For the past few weeks we’ve been serializing a chapter entitled “Piaff” from the new book Equine ER: Stories from a Year in the Life of an Equine Veterinary Hospital by Leslie Guttman (Eclipse Press, 2009). Piaff, a Dutch warmblood gelding, had a devastating case of equine protozoal myeloencephalitis (EPM), an infection of a horse’s central nervous system, from which he did not survive. (See previous posts for installments.) As a final follow-up, here is a Q&A with Dr. Stephen Reed, one of the world’s experts on equine neurology and the lead veterinarian on Piaff’s case:

EQUINE ER: Was Piaff one of the most difficult EPM cases you’ve ever had?

DR. STEPHEN REED: Certainly it was one of the most challenging É the case had already been through so many excellent veterinarians prior to coming here . The case was also difficult in that there were periods of time when it looked like there was going to be some turnaround, and it made you think, “Oh my gosh, this is going to be OK.” But in the end, we became so distraught. No matter how hard we tried, we couldn’t make the turnaround. It reiterates again all the difficult things about EPM: the difficulty with accurate diagnosis, the difficulty with effective therapies, the understanding of how the organism hides, so there are so many aspects of the case that were in fact problematic and difficult in that regard. Couldn’t have had a better owner. She was so thoughtful and compassionate