Tag Archives: anti inflammatories

Horse to Human: Transmittable Diseases

ceh.vetmed.ucdavis.edu/diseases-horse-human-transmission

Immune Booster Leads to Infection?

For the past 6 weeks, my horse has been receiving Ozonetherapy to aid in his chronic back leg related issues- dermatitis (“scratches”), previous DDFT tendon laceration, a history of Lymphingitis, and the residual scar tissue from his DDFT injury.  Due to his age (27), he lacks proper circulation in his hind end which does not help him fight his pastern dermatitis.  


According to the American Academy of Ozonetherapy, Ozonetherapy is described as;

“Ozonotherapy is the use of medical grade ozone, a highly reactive form of pure oxygen, to create a curative response in the body. The body has the potential to renew and regenerate itself. When it becomes sick it is because this potential has been blocked. The reactive properties of ozone stimulate the body to remove many of these impediments thus allowing the body to do what it does best – heal itself.”

“Ozonotherapy has been and continues to be used in European clinics and hospitals for over fifty years. It was even used here in the United States in a limited capacity in the early part of the 20th century. There are professional medical ozonotherapy societies in over ten countries worldwide. Recently, the International Scientific Committee on Ozonotherapy (ISCO3) was formed to help establish standardized scientific principles for ozonotherapy. The president of the AAO, Frank Shallenberger, MD is a founding member of the ISCO3.”

“Ozonotherapy was introduced into the United States in the early 80’s, and has been increasingly used in recent decades. It has been found useful in various diseases;

  • It activates the immune system in infectious diseases.
  • It improves the cellular utilization of oxygen that reduces ischemia in cardiovascular diseases, and in many of the infirmities of aging.
  • It causes the release of growth factors that stimulate damaged joints and degenerative discs to regenerate.
  • It can dramatically reduce or even eliminate many cases of chronic pain through its action on pain receptors.
  • Published papers have demonstrated its healing effects on interstitial cystitis, chronic hepatitis, herpes infections, dental infections, diabetes, and macular degeneration.”

 

After doing research and speaking to one of my good friends, we determined that Chance’s flare up of Lymphingitis, after almost 3 years of not a single issue, could possibly be caused by his immune system’s response to Ozonetherapy.  Let me explain.

Chance suffers from persistent Pastern dermatitis (“scratches”) since I purchased him in 2000.  I have tried everything- antibiotics, every cream and ointment and spray for scratches, diaper rash ointment, iodine and vaseline mix, Swat, laser treatments, scrubs and shampoos, shaving the area, wrapping the area, light therapy…you name it, I have tried it.  So, when we began Ozonetherapy to help break down the left over scar tissue from his old DDFT injury, I noticed that his scratches were drying up and falling off.  We continued administering the Ozonetherapy once a week for about 6 weeks.  The improvement was dramatic!  

However, one day Chance woke up with severe swelling in his left hind leg and obviously, he had difficulty walking.  He received Prevacox and was stall bound for 24 hours.  The vet was called and she arranged to come out the following day.  The next morning, Chance’s left leg was still huge and he was having trouble putting weight on it.  I did the typical leg treatments- icing, wrapping.  The swelling remained.  I tried to get him out of his stall to cold hose his leg and give him a bath but he would not budge.  He was sweaty and breathing heavily and intermittently shivering.  So, I gave him an alcohol and water sponge bath and continued to ice his back legs.   I sat with him for 4 hours waiting for the vet to arrive.  He had a fever and wasn’t interested in eating and his gut sounds were not as audible.  He was drinking, going to the bathroom, and engaging with me.  I debated giving him Banamine but did not want it to mask anything when the vet did arrive.  

The vet arrived, gave him a shot of Banamine and an antihistamine and confirmed that Chance had a fever of 102 degrees and had Lymphingitis.  There was no visible abrasion, puncture, or lump… I asked the vet to do x-rays to ensure that he did not have a break in his leg.  The x-rays confirmed that there was no break.  The vet suggested a regiment of antibiotics, steroids (I really am against using steroids due to the short-term and long-term side effects but in this case, I would try anything to make sure he was comfortable) , prevacox, and a antacid to protect Chance from stomach related issues from the medications.  It was also advised to continue to cold hose or ice and keep his legs wrapped and Chance stall bound.  

