Full Answer
How much do you know about EPM in horses?
The most current calculation of test performance was performed by Equine Diagnostic Solutions (EDS) using 66 necropsied neurologic horses with 30 diagnosed as EPM. Respectively, serum and CSF sensitivities were 90% and 83% and the specificities were 42% and 86%.
What is the a <100 ratio for EPM?
A <100 ratio has a sensitivity = 83% and a specificity = 97%. Although a wide range of serum titers was observed for necropsy positive EPM cases, there was a trend for higher serum titers (≥ 1:4000) to correlate better with EPM.
What is EPM and why test?
Why test? EPM is a neurological disease of the Americas. It is most commonly caused by the parasite Sarcocystis neurona and more rarely by Neospora hughesi. The standard of practice for diagnosis is to perform a complete neurological exam, accompanied by laboratory tests that detect an immunological response to infection.
What does the future of EPM diagnostics look like?
Reed sees a lot of potential for the future of EPM diagnostics—specifically, with next-generation genetic sequencing in a research area called metabolomics. This involves figuring out the unique chemical fingerprints that specific processes leave behind. The specific process here would be EPM infection.
How to administer Marquis to horses?
Does Marquis clear the horse's neuron?
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How much does it cost to test a horse for EPM?
The test costs $61 per sample and the results usually come back within a week. Spinal tapping allows your veterinarian to look at your horse's cerebrospinal fluid (CSF). A spinal tap better detects infection but it's more invasive than a blood test.
What is the best treatment for EPM?
How is EPM treated? Treatment to control infection should include an FDA-approved anticoccidial drug (Ponazuril, Diclazuril, Sulfadiazine/Pyrimethamine). Additional treatments should be provided as needed based on the severity of the clinical signs and any associated complications.
Can a horse recover from EPM without treatment?
The sooner treatment begins, the better the horse's chances are for recovery. Sixty to 70 percent of EPM cases aggressively treated show significant or complete reversal of symptoms. Many horses are able to return to normal activity.
Can a horse with EPM be ridden?
A Horses that recover completely can return to their original intended use. For horses that do recover, the improvement is based on the initial severity of the clinical signs (see box). However, not all horses that “improve” according to the clinical scale are able to be safely ridden again.
Can you treat EPM naturally?
The nutrient that is most commonly focused on for horses with EPM is Vitamin E. Supplementation with high levels of natural Vitamin E are often encouraged, as Vitamin E is a potent antioxidant that supports nerve function and the immune system. Levels of 5,000 to 10,000 IU per day are recommended during treatment.
What should I feed my horse with EPM?
Dietary and Management RecommendationsLow starch, high fiber and added fat are recommended since there is an increased incidence of digestive disturbances (diarrhea) as a side effect of treatment.Folic acid and vitamin E have been found to aid in nerve healing and should be included in the daily regimen.More items...
Can horses get EPM twice?
A: The short answer is, yes, horses with equine protozoal myeloencephalitis (EPM) can relapse.
What are the first signs of EPM in horses?
Owners frequently notice obscure lameness, stumbling and incoordination. If the brain stem is involved, usually a head tilt is present. Clinical signs may include: Ataxia (incoordination) and weakness: Generally centered in the rear limbs, symptoms worsen when the head is elevated, or the horse moves up or down slopes.
Is there a vaccine for EPM in horses?
A vaccine against Sarcocystis neurona, a causative agent for equine protozoal myeloencephalitis (EPM), has been available since 2000, but its efficacy has been unclear.
Is EPM painful for horses?
Horses that are suffering from EPM will also be painful around the occiput and atlas, due to the inflammation going on in the spinal cord. If you have the horse walk and have someone walk behind them and pull them by the tail off to one side, they will be unable to right themselves.
Does EPM cause aggression in horses?
Aggression is not a typical symptom of EPM, but it's not ruled out. EPM can impact both the brain and spinal cord, so symptoms can vary from case to case. Pain caused by EPM lesions may also cause a horse to become grouchy.
