Horse People? What Would You Do With This Horse if He Gets EPM Again?

by EU Humanitarian Aid and Civil Protection

Question by Sylves: Horse people? What would you do with this horse if he gets EPM again?
Our horse: 7 year old, green (can’t emphasize that enough) broke, orginially cost my hubby over $ 10 K to purchase (we just submitted the final check for the horse’s bank loan!), had EPM for two summers in a row (neurological disease effecting the horse’s coordination- advanced infections will cause permanent damage, and horse will not be ridable, very expensive to treat!), AND the equine insurance won’t cover his condition anymore (so we dropped the insurance).

So, what if our horse gets EPM for the third time this summer (I’m kinda expecting it!)? Hubby wants to spend one more heaping $ 1,600 to medicate the horse if the problem does occur again.

Our money situation: our first baby will be born in June. We will pay off lots of debt as of June, so lots of money will be freed up…but, what a great opportunity to SAVE money so that we can put OURSELVES in a better financial position for the future. save the horse, or save the money??? Hubby wants to save the horse.
Need to add, I love the horse too…but….

Best answer:

Answer by whitney r
i think ur hubby is right. give it one more run. if it happens again, then i’d choose to drop the horse. maybe even euthanize him. i hope he doesn’t get it again i love horses and hate when there’s situations like this

Answer by …x
The most exciting new development in the area of EPM research is the advent of new and different alternatives for treating EPM. There are no FDA approved drugs for the treatment of this disease, but a number of drugs have been used off-label, or imported from other countries for treating EPM. The most common treatment is still a combination therapy of pyrimethamine (1.0 mg/kg daily), in combination with sulfadiazine (20 mg/kg daily), most commonly available from compounding pharmacies . This combination is protected by a patent, and current legally licensed pharmacies include Vet’s Choice (888-809-3710). Horses should remain on both drugs for the duration of treatment, because protozoa have been shown to become resistant to pyrimethamine in the absence of sulfas. Trimethoprim is not recommended, and probably should be avoided, if possible, because it is likely to add to the toxicity of the pyrimethamine, without adding to the efficacy. Beware of compounding pharmacies that compound a combination product with trimethoprim, pyrimethamine and sulfadiazine, because the trimethoprim is contraindicated. Ideally, CSF should be obtained and determined to test negative by immunoblot before the treatment is discontinued, although this approach is likely to be extremely conservative, and many horses may actually continue to test positive for several months after the protozoa is killed.
Antiinflammatory therapy is indicated in acute EPM cases. This may include treatment with phenylbutazone or banamine (1.1 mg/kg 1-2 times daily for 3-7 days), as well as the addition of DMSO (1 g/kg in a 10% solution) administered either intravenously or by nasogastric tube. Corticosteroids may be used if necessary. Antiinflammatory drugs are occasionally necessary at other times during the first six weeks of treatment. Some horses actually get worse during treatment, presumably because of a reaction to the dying parasites. Supplementation with vitamin E, folic acid and thiamine may be helpful adjunct treatment. Some recent evidence has put the use of folic acid supplementation into question. However, it is probably safe and recommended for most performance horses, but not recommended for use in pregnant animals.
No specific research efforts have been directed at rehabilitation of horses with EPM. However, some ideas can be extrapolated from the rehabilitation of people that have been affected with polio, spinal cord injury, or other central nervous system damage. The central nervous system has an amazing ability to recover, reinnervate, regrow and compensate. Unlike other organ systems, once a nerve cell dies, it cannot grow back. Skin, liver, kidneys and even lungs have greater ability to regenerate than the central nervous system. Nonetheless, injured nerves that are not permanently damaged can regrow their axons, and neighboring neurons can take on the function of the neurons that are missing. Rehabilitation of EPM horses involves taking advantage of these natural occuring phenomena.
Any horse with EPM may benefit from physical therapy. In particular, horses that are spastic, or walk stiffly (tin soldier-like gait), may benefit from passive flexion exercises. These exercises “remind” the muscles and tendons how to function properly. Try alternating from left rear to right rear and flex the limbs fully (so that the hoof is next to the belly), then extend fully (pull the limb out behind the horse, similar to a farrier).
If the horse is safe to ride, trot him/her over poles on the ground, and do flexibility exercises, such as bending, circling and figures of eight. If the horse is not safe to ride, try these exercises in hand or on a lunge line.

Talking to a vet who specialises in EPM, with regard to the severity of your horses symptoms and quality of life, is the best option before you make any decisions in regard to having this horse destroyed…

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