The following day, Chance’s legs were still swollen but his fever had broken.  The vet called to say that the CBC had come back and that his WBC was about 14,00o. She suggested that we stop the steroids and do the antibiotic 2x a day and add in Banamine. I asked her if she could order Baytril (a strong antibiotic that Chance has responded well to in the past) just in case.  And that is what we did.  

Being as Chance had such a strong reaction to whatever it was, I did some thinking, discussing, and researching…first and foremost, why did Chance have such an extreme flare up of Lymphingitis when he was the healthiest he has ever been?  And especially since he had not had a flare up in 3+ years…plus, his scratches were getting better not worse.  The Ozonetherapy boosted his immune system and should provide him with a stronger defense against bacteria, virus’, etc.  So why exactly was he having a flare up?  And that is when it hit me!

In the past when Chance began his regiment of Transfer Factor (an all natural immune booster), he broke out in hives.  The vet had come out and she felt it was due to the Transfer Factor causing his immune system to become “too strong” and so it began fighting without there being anything to fight, thus the hives.  My theory- Chance started the Ozonetherapy and his body began to fight off the scratches by boosting his immune system.  As the treatments continued, his immune system began to attack the scratches tenfold.  This resulted in his Lymphatic system to respond, his WBC to increase, and his body temperature to spike.  Makes sense…but what can I do to ensure this is not going to happen again?  

My friend suggested attacking the antibiotic resistant bacteria by out smarting them…okay, that seems simple enough…we researched the optimal enviroments for the 3 types of bacteria present where Chance’s scratches are (shown in the results of a past skin scape test).  The bacteria – E. Coli, pseudomonas aeruginosa and providencia Rettgeri. The literature stated that PA was commonly found in individuals with diabetes…diabetes…SUGAR!  How much sugar was in Chance’s feed?  I looked and Nutrina Safe Choice Senior feed is low in sugar…so that is not it.  What else can we find out?  The optimal temperature for all three bacteria is around 37 degrees celsius (or 98.6 degrees fahrenheit), with a pH of 7.0, and a wet environment. Okay, so, a pH of 7.0 is a neutral.  Which means if the external enviroment (the hind legs)pH is thrown off, either to an acidic or alkaline pH, the bacteria will not have the optimal enviroment to continue growing and multiplying.  How can I change the pH?  

Vinegar!  An antimicrobial and a 5% acetic acid! And…vinegar is shown to help kill mycobacteria such as drug-resistant tuberculosis and an effective way to clean produce; it is considered the fastest, safest, and more effective than the use of antibacterial soap.  Legend even says that in France during the Black Plague, four thieves were able to rob the homes of those sick with the plague and not become infected.  They were said to have purchased a potion made of garlic soaked in vinegar which protected them.  Variants of the recipe, now called “Four Thieves Vinegar” has continued to be passed down and used for hundreds of years (Hunter, R., 1894).

I went to the store, purchased distilled vinegar and a spray bottle and headed to the farm.  I cleaned his scratches and sprayed the infected areas with vinegar.  I am excited to see whether our hypothesis is correct or not…I will keep you posted!

 


References & Information


Effect of pH on Drug Resistent Bacteriaijs-43-1-174

NIH: Drug Resistant Bacteria

Vinegar

Lymphatic Conditions

Horses Side Vet Guide

What does my horse’s CBC mean?

th

Nutrena SC Senior feed ingredience
The American Academy of Ozonetherapy

Hunter, Robert (1894). The Encyclopaedic Dictionary. Toronto: T.J. Ford. ISBN 0-665-85186-3.

 

Pump, Pump, Pump It Up!

The vet came out to give Chance and Lucky their fall shots and do some follow up acupuncture on Chance.  The vet said that Chance has increased flexibility especially in his cervical spine and has gained weight and muscle mass!!!!!!

His feeding regiment is as follows:

AM:

  1. 6 quarts of Nutrina Safe Choice Senior Feed
  2. 3 quarts hay stretcher
  3. Alfalfa hay mix (as much as he wants through out the day)

PM:

  1. 6 quarts of Nutrina Safe Choice Senior Feed
  2. 3 quarts hay stretcher
  3. Alfalfa hay mix (as much as he wants through out the day)
  4. 1 Scoops of DuraLactin (Natural anti-inflammatory and pain supplement)
  5. 1 SmartPak (Senior Flex, Immune Boost)

He is out all day when it is cool and all night when it is hot during the day. So he has tons of green grass to eat.  He walks constantly- up and down the hills- and runs around with Lucky.  We also walk ground poles and do stretches and massage every time I come out to the barn.