Horse Symptoms: Early Warning Signs of EPM
I have come to look at EPM in the same way I look at worms - the organisms are in the environment all the time but some conditions make a horse more susceptible to them. Like other parasites, the EPM protozoa causes more harm in a host with a weakened immune system. The EPM organism
Marquis-Antiprotozoal For Horses - 127 gm Syringe - Medi-Vet
Marquis Antiprotozoal Oral Paste (ponazuril) Marquis (ponazuril) is indicated for the treatment of equine protozoal myeloencephalitis (EPM) caused by Sarcocystis neurona. Marquis (15% w/w ponazuril) Antiprotozoal Oral Paste is supplied in ready-to-use syringes containing 127 grams of paste.
Treating Equine Protozoal Myeloencephalitis (EPM)
EPM has been around for a long time, and the horses in the United States seem to have developed some immunity to the disease. The horses that I see with severe symptoms, such as getting down and unable to rise; are usually very weak, very stressed, or very old.
Treatment protocol for Equine Protozoal Myelitis (EPM)
Dr. Lu Ann Groves graduated in 1981 from Colorado State University College of Veterinary Medicine. She opened a mobile equine clinic in 1982, then opened The Whole Horse Veterinary Clinic (thewholehorse.com) in San Marcos, Texas in 2004.
How to administer Marquis to horses?
Administering Marquis (ponazuril) to the horse: Step 1. Remove end cap and gently apply pressure to the plunger until paste is seen at the tip of the syringe barrel. Return end cap to tip of paste syringe. Step 2. Determine weight of horse and insure the horse's mouth contains no feed.
Does Marquis clear the horse's neuron?
Marquis should effectively clear the horse of S. neurona, but may have no effect on irreparable, pre-existing CNS damage caused by the protozoal parasite prior to treatment. Pharmacists are standing by to offer Pet Parent counseling regarding prescription medication purchased from WalmartPetRx before and after dispensing.
What is EPM in horses?
Equine protozoal myeloencephalitis (EPM) is a nervous system disease caused by the protozoa Sarcocystis neurona . Horses develop the disease by ingesting contaminated feedstuffs. The definitive host is the opossum, but intermediate hosts have been identified as the nine-banded armadillo, the striped skunk and the raccoon.
What are the symptoms of EPM?
EPM is an elusive disease as it presents highly variable clinical signs that may range from head tilt, ear droop, blindness, seizures, inability to chew or swallow, gait abnormalities, stumbling, muscle atrophy, weakness, incoordination, ataxia, or depression.
How many horses respond to treatment?
Testing and development of an early, effective treatment plan should be considered. It has been estimated that up to 55% to 65% of horses respond favorably to treatment. However, it is further estimated that a small percentage (no more than 10%) of treated horses do recover completely.
Is Rebalance safe for horses?
Description. When administered under labeled conditions, ReBalance is an FDA-approved, safe and effective treatment for horses with equine protozoal myeloencephalitis (EPM) caused by Sarcocystis neurona. Proven safe and effective.
How long does it take to test negative for EPM?
A negative result is usually a good "rule-out" for EPM except in cases with acute onset. Retesting in 10-14 days may be helpful if clinical signs persist, as some EPM horses test negative in CSF early in infection. Polymerase chain reaction (PCR) testing may be useful in acute onset cases.
What percentage of horses have been exposed to S neurona?
It has been estimated that ~50% of all horses in the US have been exposed to S. neurona. Few (<1%) of exposed horses develop clinical EPM.
Can a negative CSF test be used for EPM?
The CSF Index test can be helpful in evaluating intrathecal (in the CNS) production of IgG. A negative result is usually a good "rule-out" for EPM except in cases with acute onset.
How long does EPM treatment last?
Consensus statement authors say most horses with EPM are treated for six to eight weeks or longer, if clinical improvement is still apparent under treatment.
How many EPM cases are there in horses?
In previous studies, researchers determined that 61.8% of EPM cases occurred in horses 4 years old or younger, and 19.8% of cases were in horses 8 years old or older. They most commonly observed EPM signs in Thoroughbreds, Standardbreds, and Quarter Horses, but with no sex or seasonal bias.
What is EPM Society?
The EPM Society endeavors to contribute to a greater understanding of equine protozoal myeloencephalitis, encourage cooperative EPM research, promote awareness of current EPM research and new developments in the field , and evaluate and disseminate guidelines for the diagnosis, treatment, and prevention of EPM.
Why did the EPM stop being produced?
