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Equine Protozoal Myeloencephalitis is one of the most devastating horse diseases.
By Andrea Caudill

From The American Quarter Horse Racing Journal library


Cranial nerve checks include making sure the nerves that control eye dilation. Also clean up roadkill or dead intermediate host animals. but we think that perhaps the parasite catches a ride inside certain white blood cells that cross over into the central nervous system. There is a S.” said Dr.I IT IS THE MOST COMMON NEUROLOGICAL DISEASE IN HORSES . the sporocyst goes through another maturation stage and becomes a merozoite. which left untreated can cause seizures and death. so if they can get into the feed source. the horse might have paralysis of the face. The protozoa is not transferred from horse to horse. but is thought to be in endothelial cells. head tilt. difficulty swallowing. raccoons. There are also gait assessments (known as proprioceptive tests). A normal horse will twitch the skin. prevention must be centered on keeping them as far from horses as possible. The vet will perform a panniculus reflex test. abnormal gaits or lameness. there are three FDAapproved treatments for EPM. The active ingredient in Marquis is ponazuril. seizures and collapse. but only a small percentage (approximately 0. Keep water tanks clean and cover stored hay to prevent the opossums nesting. Once ingested. it is sold by Bayer Animal Health. Problems the vet might watch for in the neck include lack of flexibility or abnormal muscling. This destroys the host cell. the tester can also move the horse’s leg across its other leg to check its awareness of where its feet are (the horse should return the moved leg to its normal position within 30 seconds). and make sure they are rodent-proof. including death loss. abnormal sweating. The examiner might also test the horse’s balance by pulling its tail while walking. Onset of the disease is most common in summer and fall months. grazing or drinking contaminated water. “We don’t know for sure. A spinal tap. A horse suspected of having the disease should be inspected by a veterinarian as soon as possible. The organism is passed through the host’s body or waste products as a sporocyst.14 percent) develop the disease. the opossum. and the opossum picks it up by feeding on carcasses. followed by a neurological exam. paralysis. Morgan estimates that more than 50 percent of all horses in the United States PREVENTION The best way to treat EPM is to prevent it. “Opossums are just nasty. However. The neurological exam includes assessing the cranial nerve function and working down the body to make sure the sensations are normal. Once inside the nervous tissue. not if he has the disease. So keeping your feed contained and keeping animals out is very beneficial. have been exposed to the organism. to one that’s got profound neurological disease that is stumbling all around and can hardly right itself. If there are signs of EPM. Called Marquis. they poop in it and everything else. the first treatment was introduced. Efficacy tests are still being run. as if trying to rid himself of a fly.” Morgan said. a blood and cerebrospinal fluid (CSF) analysis can be done on the horse. EPM is caused by the protozoa Sarcocystis neurona. and horses pick it up through eating contaminated feed. swallowing or vocalizing. loss of sensation and poor balance. Neurological deficiencies are scored from 0 (none) to 4 (obvious abnormalities). Where this maturation happens is uncertain. The disease can be contracted all over North and South America. and symptoms can develop slowly or present themselves within several days. Intermediate hosts such as cats. this shows neurological damage. etc. problems coordinating actions (chewing. Discouraging the proximity of the hosts can be done by good horsekeeping practices. muscle atrophy.americashorsedaily. The first step is a general examination. the active www. a singlecelled parasitic organism. dropping feed. Keep feed rooms and containers closed. Because the disease is transferred via the definitive host. forming a structure called a schizont. so to speak. The same study found that nearly 60 percent of horse owners had never heard of EPM. Often the first indications are stiffness or an asymmetrical gait and cranial nerve deficits. Symptoms include ataxia (incoordination). although safety tests have been run and the vaccine has proved safe. At a halt. but is less common in the western United States where opossum populations are smaller. which is suspended in an oral paste. “Every presentation is a little different. damages nearby nerve tissue and releases more merozoites to infect other 2 www. The blood test will only tell if the horse has been exposed to the protozoa. If the horse loses its balance or is unable to resist the pull. neurona vaccine available from Fort Dodge on a conditional license from the USDA. Cranial nerves control function of the head. will reveal if the protozoa has accessed the nervous system. it sounded different. the merozoite begins to replicate itself.americashorsedaily. and fewer than 10 percent felt knowledgeable about it. Studies estimate that only 40 percent of horses affected by the disease are able to recover fully. They can range from mild to severe.” Morgan said. “They’re kind of like big rats. using a blunt object (such as a ballpoint pen) to press on the skin all the way down the backbone. instead placing feed in a rack or buckets. Kenton Morgan with Bayer Health Care. In 2001. but it wasn’t until the past decade that the cause was found and treatments created. “I’ve had people report that they noticed when the horse whinnied. Early treatments included antibiotic. spasticity (stiffness).” Signs of EPM vary from horse to horse. to confirm a diagnosis. The tissue death eventually causes the neural distress seen in symptoms. however. Incoordination and weakness are often exacerbated by going up or down slopes or movement when the head is elevated. but rather spread by a definitive host.” Morgan said. as this is what opossums feed on. loss of use of the horse and veterinary care. so if affected. the opossum. an owner might choose to start treatment without knowing for sure what it is. depending on where the protozoa attack the nervous system. “It can vary from a horse that’s just not doing right.). The disease’s symptoms were first reported about 40 years ago. Currently.” Clean up dropped feed immediately to discourage scavenging. the schizont eventually ruptures. circle and move on an incline. A 1998 study* estimated the yearly cost of EPM at $28 million. antiparasitic and antimicrobial drugs. Do not feed horses on the ground. Equine protozoal myeloencephalitis (EPM) attacks the horse’s central nervous system. which include watching the horse back. skunks and armadillos carry the protozoa. In Navigator. Recently released products include Navigator (produced by IDEXX) and Rebalance (Phoenix Scientific). although according to Morgan up to 60 percent are able to improve to some degree following treatment. blinking and the gag reflex work properly. The merozoite then gains access to the central nervous system by crossing the blood/brain barrier to the brain. A small sack or pouch of multiple merozoites.

we know it’s not going to hurt and it may help in the healing process.” *Study conducted by National Animal Health Monitoring Systems (NAHMS). “We know that it doesn’t help if you’ve got frank damage to the spinal cord. a division of the United States Department of Agriculture. Studies indicated that higher levels of vitamin E might aid the regeneration of peripheral nerves. which is an oral liquid administered via . so let’s go ahead and use it. those studies indicated that there may be a 3 www. hey. A horse affected by EPM might have trouble and be pulled off balance.ingredient is nitaoxanide.” said Morgan. and in Rebalance it is sulfadiazine and pyrimethamine. JIM BRET CAMPBELL In a neurological test.americashorsedaily. It’s one of those things that. www. while Rebalance is given from 90-270 days. “But for peripheral nerve healing. In addition to the medication. horses are also commonly treated with vitamin E. also in an oral paste. The first two are treated over 28 days. a normal horse can resist a pull on the tail. .com 4 www.www.