ON THE FRONT­LINES AGAINST EPM

EQUUS - - Conversati­ons -

quine pro­to­zoal myeloen­cephali­tis (EPM) doesn’t make head­lines as of­ten as it once did. But this po­ten­tially de­bil­i­tat­ing neu­ro­log­i­cal dis­ease re­mains a threat to horses all over the United States. If any­thing, its range is spread­ing.

Horses can de­velop EPM when they in­gest feed and wa­ter con­tam­i­nated with Sar­co­cys­tis neu­rona, one-celled or­gan­isms called pro­to­zoa, that are spread by opos­sums and car­ried by other wildlife. Less com­monly, an­other pro­to­zoan, Neospora hugh­esi, causes the dis­ease. Usu­ally, when a horse in­gests ei­ther pro­to­zoan his im­mune sys­tem elim­i­nates the threa threat and he does not be­come ill. In some cases, how­ever, th the or­gan­isms cross the blo blood-brain bar­rier and attack the cen­tral nerv ner­vous sys­tem (the brain and spinal cord), caus caus­ing a range of neu­rolog neu­ro­log­i­cal prob­lems in­clud­ing mu mus­cle weak­ness and in­coor in­co­or­di­na­tion. First ide iden­ti­fied in 1970, EPM re­mains diffi dif­fi­cultc to di­ag­nose and treat. Be- cause not all horses ex­posed to the pro­to­zoa de­velop the dis­ease, the pres­ence of an­ti­bod­ies is not enough to di­ag­nose EPM. Even with an­tipro­to­zoal drugs, the re­cov­ery rate is about 65 per­cent.

Clearly, more work is needed to com­bat EPM with a greater de­gree of suc­cess. To­ward that end, a group called the EPM So­ci­ety---a con­sor­tium of re­searchers and clin­i­cians cur­rently headed by Steve Reed, DVM, DACVIM, of Rood and Rid­dle Equine Hos­pi­tal in Lex­ing­ton, Ken­tucky---met last fall to share ideas on how to make more progress. “The goal of the meet­ing, which was at­tended by nearly 40 peo­ple from academia, equine prac­tices and in­dus­try, was to brain­storm about what we know and what we don’t know about EPM,” says Ni­cola Pusterla, DVM, PhD, DACVIM, of the Uni­ver­sity of Cal­i­for­nia–Davis, who adds that when cer­tain dog­mas have been es­tab­lished for a dis­ease, they need to be re­vis­ited reg­u­larly to as­sess what works, what doesn’t, and what fur­ther re­search needs to be done: “There are still a lot of mis­con­cep­tions about this dis­ease and some ar­eas that are not very clear. We re­viewed some of the ba­sic prin­ci­ples to see if they still ap­ply and to de­ter­mine the di­rec­tion we need to go---where there is still a gap in our knowl­edge.”

Here’s what we know so far.

By Heather Smith Thomas

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