Equine Protozoal Myeloencephalitis

Listen in to the Traditional Chinese Veterinary Medicine segment of the Driving Radio Show.

We have 2 shows about EPM.

In Episode 253 : EPM part 1, Dr. Ellison of Pathogenes, Inc in Ocala Florida tells us about her EPM research and novel treatment strategy. The TCVM segment starts at 36:22.

In Episode 288 : EPM part 2, Dressage trainer, Karen Abbattista shares her rehab protocol for horses post therapy. The TCVM segment starts at 49:04.

To listen to other episodes of our podcast visit ​The Driving Radio Show and you can find even more equine, pet and health shows on The Horse Radio Network, the voice of the horse world ! 

Epm part one

EPM part two

What is Equine Protozoal Myeloencephalitis - EPM ?

EPM is a syndrome caused by single celled organisms (protozoa) that infect the horse and cause inflammation and pain in the brain, spinal cord and muscles. This inflammation can cause clinical signs like lameness, weakness, a behavior change, stumbling, muscle atrophy.

The definitive host, the opossum is infected by eating infected muscle tissue from his prey or road kill that happens to be an intermediate host. Intermediate hosts have been identified as armadillos, cats, skunks, racoons, sea otters and harbor seals. The parasite then replicates inside the opossum to an infective stage and is released upon the world in opossum poop. The horse becomes infected when he ingests sporocysts from food or water that has been contaminated with opossum droppings.

The horse is a dead end host for the parasite, meaning the horse's body is not the right environment for the protozoa and it eventually dies off before completing its life cycle. These dead parasites can cause damage to any part of the nervous system so any neurologic sign is possible. Symptoms can be acute or chronic, severe or mild so it is a very difficult disease to identify and diagnose.

How is it Diagnosed ?

Owners usually notice a change in behavior as the first sign, maybe the horse is now all of a sudden spooky on trails or has started bucking. Sometimes the signs can be as subtle as muscle atrophy and/or poor performance. In these cases we will typically be called in a few months later when many common issues are ruled out and the neuro signs start to become more evident.

EPM can sometimes present very suddenly with a downed horse and diseases like neurologic rhino or Eastern Encephalitis or West Nile need to be ruled out and aggressive supportive care needs to be started immediately. These cases will go into a clinic and diagnostic test may include a spinal tap which is the gold standard for diagnosis for EPM. In the early stages with mild symptoms, conventional diagnosis can be a positive response to treatment such as Rebalance or Marquis.

TCVM Diagnosis and Treatment

In our practice each exam starts with tongue and pulse diagnosis plus an acupuncture point scan follow by standing and moving evaluations. A horse with EPM will usually be very painful in his whole body and have some level of neurologic abnormality. The scan may reveal other concurrent diseases such as ulcers or arthritis.

The TCVM diagnosis is a mixed pattern of Qi Stagnation (pain) and Qi Deficiency (weakness).

If we suspect EPM we take a blood sample and send it to Dr. Ellison at Pathogenes to screen for EPM and Lyme's Disease. Dr. Ellison has developed some novel tests and protocols to diagnose and treat EPM. You can read more about it on her website and listen to her interview on the TCVM seg of the driving radio show ....scroll down for the player. *** Many Thanks to Kate McCaffery for encouraging us to participate in Dr. Ellison's program****

Acupuncture and Chiropractic Care would focus on relieving the pain, tonifying the Qi and supporting the immune system. The points I use will be based on the exam but because there is an autoimmune component to these cases I always include hemo-acupuncture which involves injecting some of the horse's own blood into certain points.

Herbal Therapy
Herbal Therapy is very helpful in these cases for 3-6 months after the initial diagnosis and treatment.
Qing Hao San - "Artemisia Powder"
Tonifies the Qi, strengthens the immune system and eliminate the parasites.

Dr. Xie developed Qing Hao San based on Dr. Tu's nobel prize winning research using Artemisia to treat Malaria (also a protozoa like Sarcocystis), combined with of 2 traditional formulas, Guan Zhong San (Dryopteris Root powder) and Si Jun Zi Tang (4 Gentleman). Read more about Dr. Tu's research here.

To Order Qing Hao San, follow this link

Food Therapy
Our food therapy recommendation include foods that are high in vitamin E and antioxidants.

Black Sunflower seeds - high in Vit E and omega fatty acids
Chia Seeds - High in Vit B and omega 3s, Black sunflower seeds have an imbalance of omega 6 to omega 3, the chia can help balance that ratio.
Lyceum berries (goji berries) high in Vit C and antioxidants
Spirulina immune booster by stimulating IgG antibody production

My favorite sources are
Sunflower seeds - TSC
​Chia - US Chia
Lyceum berries and Spirulina - nuts.com

Homework
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What can you do to help your horse recover and reduce the chance of reinfection.

• Do not leave feed tubs in stalls or in the pasture overnight and wash feed and water buckets daily.
• Avoid leaving pet food in the barn your barn cats can eat mice !
• Review your wellness program with your vet to make sure you are helping and not harming your horse's immune system

Coming soon - rehab exercise videos