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Understanding Equine Protozoal Myleoencephalitis (EPM) (Part
2) Source: American Association of Equine Practitioners/Bayer |
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Diagnosis If
a horse shows any neurologic abnormalities (ataxia, weakness, stumbling,
dragging the toes, etc.) your veterinarian should be called. If a thorough
physical examination reveals clinical signs consistent with EPM, a blood
test and a cerebrospinal fluid (CSF) analysis may be used to confirm the
diagnosis. It is important to remember that a positive blood test for Sarcocystis neurona only confirms exposure to the organism. This
does NOT necessarily mean the horse has or will develop EPM. (Example:
Most children have been exposed to chicken pox at some point, but not all
will develop the disease.) Prompt, accurate diagnosis is essential. Treatment should begin immediately.
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Treatment As
with any disease, the sooner the treatment is begun, the better the
horse’s chances for recovery. Around 60 to 70 percent of EPM cases
treated aggressively show a significant or complete reversal of symptoms.
Until
recently, there were no labeled anti-protozoal drugs approved by the FDA
to treat EPM. Treatment was mainly supportive. Anti-inflammatory drugs
were (and still are) used to treat symptoms and prevent reactions to the
parasite die-off. Vitamin E (an antioxidant) supplementation was
recommended to aid healing of nervous tissue, and Vitamin B(folic acid)
supplementation was aimed at reversing the antifolate drugs often used as
part of a treatment protocol . The average duration of treatment for the
disease was 3-6 months, often even longer. Treatment could become
extremely costly, and not all horses respond positively to therapy.
Approximately 10-20% of horses may experience a relapse.
However,
these are exciting times in EPM treatment. Bayer has recently introduced
the first FDA approved treatment for EPM. Marquis
(ponazuril) is an antiprotozoal drug that is manufactured as an oral
paste. This product is administered by mouth once a day for 28 consecutive
days.
It is important to note that while Marquis should effectively clear
the horse of the causative parasite, S.neurona,
it may have no effect on pre-existing CNS damage caused by the protozoa
prior to treatment. |
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Methods of Prevention Recent developments in the fight against EPM have yielded a new vaccine. Manufactured by Fort Dodge, this is the first vaccine of its kind. For more information on the vaccine, visit www.epmvacccine.com.
Good
horsekeeping practices should be used to discourage unwanted visitors.
This includes keeping feed rooms and containers closed and sealed, using
feeders that minimize spillage and are difficult for wild animals to
access, and cleaning up any dropped grain immediately to discourage birds
and other scavengers. Feeding heat-treated cereal grains and extruded
feeds since these processes seem to kill the infective sporocysts. |
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