An Intensive Approach in the Treatment of Clinical Equine Protozoal Myeloencephalitis

Equine protozoal myeloencephalitis (EPM) is a serious parasitic disease of horses producing neurologic clinical signs. Sarcocystis neurona is an incriminated pathogen. If approximately 50% of US horses are seropositive but only 0.5 to 1% become clinically affected, there is a suspected immunologic influence whether a horse is S. neurona-exposed or has clinical EPM syndrome. This report presents a treatment of 28 performance horses that were serum immunoblot positive for exposure to S. neurona. This patient population was in full athletic competition, travel, or training with associated stress. We attempted to (1) improve the immunologic status of the horse, (2) protect it against inflammatory reactions, and (3) provide medication to kill the protozoa. The cell-mediated immunity was stimulated by transfer factor in the feed for 37 days. The inflammatory reactions of treatment crises from antiprotozoal activity were prevented by MicroLactin (a neutrophil-activation inhibitor) in feed for 28 days concurrently. The antiprotozoal drug ponazuril was given concurrently for 28 days. Gait abnormalities, stumbling, and behavior change were the most frequent and combined clinical signs before treatment. There were 82% (23/28) treatable horses that were back at work, including five horses that were in physical rehabilitation under saddle. Five severely affected horses were not helped by therapy.