EPM Symptoms in Horses
December 29, 2011
Know the three A’s of EPM symptoms in horses.
In a neurological test, a normal horse can resist a pull on the tail. Journal photo.
From The American Quarter Horse Journal
Equine protozoal myeloencephalitis is a neurological disease caused by a tiny parasite. Opossums carry the parasite, and horses contract the disease by eating feed or drinking water contaminated by opossum feces.
The EPM symptoms in horses include the three A’s: Asymmetrical ataxia (incoordination) with or without muscle atrophy (degeneration).
EPM Symptoms in Horses
Signs of EPM vary from horse to horse, depending on where the protozoa attack the nervous system. Onset of the disease is most common in summer and fall months, and symptoms can develop slowly or present themselves within several days. They can range from mild to severe. Often the first indications are stiffness, asymmetrical gaits and cranial nerve deficits. Symptoms include ataxia (incoordination), spasticity (stiffness, abnormal gaits or lameness, muscle atrophy, paralysis, difficulty swallowing, head tilt, seizures and collapse, abnormal sweating, loss of sensation and poor balance). Incoordination and weakness are often exacerbated by going up or down slopes or movement when the head is elevated. Cranial nerves control function of the head, so if affected, the horse might have paralysis of the face, problems coordinating actions (chewing, dropping feed, etc.), swallowing or vocalizing.
“I’ve had people report that they noticed when the horse whinnied, it sounded different,” Dr. Kenton Morgan, an equine veterinary specialist for Pfizer Animal Health, says.
A horse suspected of having the disease should be inspected by a veterinarian as soon as possible. The first step is a general examination, followed by a neurological exam. The neurological exam includes assessing the cranial nerve function and working down the body to make sure the sensations are normal. Neurological deficiencies are scored from 0 (none) to 4 (obvious abnormalities). Cranial nerve checks include making sure the nerves that control eye dilation, blinking and the gag reflex work properly. Problems the vet might watch for in the neck include lack of flexibility or abnormal muscling. The vet will perform a panniculus reflex test, using a blunt object (such as a ballpoint pen) to press on the skin all the way down the backbone. A normal horse will twitch the skin, as if trying to rid himself of a fly. There are also gait assessments (known as proprioceptive tests) that include watching the horse back, circle and move on an incline. The examiner might also test the horse’s balance by pulling his tail while walking. If the horse loses his balance or is unable to resist the pull, this shows neurological damage. At a halt, the vet will also move one of the horse’s legs across his opposing leg to check the horse’s awareness of where his feet are (the horse should return the moved leg to its normal position within 30 seconds).
EPM is a devastating disease. Learn all you can about it and be prepared in case it happens to your horse. Let AQHA help with our FREE EPM report.
If there are signs of EPM, an owner might choose to start treatment without knowing for sure what it is. However, to confirm a diagnosis, a blood and cerebrospinal fluid analysis can be done on the horse. The blood test will only tell if the horse has been exposed to the protozoa, not if he has the disease. A spinal tap, however, will reveal if the protozoa has accessed the nervous system.
Studies estimate that only 40 percent of horses affected by the disease are able to recover fully, although according to Dr. Morgan, up to 60 percent are able to improve to some degree following treatment.
EPM Quick Symptoms Checklist
- Incoordination (ataxia): stiff, stilted movements (spasticity); abnormal gait or lameness.
- Incoordination and weakness that worsens when going up or down slopes or when the head is elevated.
- Muscle atrophy, most noticeable along the topline or in the large muscles of the hindquarters, but sometimes involving the muscles of the face or front limbs.
Since approximately 50 percent of U.S. horses have been exposed to the organism responsible for EPM, it is extremely important to know the signs of infection. Early detection and treatment are key to recovery. Download AQHA’s FREE EPM report to start protecting your horse.
- Paralysis of muscles of the eyes, face or front limbs.
- Difficulty swallowing.
- Seizures or collapse.
- Abnormal sweating.