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We still need to continue upping his weight and muscle mass preferably before winter.  Fingers crossed.

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Packing On The Pounds!

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Chance is now on 6 quarts of Nutria Senior Feed with 2 quarts of Hay Stretcher and 2 cups of Rice Bran TWICE A DAY! That is 12 quarts of feed a day and 4 quarts of Hay Stretcher plus his alfalfa mixed hay!

At night he also receives his SmartPak (Senior Flex, Immune Boost, and Vitamin C) & DuraLactin (for inflammation and swelling).  He is no longer skin and bones or on daily pain medication!

New Concerns Have Sprung

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Chance greeting me as I drive up

The days are finally feeling like spring!  The grass is green, the blankets put away, the sun is shining, and the horses are shedding.

Chance is continuing to gain weight, although as I said in the previous post, he still needs to put on a good 50-75 lbs.  As the days continue to get warmer, Chance’s arthritis seems to become more manageable for him; his stride is longer and he runs around (mostly after Lucky) more frequently.

Unfortunately, when the farrier came out about two weeks ago Chance was too stiff to get his back right shoe on. The farrier decided to come back out to try and re-shoe him and, during that time in between, Chance must have tweaked it…AGAIN! 

 While Chance did not have a shoe on his back right I kept it wrapped to provide some protection and also even out all of his hooves.  However, when I arrived I noticed that Chance was significantly twisting his back right leg inward at the walk & it had some swelling.  The swelling was not horrible but it was noticeable. I cold hosed his leg for about 45 minutes while I groomed him & gave him a dose of Equinox (pain medication) and Ulcer Guard.  I put on his back leg wrap to help with reducing the swelling and provide some extra support.  Chance did his neck stretches effortlessly and was baring weight on his back hind. 

But as I was grooming him I noticed, on the left side his chest, he had patches of hair loss and dandruff.  The area did not look red or inflamed, nor did it seem itchy or painful.  So I continued grooming him and decided to put a call into the vet to come and check his leg and the hair loss.

Of course, I turned to Google to try and find out what exactly could be the cause of the patches of hair loss.

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According to a handful of sources, there are a few possibilities for hair loss- mites or Lice, a vitamin deficiency, rain rot or crud, or even just his natural shedding tendency. A skin scrape would help to confirm what may be the cause. 

 As for the swelling of Chance’s back right leg, I decided to call our previous vet who collected and injected Chance’s DDFT with stem cells to heal the hole in his tendon. We have some stem cells left over and I wanted to see if injecting his leg again would be of any benefit.  I also would like to get an ultrasound recheck to ensure that there is not another injury to his DDFT tendon sheath again.

The twisting of his back hind leg is worrisome as well.  

Everything I have read about EPM states that horses can have a relapse in symptoms after treatment is complete. My concern is that the twisting are due to the neurological symptoms coming back since Chance’s EPM treatment has been finished for a little over two weeks…. 

 Our current vet believes that Chance’s ataxia and twisting is not due to EPM but his cervical spine instead.  Could the twisting be worse due to the swelling of his hind leg?  Or is the swelling and the twisting two separate issues all together?

Update!

After two rounds of EPM treatments, stem cell injections, acupuncture, chiropractic adjustments, testing, antibiotics, ultrasounds, blood work, adding DuraLactin….Here is a video of Chance yesterday!  He has gained a lot of weight back and hopefully, with the addition of the Rice Bran in his feed, he will continue to gain weight!

Wobbler Syndrome in Older Horses

Wobbler Syndrome in Older Horses

By Erica Larson, News Editor

Mar 28, 2013

Wobbler Syndrome in Older HorsesThe gold standard for diagnosing CVSM is the meylogram (seen here), a procedure that involves injecting dye into the spinal canal before taking a set of radiographs to evaluate the spinal column’s width and to identify possible sites of compression.

Photo: University of Kentucky Gluck Equine Research Center

The neurologic condition cervical vertebral stenotic myopathy (CVSM, commonly known as wobbler syndrome) is much less common in older horses than it is in young, growing animals. But according to one clinician, this condition should be on all veterinarians’ differential diagnoses list when evaluating an aged horse presenting with neurologic signs and/or neck pain.

