EPM is one of the hardest diseases of the horse on both the owner and the horse, not only because the cure can take months but because it is expensive, requires lots of time off, and requires constant monitoring and record keeping.

When my horse, Johnny, showed severe neurological signs suddenly on October 3rd, 2005, I didn't know what the problem was, but I knew that it was big. Johnny was my best friend and companion; we rode almost daily for several hours each time and enjoyed our company as riding companions for years and years. My last ride was October 1st. On the third Johnny was showing odd neurological signs, being unable to walk straight and cantering sideways. After an extensive veterinary exam he was diagnosed with EPM. It took 1 month of Marquis, 1 month of Navigator, 2 months of Marquis, and then a double-dose of Marquis (not to mention countless hospitalizations, 5 boughts of laminitis, depression, and inappitence) before I was left with a blind, nerve-damaged, unridable but EPM free horse.

Treating for EPM is a major endeavor. It requires hours of time, lots of record keeping, and an open bank account. It is not to be taken lightly, yet the decision needs to be made quickly.

Here are my recommendations for dealing with your EPM horse through treatment.

1. Make sure you want to make the investment, and set a limit as to how much you're going to spend. For me and my horse, I love that horse as I would a child and was willing to into debt to save his life. I spent enough for a decent down payment for a house (almost my entire life savings). He can never be ridden again and I don't even know that I've saved his life. But if I have it was worth it. I will NEVER go through EPM treatments with another horse. It isn't worth the heartbreak and pain with any other horse.

2. Get a complete diagnosis. Do a spinal tap (not just the EPM blood test, because almost all horses will test positive for the antibody), get radiographs of your horse's neck, get blood tests for selenium deficiency, vitamin E deficiency, rhinopneumonitis (rhino or equine herpes), west nile, and anything else your vet can think of. This is expensive BUT there is good reason for it: the drug companies all claim that their drugs work and if your horse isn't responding you will need to PROVE to them that you have done all the testing that they can think of to be sure that it is actually EPM. You have a choice: you can spend less on tests and get the drug, then hope that you had the right diagnosis and when the drug isn't working spend more on tests later (and if it isn't EPM you just wasted time and money that may have been detrimental to your horse's health and your bank account), or spend the money up front and know what you're dealing with. This was very important for me because when my gelding kept relapsing after treatments the drug companies at first didn't believe that EPM was the correct diagnosis. When I told them that we had ruled out everything except for EPM, they finally agreed that it WAS EPM.

3. CALL the drug companies if your horse isn't responding or is having side effects. They need to know that their medication works or doesn't work. My final double-dose of Marquis was free because I had been in touch with the drug companies and had convinced them that their drug wasn't working as well as it should, not that my horse didn't have EPM.

4. Set yourself up for disappointment. It was hard to watch my horse relapse when I did everything I could possibly do for that horse. Know they usually relapse within about a month of going off treatment. It's easier to take if you're expecting it, rather than get your hopes up and then watch him suffer.

5. Expect to spend a lot of money if you're going to treat it. Each Marquis treatment runs about $950 dollars, and Navigator runs about $1800. Navigator is a stronger, better drug, but is also more dangerous, so vets have different opinions about which is the better one to use. Navigator is considered more dangerous because the dying protists might cause a reaction in the body that can trigger laminitus. Marquis can do the same thing, but Idexx labs documented the cases (6 in over 200 horses) whereas Bayer (makers of Marquis) does not document cases. Your vet will tell you that even on Marquis horses can get laminitus. My horse got laminitus on both drugs. Giving Navigator is a pain because it's forcing a tube of paste the size of a Bute tube down his throat every day. Marquis is a much smaller amount (1 tube per week), but is less effective. Blood tests ran about $100 for me, and the spinal tap and radiographs were about $550. Not to mention farm calls or clinic calls or hospitalizations and any anti-inflammatory drugs you need in the mean time, and other things you might have to deal with, such as laminitus.

6. Make sure your feed has no exposure to animals, so the drug companies can say it's being reinfected. My horse only got complete feed that I kept sealed in plastic garbage pails.

7. Add fat to the diet and Vitamin E. Vitamin E helps with neuron regrowth and fat helps hold the drug in the body longer.

8. Be careful and document everything you do. Take your horse's temperature twice daily at the same time each day. Take his vital signs such as digital pulses and check his feet for heat at the same time every day. Record everything. DO NOT miss a single dose of medication, and give it the same time every day. If you have a question, call your vet. Remember that in most adult horses, digital pulses cannot be felt unless the horse is having laminitis, and a laminitic horse with EPM may not show the traditional stance because he will be weak and unbalanced, anyhow.

9. Find support for yourself and your horse. There is an EPM yahoo group that is popular, or find another horse owner on whose shoulder you can cry and with whom you  can share your experiences. Not having many horsie friends, I found that most of my friends were not very sympathetic and thought I was crazy for spending the money and time I did on my horse because, "It's just a horse, after all." It's true that Johnny is just a horse, but he's also my best friend.

10. Cry. You will need to.