- Loss of sensation along the face, neck or body.
- Head tilt with poor balance; horse may assume a splay-footed stance or lean against stall walls for support.
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18 Comments on “EPM Symptoms in Horses”
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December 29th, 2011 at 2:48 pm
We actually lost a horse this summer due to EPM, I can tell you it is one of the worst things to watch a horse go through.
December 30th, 2011 at 6:58 am
I have a mare who survived severe EPM and even came back very close to 100%. She received Marwuis for 7 months, plus careful and intensive physical therapy by my husband. She is again very athletic and a lovely mover. However, EPM left her with a paralyzed vocal cord, making her a “roarer” and derailing her show career. It certainly doesn’t impede her ability to perform, but it does sound bad. My world class trainer said mystery needs tie back surgery which I decided to forego. I don’t like involved risks.
December 30th, 2011 at 6:59 am
Make that, “Marquis”
December 30th, 2011 at 7:00 am
Stupid iPhone autocorrect; my trainer said Magic needed tie back surgery! No “Mystery” involved
January 3rd, 2012 at 3:33 pm
Thanks for creating more awareness about this awful disease. It can strike any horse at any time,but most especially horses that are under any kind of stress. The more educated horse owners are,the better. I know from personal experience how devastating EPM can be. My horse was diagnosed with it several years ago after having been seriously ill with a bacterial infection. It was heartbreaking to watch him go from a fit athlete to the point where he was literally falling over backwards. It was absolutely one of the worst periods I have ever been through! Thanks to good vet care,Marquis,diligent physical therapy which I began as soon as he could walk without difficulty and the fact that my horse has a heart as big as Texas,he is now 100%. We are back trail driving him and he has no difficulty at all with negotiating rough terrain,hills,etc. He also was back in the show ring the following summer and winning ribbons.I cannot stress enough to anyone who is going through this the importance of getting out there and doing groundwork every day with your horse as soon as possible. I also credit Vitamin E and MSM with playing an important role in his recovery.
January 5th, 2012 at 3:33 pm
Horse owners should know that a spinal tap is not necessary to get a reasonable diagnosis to decide on treatment. Sequential SAG Eliza tests or IFAT blood tests done a few weeks apart if the result is questionable as to exposure or infection. If the result increases 2-4 weeks after the first test then the horse is fighting an infection of the parasite. If caught early, most horses can make a full recovery. There are medication options too that won’t break your pocketbook so do your homework and get second opinions if your vet is not open to various options. It is not a death sentence anymore!!!
January 10th, 2012 at 5:24 pm
My horse was finally diagnosed with EPM after having displayed symptoms for at least 3 years. The vets did not want to treat it as EPM, but finally relented. After 7 months of Marquis, he improved to about 75% of normal. Now, 2 years after Marquis, he has lost his sight almost completely, and has become more ataxic in the rear end. Can anyone advise? I haven’t found a vet knowledgeable or willing to research what to do now.
March 1st, 2012 at 10:50 pm
You might want to nresearch and speak with dr ellison of http://www.pathogenes.com for field trial.studies for a new epm test and drug.
June 13th, 2012 at 7:35 am
If “Marla” still is in need of help with her EPM horse, I STRONGLY advise contacting Dr. Fred Shiery in Camden Michigan. His success rate is amazing!!! (tip- he does not use Marquis) 517-368-5721
June 22nd, 2012 at 7:42 am
My apoloosa mare was diagnosed with EBM two years ago after having multiple seizures. She was treated and after about six months seemed to be doing great. Two weeks ago when I was putting on her bridle to go out for a ride she had another seizure in the wash stall at the barn. This was not as severe as she has had and she didn’t fall down. (thank heaven that she was not hurt) I had read enough to know that the reoccurance was possible. Now we are at square one and I am trying to decide what to do. The only difference is this time I don’t feel completely lost. She is my first horse and she has helped me through a lot.