At the 2013 Western Veterinary Conference, held Feb. 17-21 in Las Vegas, Nev., Laurie Beard, DVM, MS, Dipl. ACVIM, associate clinical professor at Kansas State University’s College of Veterinary Medicine, presented a review of CVSM in aged horses.

Horses affected by CVSM essentially have a damaged spinal cord. The major causes of spinal cord damage include cervical (neck) vertebrae malformation or trauma.

“The exact pathogenesis of CVSM in older horses is unknown and likely different than younger horses,” Beard said. She said older horses are more likely to have lesions located in the caudal cervical vertebral column (near the base of the neck), between the vertebrae C5 and C6 or C6 and C7. She noted that some studies suggest biomechanical loading related to “wear and tear” could contribute to lesions. Additionally, she said, articular process osteophytosis (bony remodeling) is a common finding in older horses with CVSM.

Beard said common clinical signs associated with CVSM in older horses include:

  • Spinal ataxia (incoordination), generally symmetric with the hind limbs affected more than the front limbs. Beard noted that in some cases, however, mature horses with CVSM might appear more lame than ataxic;
  • Neck pain or stiffness;
  • Neck arthritis; and
  • Decreased appetite.

Beard said veterinarian frequently use standing cervical radiographs to diagnose CVSM in mature horses. However, if cervical radiograph results are inconclusive, a myelogram, considered the gold standard CVSM test, might be required. This procedure involves injecting dye into the spinal canal before taking a set of radiographs to evaluate the spinal column’s width and to identify possible sites of compression.

Treatment options for mature horses diagnosed with CVSM include:

  • Anti-inflammatory drugs (both steroidal and non-steroidal, depending on disease severity);
  • Natural vitamin E supplementation (Beard explained that vitamin E is an antioxidant that could act as an anti-inflammatory in horses with CVSM);
  • Cervical facet steroid injections (this procedure must be repeated every six months or so, but can reduce pain and soft tissue swelling); and
  • Surgical correction (which typically consists of fusing the affected vertebrae–the movement of which causes the spinal cord compression–together using a metal implement called a “basket” in a surgical procedure called cervical stabilization).

The prognosis for for return to work in mature horses with CVSM is variable and depends on the degree of ataxia present, Beard said.

“A horse with mild clinical disease that is a trail riding horse (or low-level performance horse) probably does have a reasonable chance of still performing,” she said. “However, higher level performance horses probably will not be able to perform at the level they were.”

Additionally, horses used for pleasure riding are more likely to have a good prognosis for full return to athletic function than higher performance athletes, she said.

Take-Home Message

Although it’s commonly thought of as a young horse disorder, Beard stressed that veterinarians should consider CVSM as a differential diagnosis in any horse with spinal ataxia. Prognosis for return to work depends on the degree of ataxia present, but many horses show improvement with medical management, she said.

Early Detection of Equine Arthritis?

Is Early Detection of Arthritis in Horses Finally a Reality?

Is Early Detection of Arthritis in Horses Finally a Reality?Radiography’s ability to correctly identify joints without OA was 97%, meaning it had few false-positives, and that radiography was equal to or better than MRI for detecting early joint changes consistent with OA.

Photo: Kevin Thompson/The Horse

Osteoarthritis (OA) is a progressive deterioration of joint health with no known cure. Not only does OA negatively affect athleticism and quality of life but it is also a major cause of economic loss throughout the equine industry.

For years researchers have been trying to find ways to diagnose OA early in the course of disease to either slow or, better yet, arrest its progression. And although OA has proven a stubborn opponent, an international group of researchers recently found that radiographs (X rays) and low-field MRI appear to be useful tools for diagnosing OA.

“For our study we chose to use Icelandic horses, a breed that is known to have a high prevalence of OA and one in which a large number of older riding horses are culled due to the pain and lameness that result from the disease,” explained Charles Ley, BVSc, Dipl. ECVDI, PhD, from the Swedish University of Agricultural Sciences, in Uppsala. “Young horses without obvious lameness were used in the study in order to include horses likely to have a very early stage of the disease and normal horses. We chose to use two noninvasive and clinically available imaging techniques—radiography and MRI—to see if it was possible to detect early OA changes in the joints.”

