Progressed EPM Symptoms

[BonnieDoll99]

I've got a 21 yr old quarter horse gelding that has had EPM for at least 10 years. His mane & tail are very short and thin, his tail is cocked to one side, he has difficulty maintaining his balance, etc. He now lays down and can not get up. If I scare him, then the adrenaline gets him up, but otherwise he doesn't have the strength. It looks like he is extremely weak in the back end. Is this common for the disease once it has progressed or is this something else? Is there anything I can do or should do? He has had no medications for the treatment of EPM. I'm wondering if he is too old to benefit from any meds or should I consider the alternative? *gulp* Any advice is most welcome.

[Elana55]

Rather than wing it through anecdotal discussion here, perhaps it is time to discuss this with a veterinarian.

If you really care about this horse, a visit from the vet is in order. A gelding that lays down and cannot get up will die from toxins (can't urniate) and/or dehydration (can't get up to get water).

Relying on scaring the horse to get him up will eventually cease to work as the condition progresses.

Call a vet. Spend the money on some answers and if the answer is there is nothing to be done, do the kind thing. Dying of a burst bladder, uric acid build up or dehydration are a terrible way for a good old horse to die.

[BonnieDoll99]

Let me clarify: I want to know if the horse acting weak in the back end and not being able to readily get up is a progressed sign of EPM ........ or whether it is something else.

He has laid down daily his whole life (I've owned him since he was 4), but he has only laid down maybe 10 times this past year where he couldn't get up.

I have spoken to two local emergency vets, but they couldn't answer my question, therefore I'm looking to research it a bit and seek info from someone that has experienced progressed symptoms of EPM. Once I get some answers, then I will haul the horse out to a renowned equine hospital. I just want to know what I'm up against. The horse is by no means near the condition you speak of. The horse is healthy otherwise and if I thought for one moment that this horse was suffering, then I will do what is necessary. Right now though it is merely an inconvience, but obviously something is very wrong. I should have clarified that he will be seen by a vet, but I thought I'd ask around about it before I went. I like to be some what informed before I go.

[Elana55]

I agree with being informed. You did state your horse had EPM for 10 years? Have you attempted standard treatment? I assume you have had a proper diagnosis with a spinal tap?

I had a neghbor who had a horse with EPM and he lost use of his legs and eventually could not get up and had to be put down. This horse was an Arabian Stallion in his 20's.

Ataxia is often part of EPM because the protozoan ends up in the spinal cord and getting anything to cross the interface into the spinal fluid is problematic. Even if you do get a drug to cross, the protozoan can die and I would guess that is also a problem.

No expense was spared to save this stallion I speak of but the end result was the same. The horse eventually could not get up at all.

As you likely know EPM is not a "horse disease" and the horse is an unfortunate dead end host for the protozoan that causes the problem. The protozoan prefers the possum as a host I believe.

I am sure you have done a search and seen the following articles, but I include the links for your information. Good Luck.

http://www.cvm.uiuc.edu/ope/enotes/showarticle.cfm?id=16

http://www.cvm.uiuc.edu/petcolumns/showarticle.cfm?id=323

http://www.vet.purdue.edu/horses/EPM.html

[BonnieDoll99]

I was competing about 10 yrs ago, and someone commented to me that they thought my horse had EPM. It wasn't until the horse started showing symptoms about 3 yrs ago, that I stopped competing, and called a vet for a diagnosis. Since my horse had all the symptoms, the vet told me to save the $1,000 and not get the spinal tap. He did give me a medication for the horse (name eludes me), but it was a 60 day supply and I did not purchase any more after that.

Anyway.....Thank you for your last post... you confirmed what I needed to know and that was that the laying down and not being able to get up issue is indeed due to EPM and not something else. I just wanted to know if this was something that happened with horses that had EPM in advanced stages.