July 14th, 2012 at 10:21 am
So glad I found this sight! I need advise from people who have been through this with their horses: background: Cisco, 5 year old mustang/quarter cross. I can trace the symptoms back to October 2011 on a trail ride standing on a slight downward slope Cisco sat down like a dog and rolled on over with me in the saddle. People with me thought he may have gotten his rear legs tangled in briars. 2 weeks later on a medium-challenging uphill climb he struggled, lost his confidence and balked. I had to have another rider pull him with me walking behind. Up to this point he was exceptionally steady, confident and sure-footed. Over the course of the winter Cisco began displaying mild signs of a stifle problem, which gradually migrated to both rear legs. It was occassional. Then came the loss of strenth in the hocks where the leg(s) would simply buckle a moment. As this problem grew more frequent he began showing signs of depression and carrying his head lower (straight, no tilt, but abnormally low. I am beginning to notice him “park out” on his front legs when he’s at rest but the rear legs will be cocked (toes pointed inward) with one rear foot under his belly it appears, for balance. In April he saw a chiropractor who diagnosed a shoulder issue. The adjustment had no affect whatsoever, however I noticed (for the first time) when I loaded him, stiffness in his front legs and shoulders. Through my internet research I have found EPM. I have an appointment with our vet this Wednesday for testing, however he does not seem to be very knowlegable about the latest testing (Multiplex Sarcocystis neurona Detection pack–20 minute test with no false positives) or the latest in treatment/field trial (Oroquin-10 through Pathogenes, Inc). I have faxed this information to him requesting his assistance by getting the test for our Wednesday appt and depending on what the test says, getting us into the field trial. I do not know if he will be willing. However here is my question/dilema: I haven’t been able to determine how long a horse will display mild symptoms before the big ones (seizures, teetering while walking, falling) become evident. It seems like this has been coming on for a while (since October) and has SLOWLY progressed. Cisco is not that bad even yet. Just the mildest signs…carrying the head low, the buckling of the rear legs, stiffness in the fronts and the depression, which is mild. And I have not seen him play or gallop in months. He just quietly follows the others. I keep hearing that if it was EPM, he would have progressed much faster without treatment. But my common sense tells me each horse would be different depending on their own immune system and other contributing factors. It appears to me he is fighting this, but it’s beginning to get the better of him. Please note: Cisco has never shown signs of a virus–snotty nose, cough, temp, etc. Just a very SLOW deterioration. Readers, in your experienced opinion: Is EPM the likely culprit?
August 8th, 2012 at 10:41 pm
I just had my horse diagnosed with EPM 3 weeks ago. He was treated with Oraquin 10 and now is stating the follow up powder that is added to his grain 1x each day. I am very concerned as to the recovery. We are walking him each day about 30 feet. We take each step very slowly and let him rest in between steps. We have had one really great day, where he lifted up each hind leg and held it up as if he was getting his hoof cleaned. We were very impressed that he was able to do that. The next day, he could barely keep his balance on his hind legs. He is also being treated with natural Vitamin E. My gelding is 26 years old. I really am not sure about the re-hab and what we should expect.
August 8th, 2012 at 10:45 pm
I also forgot to mention, the only symptoms we had noticed was that he seemed to be lame on his right hind leg. I had the vet look at it and I was told he had soft tissue damage and to treat accordingly. He did not seem to get better. We have had extremely hot weather this summer, and I noticed he did not shed out completely and was sweating profusely. I called the vet and requested she draw blood for a Cushing’s test when he was preliminary diagnosed with EPM. He also was dropping grain in the early spring when eating, but needed his teeth floated, and therefore assumed the problem was rectified. There were symptoms there, but did not put them together to even think it was EPM.
