EPM is one of the most difficult to pinpoint and progressively debilitating neurologic diseases to strike the horses we love. by LA Pomeroy
When it savages the central nervous system, it leaves behind gait abnormalities, ataxia (inability to control voluntary muscle movement) limb spasticity, sore backs, locked stifles, and muscle atrophy. If it attacks the brain stem, the results are depression, behavioral changes, facial nerve and/or tongue paralysis, roaring, vision problems, drooping eyelids, and difficulty swallowing. Left unchecked, it will take a horse’s life.
“It” is equine protozoal myeloencephalitis, or EPM, and in the United States, the number of horses who test positive after exposure to it varies from 5% or less among wild herds in Montana and Wyoming to 50% or more among backyard barns and professional show stables abutting the natural habitat of opossums. Yes, opossums have been identified as a vector (transmitter of disease) for EPM. But this “enigmatic infection,” as the UC Davis Center for Equine Health calls it, is more complicated.
Clinical researchers Chinedu Njoku, William Saville, and Stephen Reed, who have looked at how reduced levels of nitric oxide metabolites in cerebrospinal fluid are associated with EPM, observe: “EPM is the most prevalent cause of neurologic disease in horses in the Americas. In some parts of the US over 30% of horses have antibodies to Sarcocystis neurona (the most common protozoan parasite causing EPM infection), although a much smaller percentage develop clinical EPM, indicating that additional factors, which we do not yet understand, contribute to the onset of this disease.”
Alternative equine care practitioners who say they have been treating EPM symptoms in racehorses and performance horses for decades are also looking at some of those “additional factors,” and arriving at some bold new conclusions that may help take aim at a disease that has staunchly remained a moving target.
According to EPM expert Robert MacKay, BVSc, PhD, DACVIM, roughly 60% of horses who get an active infection will respond to drug treatment, with 10% recovering fully.
“That leaves 40% of cases in declining health, usually ending in death,” MacKay notes. “The better news is that, if diagnosed and treated early, the statistics rise to 80% responding well to treatment, with many recovering fully. You, the owner, can make the difference in where your horse falls in the statistics by learning prevention and how to identify symptoms of EPM before it strikes.”
Because 30% to 60% of horses in North America have antibodies to the primary protozoal parasite responsible for EPM, S. neurona, UC Davis researchers call EPM inherently difficult to diagnose: “At present, definitive diagnosis of EPM relies on post-mortem examination of neural tissue. No test in the live horse is currently considered definitive.”
One opinion says it’s the owner’s responsibility to diagnose EPM early; another says the only way to confirm it is after death. What’s a horse owner to do?
ACUPUNCTURE: GOOD VIBRATIONS
Dianne Volz has dedicated more than 20 years to using acupuncture points, electric muscle stimulation, ultra- and infra-sound, and laser and photon therapy to listen to the equine immune system and respond accordingly. Her mentor has been Dr. Marvin Cain, founder of the Equine Acupuncture Society of America, who is credited with identifying acupuncture’s EPM immune points, and has suggested a link between suppression of the immune system and EPM.
“Eighty percent of horses we look at are in some stage of EPM,” she says. “Those who don’t have a strong immune system are in greatest need of a defense against the protozoa.”
In Chinese acupuncture, diagnostic points are called “Au Shi” and are sensitive during periods of illness, when the body’s electrical systems are disrupted. Blockages of energy or Qi (pronounced ‘Chi’) cause buildups in inappropriate places (much like a tree falling across a stream blocks the water, flooding areas nearby). When an aggravating condition in the body is resolved (the “tree” removed), Au Shi points ebb away, too.
Volz identifies EPM acupuncture points as located in a triangle over the rib cage, hip, hind leg, and shoulder. “When these points are reactive, we find soreness, hock tenderness, and a tendency to shift weight to the forehand. Therapeutically, we look at the whole body, but we tend to see EPM expressed in the right hind leg.”
This right-sided affliction is important, since EPM mirrors other neurological diseases including Wobbler Syndrome, Equine Herpes Virus (EHV-1), or Lyme Disease. Dr. Cain has observed that soreness or lameness expressed in the left hind tends to lead to a diagnosis of EHV-1; signs in the right hind are more likely attributed to EPM.
Pocono Downs Race Track veterinarian, Dr. David Sachs, who uses acupuncture and acupressure on its racehorses, also sees problems in the right hind trace back to EPM. He thinks EPM has reached “nearly epidemic” proportions and for young racehorses following a circuit, without time off to rest and rebuild their immune system, recovery is difficult.