In the early 2000s an EPM vaccine was briefly available, but production stopped because it was difficult to prove the vaccine’s efficacy in the existing research model, which involves challenging horses with protozoa produced by families of opossums and raccoons in the laboratory.
When was EPM formed?
In 2001 scientists with an interest in equine protozoal myeloencephalitis (EPM) formed the EPM Society. Made up of researchers and clinicians from veterinary schools, private practice, and industry around the United States and world, the group convenes every three to four years to brainstorm current approaches and new directions to managing the disease; they try to make sense of the complex causative parasites Sarcocystis neurona and Neospora hughesi, how and why they infect horses, and how we can best manage cases.
When was EPM first described?
The Parasite and the ’Possum. Veterinarians first described what’s now called EPM in 1968, and in the 1970s researchers identified protozoa as the cause of this devastating neurologic illness. They didn’t pinpoint S. neurona as the specific culprit until the 1990s.
How does protozoal myeloencephalitis manifest in horses?
Equine protozoal myeloencephalitis can manifest in myriad ways, from the weakness and incoordination Icy showed to facial paralysis and difficulty swallowing. Anyone who’s managed a horse struggling with EPM knows firsthand how agonizing it can be.
How to administer Marquis to horses?
Administering Marquis (ponazuril) to the horse: Step 1. Remove end cap and gently apply pressure to the plunger until paste is seen at the tip of the syringe barrel. Return end cap to tip of paste syringe. Step 2. Determine weight of horse and insure the horse's mouth contains no feed.
Does Marquis clear the horse's neuron?
Marquis should effectively clear the horse of S. neurona, but may have no effect on irreparable, pre-existing CNS damage caused by the protozoal parasite prior to treatment. Pharmacists are standing by to offer Pet Parent counseling regarding prescription medication purchased from WalmartPetRx before and after dispensing.
The Signs and Symptoms
- Most horses affected by the disease have some ataxia (incoordination) with weakness, abnormal gaits and lameness; some will have muscle atrophy to go along with this. Other horses may have paralysis of the face or mouth, or abnormal sweating patterns. Other, more severe cases, may have an abnormal head tilt, or difficulty swallowing, others may have seizures and collapse. The …
Prevalence of EPM Diagnoses
- “EPM diagnosis and treatment has gone through quite a few changes over the last two decades,” says Dr. Clara Fenger, “changing from the ‘diagnosis of the moment’ to a condition that is considered overdiagnosed at every turn. In my personal practice, the prevalence has been remained stable over the last 20 years.” Fenger believes that the condition is “simultaneously ov…
A Shift in Diagnosis
- As compounded pyrimethamine and sulfa became a standard treatment, the cost of the medication dropped to a range of $200 to $300 per month and even less in recent years. At the same time, the veterinary community began to understand that EPM was by far the most common cause of neurologic disease in young horses, Fenger notes. When this happened, th...
What We Learn from EPM Tests
- The different testing options offer different information, says Fenger. The original testing method was testing by Western Blot. “The pattern and intensity of reactivity of the horse serum on the blot would then be interpreted against a known positive horse to determine if the horse has antibodies to EPM.” ELISA and IFAT testing report a “titer” or relative strength of the response, which can de…
Physical Testing: A Non-Invasive Option
- If you choose not to run any blood or serum tests, there are still ways your vet may make a more-specific diagnosis. Many vets will want to do these physical tests in addition to a blood or serum test, just to be sure that EPM is what is ailing your equine. The hallmark of neurologic gait deficits is an irregularly irregular gait, says Fenger. “The lack of proprioception-the sense of position in s…
Treatment Options
- “Response to therapy [treating the horse without a definitive diagnosis] is certainly a legitimate diagnostic approach, but it is not without its drawbacks,” Fenger explains. “There are many conditions, such as Herpes Myelitis, which may improve on their own, regardless of what else is done. Additionally, some conditions may wax and wane, such as Wobbler’s Disease, leading the …
Potential Treatment Issues
- Because of the problems with non-FDA approved medications, it’s always recommended to use FDA-approved medications where possible, Fenger notes. “I have yet to see any data compiled convincingly on the Decoquinate product, and it is a compound that is minimally absorbed, making it highly unlikely to achieve levels high enough in the central nervous system to be effect…