Also, thank you for sharing the articles. One can never read enough about horse health and the information generated from new research each year is priceless. Thanks again for your help.... Bonnie

[Ryle]

First, you never had a good diagnosis on the EPM. It is impossible to diagnose just by symptoms because so many conditions that affect the brain and/or spinal cord can present with exactly the same symptoms. The fact that someone said that they thought your horse had EPM 10 years ago and then the horse didn't show enough symptoms for you to get your vet involved until 3 years ago points to the fact that it was most likely NOT EPM. Once you start seeing symptoms with EPM they become progressively worse in a rather short time because the parasite continues to infect nerve cells, reproduce in there until they rupture the cell and then all the new little parasites infect the neighboring cells and continue the cycle. Along with the parasites themselves destroying cells as they reproduce you also end up with inflammation caused by the damage that they do which adds to the damage and increases the neurological symptoms. EPM is often over-diagnosed---anything neurological was dubbed EPM for many years when the real cause was often trauma or related to a viral disease like WNV, EEE or WNV. EPM actually only occurs in less than 1% of the horses that get exposed to the parasite--it's far from as common as many vets seem to think it is. Trauma is a more common cause.

So, you don't know that your horse ever had EPM and the fact that your horse has been showing very slow progression of neurological deficits over 10 years points to something other than EPM as the cause. The new inability to rise and weakness in the hind end is most likely not from EPM and could be from any number of conditions. The tail cocked to one side is striking a cord with me, but I'll have to go dig through my notes from the recent seminar I attended on equine neurological diseases.

You need to get a vet out to actually look at and accurately diagnose your horse. I can't stress this enough. Too many people just assume that symptoms that they have only just started seeing are related to something the horse had in the past and miss thier opportunity to help their horse. I would strongly recommend that you have your horse's head/neck x-rayed. Arthritic changes in the neck can occur from trauma and progress over the years. It is not uncommon to see these older horses with neck pain that presents looking like a neurological horse because they don't want to move their neck and so move the rest of their body oddly.

I'll dig about the tail cocked thing, but it may take some time....there were 2 days of neurological lectures.

Cindy D.
Registered Veterinary Technician

[horsefun]

I have a horse that is 30. What you are talking about here is all to familiar to me. I have only had him about a year. I was told he had EPM twice before I got him. The second time being more severe as he was paralyzed on his right side completely and within a couple years of the first time that he had it. He came out of it ok other than a crooked but not to bad back leg and has been rideable. My vet told me to keep working him so his muscles keep in shape. That was the only recommendation he had. I worry about him because he lays down to roll then has a heck of a time getting back up also since his rear end is weak. Although he is able to get back up after a few tries. I am wondering about a couple of the other posts. You guys said this parasite stays in them and continues to eat away at the spine. What!?! Is that true?

[Ryle]

If left untreated, EPM is a progressive disease because the parasite gets into nerve cells in the central nervous system and reproduces there until the cell ruptures then all those new parasites move into other nerve cells and reproduce until those nerve cells rupture--on and on.

Horses who have been treated for EPM may continue to have neurological deficits for the rest of their life due to damage that is irrepairable in the central nervous system. This may be very severe or so mild that the horse can compensate and thus appear completely normal until injured, sick, overworked, etc. This could be what you are seeing with your old horse.

HOWEVER, and this is a big however, many many horses are misdiagnosed as having EPM. This has been a huge issue especially during the 1990's. It's also quite common for owners to just assume any "neurological appearing issue" is EPM without any veterinary care or diagnostics and just tell the next person as though it were fact. So, I would not just assume that any problems that appear neurological especially in a geriatric horse are related to EPM. Geriatric horses commonly have neck pain associated with arthritic changes in the spinal column that can present as a "neurological horse" yet are related to pain instead. (Consider if you've ever had a pinched nerve/crick in your neck or shoulder how very differently you moved to try to prevent that area that hurt from moving.)

I would have a vet who is familiar with geriatric horse issues look at your old horse and check specifically for neck pain. If it's a pain issue then NSAID's or even joint injection in the neck can work wonders.