Ley and colleagues collected 75 hock joint radiographs and MRIs from 38 Icelandic horses between the ages of 27 and 31 months. The team then used microscopy to classify joints as positive or negative for OA.

The team classified 42 of the 75 joints as OA-positive after they detected lesions on both radiography and MRI that corresponded with OA, including mineralization front defects and joint margin lesions. The team determined that radiography’s ability to correctly identify joints without OA was 97%, meaning it had few false-positives, and that radiography was equal to or better than MRI for detecting early joint changes consistent with OA.

“Radiography is a widely available, cost-effective, and repeatable method, and the high specificity and high frequency of the detection of mineralization front defects in radiographs suggests that this is a promising marker of early OA in the distal intertarsal joint (one of the middle hock joints),” Ley concluded. “Such a tool has a vital role in selecting horses for inclusion in long-term studies of how and why OA develops and evaluating early intervention and prevention methods for OA.”

The study, “Detection of early osteoarthritis in the centrodistal joints of Icelandic horses: evaluation of radiography and low-field magnetic resonance imaging,” will appear in an upcoming issue of the Equine Veterinary Journal.

Another Try

Yesterday, while at the farm, Chance’s medications arrived at my house instead of the farm.  I drove home, grabbed the meds, and began my drive back to the farm.  A winter storm was just beginning.  4 hours later, I dropped off the medication and turned back around to head home.

Thankfully, Chance began his second round of EPM treatment this morning.

I decided to try a different type of treatment this time around- round one: Protazil and round two: Marquis.  Marquis has been around longer and has similar potential side effects and outcomes as Protazil.

Rebalance recently was linked to the death of 4 horses in 2014.

Or

Oraquin-10 which is a 10 day treatment that is more cost effective.  However, it is a newer medication and the vets that I have spoken to were not as comfortable with the outcomes in the horses with EPM.

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Our Regiment


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Chance receives the following:



AM:

1. Protazil 50mls

2. Vitamin E 4 scoops (Watch for loose stools.  This would indicate that his VitE should be cut down)

PM:

1. SmartPak: Immune Boost

2. SmartPak: Senior Flex

3. Equinyl 2 scoops first two weeks, 1 scoop after

OTHER:

If Chance’s symptoms are worse, he can receive Equinox and UlcerGuard.

An All Natural Option?

While doing research on EPM, and ways to prevent a treatment crisis, I came across something called MicroLactin. Below are two of the many studies I found regarding the use of MicroLactin and its use for EPM.

STUDY 1: Journal of Equine Veterinary Science (Impact Factor: 0.89). 09/2005; 25(9):380-382. DOI: 10.1016/j.jevs.2005.08.004
ABSTRACT Fifty-eight horses with inflammation from lameness/foot trauma, muscle and skin trauma, and respiratory, gastrointestinal, and soft tissue toxins were fed MicroLactin (Duralactin Equine, Veterinary Products Laboratories, Phoenix, AZ) as an aid to therapy to inhibit neutrophil participation in the inflammatory response. Based on clinical signs of observed improvement and owner's observations, there was 86% positive effect, 14% no effect. Owner's satisfaction of results was seen by continued use of MicroLactin instead of nonsteroidal anti-inflammatory drugs and steroids in respiratory inflammation and in chronic lameness, myositis, and skin inflammation.
STUDY 2:  Sandhill Equine Center, Southern Pines, NC Journal of Equine Veterinary Science (Impact Factor: 0.89). 06/2009; 29(6):547-550. DOI: 10.1016/j.jevs.2009.05.004
ABSTRACT MicroLactin is a patented milk protein concentrate whose mode of action is proposed to inhibit neutrophil activation in inflammation and to bolster the immune response in musculoskeletal diseases. MicroLactin was empirically used in the treatment of a series of equine clinical cases. MicroLactin was given in two trials to 166 horses in which neutrophils were associated with an inflammatory response. The primary clinical groups having the greatest positive responders to the use of MicroLactin were: respiratory (92%), joint lameness/foot trauma (90%), muscle injury/myositis (92%), equine protozoal myeloencephalitis (EPM) (81%), skin trauma/hypersensitivity (89%), and toxic enteritis (89%). Positive clinical results were seen within 10 to 14 days when MicroLactin was used as a daily treatment either alone or in combination with other anti-inflammatory agents or as an adjunct to the primary treatment.