“Without three to four weeks off, a racehorse can’t bounce back,” Dr. Sachs says. He prefers avoiding corticosteroids (“It bothers the immune response”), and has seen his best results over the last three years treating EPM with kinesiology and injecting “hot” points with the patient’s own blood.
The theory behind blood injections is that, through spinning the blood in a centrifuge, red blood cells are removed, and the remaining platelets (containing helpful hormones and proteins) de-granulate, so they can be injected more “cleanly” back into receptors in the horse’s body.
Lindsay McLean, an acupuncturist who also identifies EPM by what she calls “Environmental Illness” points, says horses get “very beneficial effects when blood is injected. It is especially helpful for depressed states, chronic fatigue, and autoimmune disorders.”
Dr. Sachs emphasizes that the degree of success depends on where in the EPM cycle the treatment begins. He has had “good results” when injecting sites two to three times per week. “Check the points to see if they are hot, and if necessary, inject again.”
Gary and Michaela Young opened Camden Equine Rehabilitation and Conditioning Center in Camden, South Carolina, earlier in 2010 to offer alternative sports medicine and veterinary technology for equine injury recovery, post-surgical care, and accelerated conditioning.
“We started with Dr. Cain a long time ago,” Gary Young says. “Along with our vet, Dr. Sam Tetterton, we have probably brought more horses back from EPM than just about any stable in the country. We have been treating it for over 25 years.”
Like Dr. Cain, Young has discovered markers for EPM on the hindquarters, with signs arising in the right stifle first, and in immune points in the shoulder. One test he uses to determine if a horse is EPM-positive is to blindfold the animal and see if it can walk a straight line. “Since EPM can affect the brain stem and coordination, they can’t walk straight.”
IMMUNE TO HARM
Young calls EPM the single most misdiagnosed equine disease in America today: “In the 1960s my parents believed horses who showed ‘Wobbles’ were showing the first signs of EPM. The parasite has since changed and evolved.” He cites how blood tests identify two protozoa (S. neurona, and less commonly, Neospora hughesi), but who’s to say we are not missing others?
A strong immune system is the first line of healthy defense.
“Stress and/or a weakened immune system can cause relapses,” Young says. He often suggests administering an ulcer-prevention drug prior to shipping, to lower the chance of relapse, since “parasites love ulcers.”
Young owns a horse with EPM, and his personal strategy is low-stress, low-impact therapy. “Aquatherapy – working on a treadmill in water – keeps muscles conditioned while minimizing stress.”
He also uses Pulsed Electro-Magnetic Field (PEMF) MaganWave to stimulate cell metabolism and tone down “hot” nerves: “Cell protein synthesis is enhanced, which allows the body to take advantage of all the protein available. Circulation is improved, not by increasing heartbeat or blood pressure, but by opening and dilating arteries and capillaries, and the lymphatic system is stimulated, to clean damaged areas and detoxify the body.”
Young and Volz both use Chinese herbs to help boost the immune system. “Twice a year, I ‘clean out’ their systems with Chinese herb supplements,” Young says. “I also supplement before shipping. Even if my horse is ‘clean’ at home, shipping can cause a relapse so I keep them on supplements while at a show and for several days after coming home.”
Volz sees herb supplements as conducive to restoring nerve endings, boosting the immune system, and easing gastric ulcers. She agrees that protozoa love ulcers, where holes in the stomach lining allow entrance into a horse’s bloodstream. Among her favorite “protozoa killers” is the hardy American herb, artemsia, related to the daisy family, Asteraceae.
EPM: THE NEXT GENERATION
“We have become more aware” of EPM, Volz says. And more open-minded to the use of Chinese herbs or blood injections, and to earlier diagnoses through acupuncture points.
“EPM is a battle,” acknowledges Gary Young, “but don’t panic. It is manageable and you and your horse can learn to live with it.”
Young concludes, “If your veterinarian is not trained in Eastern medicine, i.e. acupuncture, Chinese herbs, etc., they might miss the early warning signs, but even the top ‘traditional medicine’ vets are starting to believe they can learn more about this disease by keeping an open mind to alternative medicine, which can minimize the dependency on drugs, save money, and ultimately and most importantly, save the horse.”
