfadiazine Pyrimethamine) as the owners could not afford the Marquis.  He had several other health problems (heaves, perhaps some liver damage, and who knows what else).  He was about 18 at the time, and was an absolute love.  Despite treatment and loads of TLC, he became increasingly ataxic to the point where he lost control of his hind end and was stepping on his own feet, badly injuring the coronary bands.   The difficult fact to deal with, with EPM, is that the horse is often not in pain, at all, and maintains a good appetite and cheerful spirit, as was the case with this old guy.  It was very heart-wrenching to make the decision to euthanize him, but we were afraid he'd fall in the middle of the night and really injure himelf or not be able to get up, so we put him down.  And cried for weeks.  I hope you have better results. I believe there have been some great advances in treatment, since that time.

Other experiences I've had involved TB racehorses with EPM, who were VERY scary to gallop, as they'd just drop out from under you (these were horses worth 10's of thousands to millions of dollars, literally).  Back when EPM was only just beginning to be understood, and Rebalance was the only available treatment, the vast majority of them were eventually put down, but now most are treated with a combination of Marquis (Ponazuril) and Navigator (Nitasoxanide) with great success.

I believe a new diagonostic has just been developed (in Gemany?) which definitively distinguishes EPM from other neurologic diseases.

I wish you the best of luck with your horse.

Answer 4

My friend had a three year old who we had to put down for EPM.  He was just too far gone too quick.  He had no control of his back end.  If your horse is 21 and has it, It might be better to put him down.