Every study I read claimed MicroLactin to be a “miracle anti-inflammatory” that aided in cell regrowth. People were raving about this substance that is derived from cow’s milk. The studies dated back to the 80’s and not only suggested that MicroLactin truly was a natural cure all, but that it also had zero side effects or interactions.

I figured that I should give it a try. Again, I looked everywhere and nobody carried it. I looked online and saw that there was a brand called DuraLactin but that I would not be able to actually receive it for about a week. I began looking for supplements that contained the same ingredients as DuraLactin. Sure enough, I was able to find it!

The brand is called Vita-Flex Equinyl.

Vita Flex® Equinyl™ Combo is designed to help ease pain and inflammation associated with training and competition without causing gastrointestinal side effects. This supplement provides joint health support and increases flexibility. It shortens recovery time by reducing the emigration of neutrophils to the site of the inflammation. Contains glucosamine, which helps maintain synovial fluid that lubricates the joints for all day pain associated with daily exercise and activity. 5,000 mg glucosamine, 875 mg chondroitin. 7500 mg MSM. 3.75 lb (60-day supply).

How to we get there?

As I said previously, the idea of Chance collapsing and no one being there terrifies me. Vet4 is shipping me the Protazil and I am trying to find another vet to come and administer the DMSO before beginning treatment.  DMSO typically helps the Protazil adhere better, thus making the treatment more effective.

EPM: Is DMSO the Cure for Treatment Issues?

By Stacey Oke, DVM, MSc Aug 3, 2009

New research on treating horses with equine protozoal myeloencephalitis (EPM) has found dissolving toltrazuril sulfone, commercially known as ponazuril, in dimethylsulfoxide (DMSO) instead of water prior to oral administration in horses increases the bioavailability by three times and achieves therapeutic levels in both the blood and cerebrospinal fluid.
Ponazuril and related triazine-based antiprotozoal agents used to treat horses with EPM are highly lipid (fat) soluble. As a result, these agents dissolve poorly in the gastrointestinal systemand are therefore poorly absorbed.
Poor drug absorption results in variable drug concentrations in the bloodstream, which translates into a variable therapeutic effect in the treated horse, explained Levent Dirikolu, DVM, PhD, from the Department of Veterinary Biosciences at the University of Illinois, and co-researchers from the University of Kentucky Gluck Equine Research Center and the United States Department of Agriculture (USDA) Animal and Natural resources Institute.

I finally found a vet who was able to come to the farm to meet Chance and administer other medications.

Vet6 felt that DMSO wasn’t necessary and that Chance would be fine. I called Vet4, explained the situation, and he advised beginning Chance on 1/2 a dose of Protazil for the first couple days in conjunction with a mild anti-inflammatory.

So, that is what we did. I had also read that Vit E (only in its all natural form) was helpful during treatment, along with Ulcer Guard to keep his stomach safe from the medications.

I called 5 different vets and no one has what I was looking for in stock. I finally found it in Chantilly!

Other EPM Therapies

The below research was found athttp://www.epmhorse.org/Treatment/Other_Therapy.htm

Veterinarians should discuss other drug therapies, in addition to the protozoa killing drugs, to address symptomatic problems that may occur during treatment.  Limiting inflammation of the cerebrospinal column, stimulating the immune system, and anti-oxidants are three things that the owner should be prepared to handle during treatment.  If the veterinarian does not discuss these, ask about them.

Inflammation

An active S. neurona infection in the central nervous system (CNS) will produce both temporary inflammation and permanent nerve damage. The inflammation can get worse when the protozoa start to die during treatment.  This can happen as the treatment drug level builds in the CNS, and is known as a ‘treatment crisis’.  Watch for symptoms to get worse 7 to 14 days after the start of treatment drugs.

Inflammation by itself can cause permanent nerve damage, so treating it is important.  Veterinarians report that horses with higher neurologic deficiencies, and possibly higher levels of protozoa, tend to get treatment crises more often that horses with a Mayhew score of 1.  Some veterinarians will place a horse on anti-inflammatory drugs immediately, to prevent additional damage to the CNS.

Banamine   Many owners already have the non-steroidal anti-inflammatory drug (NSAID) Banamine at the barn.  Even if your horse is a 1 on the Mayhew scale, you may wish to have Banamine on-hand to deal with any worsening of the symptoms. Banamine can cause gastro-intestinal side effects such as ulcers when given in high doses, or longer than five days.  A January 2009 cost was $35 for 5 doses.