L.A. Pomeroy of Northampton MA is an equestrian photojournalist and award-winning publicist. A member of American Horse Publications since 1992, she is a prolific participant in the horse care realm. She enjoys trail riding in her native Catskill Mountains of upstate New York, and collecting/researching equestrian art and collectibles. Follow LA on Facebook and read her blog at HolisticHorse.com
EPM ni moja ya magonjwa ya neva ya kuharibu zaidi na ya kuathiri sana farasi tunaowapenda. "Kama vile ugonjwa wa ""spooky"" unavyoathiri mfumo wa neva, ugonjwa huo huathiri pia mwendo wa miguu, ataxia (kutokuwa na uwezo wa kudhibiti mwendo wa misuli), spasticity ya viungo, mgongo wenye maumivu, stifles zilizofungwa, na atrophy ya misuli." Ikiwa huathiri shina la ubongo, matokeo ni kushuka moyo, mabadiliko ya tabia, kupooza kwa neva ya uso na au ulimi, kunguruma, matatizo ya kuona, kuanguka kwa paji la macho, na ugumu wa kumeza. Ikiwa haitachunguzwa, itaua farasi. "Kuna ugonjwa wa ""Equine protozoal myeloencephalitis"" (EPM) ambao ni ugonjwa wa kuambukiza farasi wa Montana na Wyoming, ambao huathiri zaidi ya asilimia 50 ya farasi wa pwani na wa mashamba ya wanyama." Kwa mfano, opossums ni vector ya ugonjwa wa EPM. "Ugonjwa huu wa ""enigmatic"" unaoitwa ""Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa wa Ugonjwa." "Wanachunguzaji wa kliniki Chinedu Njoku, William Saville na Stephen Reed, ambao wameangalia jinsi viwango vya chini vya nitrous oxide metabolites katika maji ya cerebrospinal vinavyohusiana na EPM, wanasema: ""EPM ni sababu ya kawaida ya ugonjwa wa neva katika farasi katika Amerika." Katika sehemu fulani za Marekani, zaidi ya asilimia 30 ya farasi wana antibodies kwa Sarcocystis neurona (parasite ya protozoa inayoathiri zaidi ya EPM), ingawa asilimia ndogo zaidi huendeleza EPM ya kliniki, ikionyesha kwamba mambo ya ziada ambayo hatuelewi bado huchangia mwanzo wa ugonjwa huu. Kulingana na Robert McKay, PhD, BVSc, DACVIM, karibu 60% ya farasi ambao hupata maambukizo ya kazi watarejelea matibabu ya dawa, na 10% hupona kabisa. "Hiyo inaacha 40% ya visa katika afya inayopungua, kwa kawaida ikimalizika kwa kifo", MacKay anasema. Habari njema ni kwamba, ikiwa itagunduliwa na kutibiwa mapema, takwimu zinaongezeka hadi 80% ikijibu vizuri kwa matibabu, na wengi hupona kabisa. "Kwa sababu asilimia 30 hadi 60 ya farasi katika Amerika ya Kaskazini wana kingamwili dhidi ya vimelea vya protozoa vya msingi vinavyohusika katika EPM, watafiti wa UC Davis wanaita EPM ""mzito kwa asili kugundua.""" Hakuna mtihani katika farasi hai kwa sasa ni kuchukuliwa dhahiri. maoni moja anasema ni jukumu mmiliki wa kugundua EPM mapema; mwingine anasema njia pekee ya kuthibitisha ni baada ya kifo. Mmiliki wa farasi anapaswa kufanya nini? "Diane Volz, mtaalamu wa matibabu ya kuumiza, amejitolea zaidi ya miaka 20 kwa kutumia pointi za acupuncture, stimulation ya misuli ya umeme, ultrasound na infrasound, na laser na photon therapy kusikiliza mfumo wa kinga ya farasi na kujibu ipasavyo.""" Marvin Cain, mwanzilishi wa Equine Acupuncture Society of America, amekuwa akifundisha juu ya athari za dawa za kulevya kwa mfumo wa kinga. "Asilimia 80 ya farasi tunaowatazama wako katika hatua fulani ya EPM", anasema. "Wale ambao hawana mfumo wa kinga wenye nguvu wanahitaji zaidi ulinzi dhidi ya protozoa. "" Katika acupuncture ya Kichina, pointi za utambuzi