| EPM: Syndrome or Symptom?
EPM, or equine protozoal myelitis, is being reported and diagnosed with increasing frequency. Let's take a quick look at the symptoms and common diagnosis and treatment. The horse may initially just act a little depressed and be unwilling to work. In the next phase,hyperexcitability and behavioral problems such as bucking, head tossing and emotional symptoms may show up. Then, sore back, rear end weakness and incoordination manifest. Often, the misdiagnosis is sore hocks, sore stifles, etc. At the point where severe neurological damage has occurred, the horse may show atrophy or wasting of the rear end muscles, dog-sitting behavior, and/or total inability to control the hind or front limbs. Veterinary therapy consists of aggressive treatment for a number ot months with pyrimethamine and sulfa drugs. A few horses recover completely, some recover but with impairment, and some never recover. Interestingly, many veterinarians are coming to the conclusion that the equine Herpes virus (Rhino Pneumonitis Neurotrophic Herpes Syndrome) and EPM are frequently found to coexist.
The culprit has been determined to be a protozoan parasite called sarcocystis neurona, which is harbored by opossums, and transmitted via certain species of birds. When opossums urinate and defecate on hay or grain, the parasite is ingested by the horse, and the games begin. The only definitive test for the syndrome is a cerebrospinal fluid tap, and by the time a tap is positive, the blood/brain barrier has been breached and major neurological damage has taken place. There is a blood test available, but that only confirms the presence of antibodies to the parasite showing that exposure has occurred, and most of the seropositive horses do not develop the EPM syndrome. So why do some horses get EPM, while the vast majority of those exposed do not?
There is getting to be a lot of hysteria around this situation, and I am up to 2 and 3 calls a day seeking help for horses that exhibit symptoms or are serologically positive. Let's look rationally at the situation.
Opossums have existed for a long, long time, and have been happily pooping and peeing in hay barns for centuries, at least. Gosh, could it be that horses are not as healthy in recent times as they used to be? The first and best line of defense against any ingested parasite or bacteria is healthy stomach acid. In order to make strong stomach acid, the parietal cells of the stomach need to be bathed in an alkaline medium.What is alkalizing to equine (and human!) bodies? Altogether now: bioavailable (properly chelated) minerals! And a sensible protein level (12% for horses) as is found in a diet of top quality grass hay and grain without a lot of protein additives and sugars (molasses). A pH imbalance due to high carbohydrate (grain) diet and too much protein (alfalfa hay) throws open the door for parasites and harmful bacteria to invade, according to veterinarian Dr. John Whittaker. The digestive microbes must also be on top of their game, fortified with a pH balancing medium that allows them to be strong and.to deter the harmful microorganisms.
What are the microbe zappers? Hauling, competition, chlorinated water, chemical wormers, antibiotics, Bute, over-vaccination ..... I am sure you can add a few more.
Next, we need to look at the immune system. The primary enzymes that control immune response are S.O.D. (superoxide dismutase) and glutathione peroxidase. These enzyme systems have at their core trace minerals, primarily copper and zinc. The immune system can be stressed any number of ways. Dr. Marvin Cain states, "The pharmacologic approach (the drugs mentioned above) does not kil the EPM organism. Definitive control is dependent upon the immune system. Compromising the immune system with stress, whether environmental, nutritional, emotional, pharmacologic in the form of repeated vaccinations or corticosteroids given in suffficient quantities to cause white cell suppression, can with all or any cause exacerbation of the immune system. What does this all mean? Simply that our focus must shift from treating symptoms which is becoming outrageouslv costly, to say nothing about the extreme problems that the animals must endure, to maintaining the integrity of the immune system. We are not going to kill the Herpes or EPM organisms. We can coexist with them as long, as the immune system is healthy."
So, what can we do to make sure that our animals have healthy immune systems? Properly chelated minerals as found in Dynamite, Dynamite Plus or TNT and/or Pelleted Grain Ration is where I start. Whenever there is any kind of stress - hauling, weather changes, competing, etc. the whole barn gets a daily blast of DynaPro. My horses get Herbal Tonic several times a year for 28 days, then I use parasite reflex point testing to determine the need (if any) for chemical worming. I used to worm by the calendar, but discontinued that practice years ago. If they need it, it, if not, they don't - pretty simple. Any sniffles or snarfles are attended to with some Ester C or Hiscorbadyne, for the immunostimulant properties of vitamin C. If I know the horse will be subject to a major stress like a cross-country haul, I will do 10 days of SOD powder. The chelated copper, manganese and zinc in this product are the trace minerals that promote production of the SOD enzyme, the best immune booster possible.
We have actually had good success on EPM positive horses that were manifesting some symptoms, or on horses exhibiting neurological symptoms from any cause, by giving them the following nutritional support:
- Dynamite Plus and new E- Selenium, or Regular Dynamite, or TNT
- DynaPro twice daily to support the healthy gut bacteria
- SOD powder for 10 days every three months
- MSM at 16 tsp per day for bioavailable sulfur
- 2 cloves of fresh garlic, also for sulfur
- Ester-C® or Hiscorbadyne for vitamin C
- Hypericum 30 c homeopathic, for nerve damage
- Choline, a B vitamin available at health food stores, which enhances nerve transmission to the muscles
This nutritional program can be given with the antibiotics and sulfa drugs if that course of treatment is chosen, just be sure to give DynaPro at least an hour afterwards to help re-establish the gut bacteria. Homeopathic sulfur also seems to be helpful. There is an EPM accupressure test point discovered by Carl Nafziger, trainer of Kentucky Derby winner Unbridled. It is behind the patella (stifle joint) and behind the lateral condyle of the femur, over the tibialis nerve, between the bellies of the biceps femoralis muscle. (That should send you all scurrying to the anatomy books!) Light pressure causes an extreme pain reaction if EPM is present, and this test point will show up long before a spinal tap confirms the syndrome, so it is valuable in early treatment.
Remember: "Insects, bacteria, parasites and disease are nature's garbage collectors." The best offense against any of these is a good host defense. Rather than grabbing your gun and blasting away at opossums, consider that the EPM "syndrome" is actually just another symptom of a compromised immune system. Parasites, bacteria and diseases are around us all the time, and we succumb to them only if we are unhealthy. There seems to be a point of diminishing returns on a worming and vaccination program, so work with your practitioner to determine the best schedule for our horses and don't over-worm and over-vaccinate. Spread out the stresses: don't vaccinate and worm on the same day; consider giving single vaccines instead of 4-way, and space them out over a period of time; don't ride, ship, or stress the horse in any way just before or for a few days after a vaccination. If the horse is not healthy, wait to worm or vaccinate. You might wish to explore the safe, effective and non-invasive homeopathic nosodes as an alternative to vaccines. Build the immune system with optimal nutrition, homeopathy, massage, or whatever modalities speak to you. We have noticed an increase in neurological deficit symptoms the last number of years in horses who receive Ivermectin wormers or Quest, which are neurotransmitter inhibitors. The rhino vaccines are also a nerve-culture based vaccine, as is the West Nile Virus vaccine, and a number of veterinarians whom I know personally recommend avoiding these vaccines. Repeated use of these wormers and vaccines have been known to cause symptoms which mimic EPM, as well as reducing the effectiveness of the immune system.
And remember to throw in a good dose of love, the greatest healer of all!
(see related article: That West Nile Thing)
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