MicroLactin   This supplement is gaining recognition as an overall, mild anti-inflammatory.  This non-prescription supplement is a derivative of cows milk, and is known as Duralactin, or the ingredient ComfortX in Equinyl.  MicroLactin does not have side effects, so it can be used over the entire course of treatment.  It is possible to supplement with Banamine during a treatment crisis.  March 2009 price was $50 per month.

Dexamethazone   (Dex) This steroid suppresses the immune system, so it should not be used as an anti-inflammatory for EPM horses except in an extreme neurological case.  Used longer than 5 days, it can cause Laminitis.

DMSO   Dimethyl sulfoxide given intravenously, can be useful when the horse has extreme neurological symptoms.  The veterinarian should administer this drug, it should only be used for short time periods, and it can interact with other drugs.

Immune System

In many regions of the U.S. more than 50% of the horses have been exposed to EPM. Researchers do not know why less than 2% of them get an active infection in the CNS.  Studies on blood of EPM horses indicate a change in the immune system response and cells.  Relapse rates for EPM are high, often with the same symptoms. Some researchers believe that the relapses are latent infections which were never completely killed, and the immune system does not recognize.  Immune system stimulants have been suggested to help the horse fight the infection.

Levasimole   This drug has been used as part of a wormer, and anti-inflammatory.  It is known to increase immune response.  It has not been clinically tested specifically for use with EPM, but is being used for it.

Transfer Factor    This supplement has been around since the 1940’s for human use. The older studies on humans suggest it increases the cell-mediated immune response.  It has not been clinically tested in horses.  The supplement is suggested to increase the cell-mediated immune response (see research below).  It WILL NOT kill the protozoa; it is only an immune booster.  It is made from cow colostrum, eggs, and mushrooms.  At least two companies produce this for equine use, and while the main ingredients are the same, there are differences.  4 Life Research and Nutrition Horizons USA offer this at March 2009 prices of $150 to $200 per month.

Vitamin E

Vitamin E has been shown to relieve inflammation, promote regeneration of nerve cells, and is an anti-oxidant protecting the CNS.  This vitamin is suggested by many veterinarians for supplementation during and after drug treatment for EPM.  It crosses the blood-brain barrier to work in the CNS.  A deficiency in Vitamin E is thought to impair the blood-brain barrier.  It is suggested at therapeutic rates from 5,000 to 10,000 total IU per day.  Add the total Vitamin E content of all supplements and feed to reach the target rate.  Research has shown that natural source vitamin E (D-alpha tocopherol) is absorbed by the body better than manufactured E (DL-alpha-tocopherol).

Recent Research

A 2006 study published in Veterinary Parasitology indicated: “Our results demonstrated that naturally infected horses had significantly (P < 0.05) higher percentages of CD4 T-lymphocytes and neutrophils (PMN) in separated peripheral blood leukocytes than clinically normal horses.  The product MicroLactin has been shown to limit neutrophil activity thereby reducing the inflammation process in the CNS.  The study goes on to say, “Leukocytes from naturally infected EPM horses had significantly lower proliferation responses, as measured by thymidine incorporation, to a non-antigen specific mitogen than did clinically normal horses (P < 0.05).  Cell-mediated immunity is lowered in EPM positive horses.

An ongoing study by Dr. Bello, Journal of Equine Veterinary Science, vol. 28, issue 8 (2008), uses Marquis, MicroLactin, and transfer factor in a protocol.  The initial study involved 28 horses, and 8 more have been studied.  This study was presented at the AVMA conference in 2007, and was published in 2008. The full text article is available below with permission from Dr. Bello.

Continuing research by others indicates controlling inflammation is a large part of the treatment process, and immune system stimulation is critical to avoiding relapses.

January 2012

References:

Veterinary Parasitology 138 (2006) 200–210

J Appl Res Vet Med 2003;1:272-8.

J Eq Vet Sc, vol. 28, issue 8 (2008) 479-482
An Intensive Approach in the Treatment of Clinical Equine Protozoal Myeloencephalitis 

Am J Vet Research, June 2008  Vitamin E

J Eq Vet Sc, vol. 25, issue 9 (2005) 380-382

TheHorse.com articles # 12025, 4829