huitwa ""Au Shi"" na ni nyeti wakati wa magonjwa, wakati mifumo ya umeme ya mwili imevurugwa." Vizuizi vya nishati au Qi (vitamtangazwa <unk>Chi<unk>) husababisha ujenzi katika maeneo yasiyofaa (kama vile mti unaanguka kwenye kijito unazuia maji, kufurika maeneo ya karibu). Hali mbaya katika mwili inapokataliwa (mti unaondolewa), alama za Au Shi pia hupungua. "Waziri wa afya wa Marekani, Volz, anasema ""pointi za EPM zinapatikana katika pembetatu juu ya kifua, kiuno, mguu wa nyuma na bega.""" <unk>Wakati sehemu hizi zinafanya kazi, tunapata uchungu, uchungu wa kiuno, na mwelekeo wa kuhamisha uzito kwenye mkono wa mbele. Kwa upande wa matibabu, tunatazama mwili wote, lakini tunaelekea kuona EPM iliyoonyeshwa katika mguu wa nyuma wa kulia. <unk> Ugonjwa huu wa upande wa kulia ni muhimu, kwani EPM inaonyesha magonjwa mengine ya neva ikiwa ni pamoja na Wobble syndrome, Equine herpes virus (EHV-1), au ugonjwa wa Lyme. Dr. Cain amegundua kuwa maumivu au kuugua katika mgongo wa kushoto huelekea kuongoza kwenye utambuzi wa EHV-1; dalili katika mgongo wa kulia ni uwezekano mkubwa zaidi kuhusishwa na EPV. Daktari wa mifugo wa Pocono Downs Race Track, Dk David Sachs, ambaye hutumia acupuncture na acupressure kwenye farasi wake wa mbio, pia anaona matatizo katika mgongo wa kulia wa nyuma kurudi kwa EPM. "Kama ilivyoelezwa, "" EPM imefikia viwango vya karibu na janga na kwa farasi wachanga wa mbio kufuatia mzunguko, bila wakati wa kupumzika na kujenga mfumo wao wa kinga, uponyaji ni ngumu. """ "Bila mapumziko ya majuma matatu hadi manne, farasi wa mbio hawezi kurudi nyuma", asema Dakt. Sachs. Yeye anapendelea kuepuka corticosteroids (inaathiri majibu ya kinga), na ameona matokeo yake bora katika miaka mitatu iliyopita kutibu EPM na kinesiology na kuingiza "mahali pa moto" na damu ya mgonjwa mwenyewe. Nadharia ya sindano za damu ni kwamba, kwa kugeuza damu katika centrifuge, chembe nyekundu za damu huondolewa, na platelets zilizobaki (zinazokuwa na homoni na protini zenye kusaidia) huondolewa, ili ziweze kuingizwa kwa safi zaidi nyuma katika receptors katika mwili wa farasi. "Lindsay McLean, mtaalamu wa acupuncture ambaye pia hutambua EPM kwa kile anaita ""Mgonjwa wa Mazingira"" pointi, anasema farasi kupata ""matokeo mazuri sana wakati damu ni injected.""" Ni muhimu hasa kwa hali ya kushuka moyo, uchovu wa muda mrefu, na matatizo ya autoimmune. <unk> Dk Sachs anasisitiza kwamba kiwango cha mafanikio inategemea ambapo katika mzunguko EPM matibabu huanza. Amepata "matokeo mazuri" anapofunga mara mbili hadi tatu kwa juma. "Gary na Michaela Young walifungua Kituo cha Urekebishaji na Urekebishaji wa Farasi cha Camden huko Camden, South Carolina, mapema mwaka 2010 kutoa dawa mbadala za michezo na teknolojia ya mifugo kwa uponyaji wa majeraha ya farasi, huduma ya baada ya upasuaji, na hali ya haraka. """ "Tulianza na Daktari Kaini muda mrefu uliopita", Gary Young anasema. Pamoja na daktari wetu wa mifugo, Dk. Sam Tetterton, labda tumeleta farasi wengi kutoka EPM kuliko tu kuhusu stall yoyote nchini. "Kama Dr. Cain, Young amegundua alama za EPM kwenye sehemu ya nyuma ya mwili, na dalili zinazotokea katika stifle ya kulia kwanza, na katika sehemu za kinga kwenye bega. """ Mtihani wa kupima ikiwa farasi ana EPM ni kumfunga macho na kumwona kama anaweza kutembea kwa mstari wa moja kwa moja. "Kwa kuwa EPM inaweza kuathiri shina la ubongo na