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Diagnosis
Conditions or ailments that are the cause of a problem that you see - your observation.

Your vet may diagnose

Equine Protozoal Myeloencephalitis, EPM

Synonyms: Sarcosporidiosis

Summary

Equine Protozoal Myeloencephalitis, Myelitis is the most common infectious cause of neurologic disease in horses. It is caused by one of two protozoal parasites (Sarcocystis neurona or Neospora hughesi), that attack the brain and/or spinal cord and damage the nerve tissue.

Sarcocystis neurona has been implicated in the disease for years. Neospora as a causative agent was discovered more recently. Sarcocystis has a complex life cycle involving the opossum as definitive host, so it is more prevalent in areas where opossums live.

Usually, a horse contracts Sarcocystis by ingesting contaminated opossum feces that have been deposited in water, feed, hay and pasture areas.

Signs of this disease are similar to those associated with other spinal cord disease disease and severity can range from mild to severe. Classic signs are wobbliness, weakness and areas of muscle loss. Often, signs appear asymmetrically, and are worse on one side.

A great deal is written about EPM and much can be found on the Internet. However, there is also a great deal not known about the disease. The hardest part of dealing with this disease is establishing a definitive diagnosis. There is a great deal of misdiagnosis surrounding EPM.

There are many limitations and uncertainties associated with this diagnosis. One of the greatest difficulties in diagnosing this disease is separating horses that have been exposed to the disease from those that truly have the disease. In addition, many cases are complicated by unclear or confusing laboratory results.

There currently are several different tests being used. We use the UC Davis IFAT test, which returns a likelihood of infection.

Your vet may lean toward this diagnosis after taking a careful history and performing a careful physical and neurologic exam. Usually the signs are worse in a localized area or on the left or right side. Antibody testing is performed on a blood sample, and cerebrospinal fluid may be taken and analyzed. Radiographs may be taken to rule out other possible diseases.

my vet's role

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OTHER DIAGNOSES CONSIDERED

Other conditions or ailments that might also need to be ruled out by a vet.

Very Common
Less Common
Rare
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PROGNOSIS AND RELEVANT FACTORS

The prognosis is fair with early diagnosis and treatment. A majority of cases that are properly diagnosed and treated show great improvement, but about 10-20% will relapse and require more treatment.

There may be long-term neurologic deficits even in horses that have been successfully treated. It is somewhat determined by the severity of damage to the spinal cord.

my role

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I might observe

You might make these observations when a horse has this condition.

Very Common
Less Common
Rare
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Questions To Ask Your Vet:
  • How severe is the disease process?
  • How long will the course of treatment take and what is the cost?
  • What are the chances of relapse?
Prevention

There is no vaccine for EPM, so other preventative measures are very important. Keep opposums, cats, skunks and other animals out of your horse facility, and especially away from your horse feed storage areas.

Good facilities management to decrease the population of rodents is recommended, including the use of traps and bait. Remove brush piles where rodents like to live. Keep your tack room clean and keep all grain and treats in sturdy trash cans or plastic bins with lids.

Keep your horse in good health to maintain strong general immunity.

further reading & resources

Author: Doug Thal DVM Dipl. ABVP