October 7th, 2012 at 9:03 pm
I have a 9 yr. old donkey. I have had her approx. 1 yr. recently about 8 months ago or so (Cindy) has been trying to roll over. When she does this she gets stuck on her back and can’t move. She thrashes her legs around. They are stiff. and she throws her head around. Sometimes I have found her laying on her back not moving, still. She absolutly can not get herself off her back. Cindy has a very flat back. Since I have had her she favors her back. At times it seems like her back might be broken.She is fat and has many large fat pockets. People tell me that’s the problem and another says EMP. Not sure what to do. Everyone says “It’s only a donkey!”/Users/juneeddings/Desktop/0217121245.3g2 I am enclosing a video of Cindy. Can someone suggest something to me?
December 6th, 2012 at 12:54 pm
My horse Rascal was tested for EMP on Monday. We moved him from one ranch that had 25 horses to a ranch that only has 3 horses and with him being at the ranch with too many horses put a lot of stress on his body which caused him to start showing symptoms (at least that’s what the vet told us). But Monday when we called the vet, the sheath was swollen which causes him to have a semi erection. Is this common in horses that could have this? We are still waiting on test results to confirm but I just wanted to see if anyone else has had this happen and was told something different.
December 17th, 2012 at 3:10 pm
I have a two year old thoroughbred mare..she is a track rescue from South Dakota and is now calling Manitoba Canada her home…I got her in June of this year (2012) and she was good..when we brought her home after pasturing her on a friends property she seemed (on colder days) to drag her right hind leg…we didn’t really think anything of it since it just seemed to be the way she walked…lazy like.
Now it is December and the when the temps got colder she seemed stiffer in the rear end…a few days ago she walked outside and while she was walking she seemed very wobbly in the rear end almost like a drunk person would walk…after a few steps outside she collapsed…
My husband and I were able to get her up and bring her into the barn…the next day it was worse…she would fall down several times during the day and on Sunday she spent most of her time laying down….we propped her up with bales of hay so she would not lay flat…she seems comfy and eats and drinks as well as does her busines…vet was here and can’t figure out what is going on with her…he thinks it may be an injury from the track from being raced at to young of an age and damage was done…but a friend who has dealt with horses all her life said that this sounds a lot like EMP…
My horse Santana tries to get up but just seems to not have the strength in her legs…both her front and hind right leg are swollen…her knee bone is very defined and it looks like protruding when she relaxes her legs…Thank you all for posting this it helped me a lot since some of the symptoms my horse has have been talked about here as well and I will pass this on to our vet…I don’t want to lose my little girl…she means the world to me!!
January 30th, 2013 at 1:08 pm
From a horse owner and friend of ours in Oklahoma City: “My appy gelding recently had EPM symptoms pretty bad, EPM is a death sentence in almost all cases. Three weeks on two Protandim a day, he has no symptoms at all and is running, playing and being obnoxious again. Now he hunts me down so he can try to get in the pocket where he knows I keep his Protandim. He eats it right out of my hand like it’s his favorite treat.”
PROTANDIM is an Nrf2 activator in mammals and is not designed to cure, prevent or treat any disease, says it’s manufacturer, LifeVantage Corp. Here is an amazing ABC NEWS report on this phenomenal product for all mammals: http://www.2nrf2.com
March 28th, 2013 at 7:03 pm
My 28+ QH Gelding displayed EPM symptoms for 2 days before I googled and found this site or even what EPM was. I was not sure but was hopeful it was a pulled tendon or muscle, but after wathching videos of horses with this I could not help but notice this is how my horse walked. Our vet came out on day three of showing ataxia and what seemed to be muscle weakness and is pretty sure it is a blood clot in his upper thigh. Due to his low body temp and history of the horse being bitten by a dog in the fetlock area a month prior. When he was bit. it bled alot for a long time. It was bandaged and treated for almost a month. Also a shot for (Tetnus, and antibiotic) was given the same day. Today he was given a steroid injection plus a IV of DMSO and is on bute. The vet also advised 5000iu of vit E a day and also ultraguard past for stomach upset from meds. I am continuing to monitor my horse and am staying hopefull this is the answer. I am also praying for all the horses that have EPM. It is very very heartbreaking.