uratibu, hawawezi kutembea moja kwa moja. ""Immune to HARM"" Young anaita EPM ugonjwa wa farasi wa pekee unaogunduliwa vibaya zaidi nchini Marekani leo: ""Katika miaka ya 1960 wazazi wangu waliamini farasi ambao walionyesha ""Wobbles"" walikuwa wakionyesha ishara za kwanza za EPM." Parasite tangu wakati huo imebadilika na kubadilika. <unk> Anataja jinsi vipimo vya damu vinavyofahamisha protozoa mbili (S. neurona, na mara chache, Neospora hughesi), lakini ni nani anayesema hatupungukiwi na wengine? Mfumo wenye nguvu wa kinga ndio mstari wa kwanza wa ulinzi wenye afya. "Mkazo na au mfumo wa kinga uliodhoofika waweza kusababisha kurudia", Young asema. "Yang anaonyesha kuwa dawa ya kuzuia ulcer kabla ya usafirishaji, ili kupunguza uwezekano wa kurudi nyuma, kwa kuwa ""parasites upendo ulcers"" Young anamiliki farasi na EPM, na mkakati wake binafsi ni chini ya mkazo, chini ya athari ya matibabu." "Kwa mfano, ""kufanya kazi kwenye treadmill katika maji"" huhifadhi misuli wakati wa kupunguza mkazo, na pia hutumia uwanja wa umeme wa umeme (PEMF) wa MaganWave kuchochea kimetaboliki ya seli na kupunguza mishipa ya neva: ""Ufanyizaji wa protini ya seli huimarishwa, ambayo inaruhusu mwili kutumia protini zote zinazopatikana." Mzunguko wa damu hupandishwa, sio kwa kuongeza mapigo ya moyo au shinikizo la damu, lakini kwa kufungua na kupanua mishipa ya damu na mishipa ya damu, na mfumo wa lymphatic huchochewa, kusafisha maeneo yaliyoharibiwa na kuondoa sumu mwilini. <unk> Young na Volz wote hutumia mimea ya Kichina kusaidia kuongeza mfumo wa kinga. "Wakati mbili kwa mwaka, mimi "nasafisha" mifumo yao kwa virutubisho vya mimea ya Kichina", Young anasema. <unk>Mimi pia kuongeza kabla ya usafirishaji. Hata kama farasi wangu ni "safi" nyumbani, usafirishaji unaweza kusababisha kurudi nyuma kwa hivyo ninawahifadhi kwenye virutubisho wakati wa maonyesho na kwa siku kadhaa baada ya kurudi nyumbani. <unk> Volz anaona virutubisho vya mimea kama vinavyosaidia kurejesha mwisho wa neva, kuongeza mfumo wa kinga, na kupunguza vidonda vya tumbo. Inasemekana kwamba protozoa hupenda vidonda, yaani, mashimo katika tumbo la farasi ambayo huingiza damu yake. Miongoni mwa "wauaji wa protosoa" anayowapenda zaidi ni mimea ya Amerika yenye nguvu, artemsia, inayohusiana na familia ya daisy, Asteraceae. "Wakati wa mkutano wa EPM, Volz alisema: ""Tumeanza kuwa na ufahamu zaidi wa EPM." Pia, ni rahisi zaidi kutumia dawa za dawa za asili za Kichina na dawa za damu, na pia ni rahisi zaidi kupata matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu ya matibabu. "EPM ni vita", anakiri Gary Young, "lakini usishangae. "Hii ni hali ambayo unaweza kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu na kuifahamu.""" "Wanaweza kukosa ishara za onyo la mapema, lakini hata wataalamu wa juu wa ""dawa ya jadi"" wanaanza kuamini wanaweza kujifunza zaidi juu ya ugonjwa huu kwa kuweka akili wazi kwa dawa mbadala, ambayo inaweza kupunguza utegemezi wa dawa, kuokoa pesa, na mwishowe na muhimu zaidi, kuokoa farasi. - L.A. Pomeroy, Northampton, MA" Mshiriki wa American Horse Publications tangu 1992, yeye ni mshiriki wa uzalishaji katika uwanja wa huduma ya farasi. Yeye anafurahia trail farasi katika yake ya asili Catskill Milima ya upstate New York, na kukusanya / utafiti farasi sanaa na collectibles. Fuatilia L.A. kwenye Facebook na kusoma blogu yake katika HolisticHorse.com