EPM Diagnosis and Treatment Recommendations
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Have you ever wished you could pull all the scientific recommendations on equine protozoal myeloencephalitis (EPM) diagnosis and treatment together in one place? Done! At the 2009 American Association of Equine Practitioners Convention, held Dec. 5-9 in Las Vegas, Nev., one practitioner summarized the available literature on EPM diagnosis and treatment for a large crowd of equine veterinarians.
"Sarcocystis neurona (a species of protozoa) infection is the most common cause of EPM," began Amy L. Johnson, DVM, Dipl. ACVIM-LAIM, lecturer in clinical studies at the University of Pennsylvania. "This neurologic disease presents a diagnostic challenge to practitioners because many horses are exposed to the protozoa and clinical signs can mimic many other conditions. Treatment is also challenging because several medications are available and response to treatment is not consistent among horses."
Diagnosis
Diagnosing EPM in a live horse is challenging because no test is 100% accurate; the gold standard for diagnosis is finding the protozoan parasite in the spinal cord, which can only be sampled after the horse is euthanized. So for live horses, diagnostics include a complete neurologic exam, exclusion of other common neurologic conditions, and confirmation of exposure to S. neurona through analysis of serum (clear fluid portion of the blood) or cerebrospinal fluid (CSF, the fluid surrounding the brain and spinal cord)
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