PARASITE CONTROL
Is “diagnosis via treatment” an option for EPM?
Q: Recently, a friend’s horse was suspected of having EPM. There was a lot of talk of the best way to test to confirm the disease: blood tests vs. spinal taps, the likelihood of false positives, etc. It all seemed very complicated and expensive. The results weren’t conclusive, but treatment was started and the horse improved. I’m left wondering why they didn’t just skip testing and begin treatment, saving a bunch of money? This wasn’t my horse, so I didn’t want to second-guess their approach at the time, but I’d love to know why diagnosis via treatment isn’t an option if the available tests aren’t fully reliable?
A: Equine protozoal myeloencephalitis (EPM) is a neurological disease caused by protozoa, primarily but also It is generally treated with a combination of antiprotozoal medications including ponazuril, diclazuril or the antibiotic trimethoprim-sulfonamide and the antiprotozoal pyrimethamine, as well as anti-inflammatory drugs such as flunixin meglumine. Although EPM has been studied for decades, diagnosing the condition can be challenging. For horses where EPM is suspected, serum and cerebrospinal fluid (CSF) testing is performed to look for antibodies to—or the presence of— and , as well
