Life After EPM

One woman's account of managing the rehabilitation process—and her own expectations—as her horse recovers from a severe neurological condition.

One of the previous articles on this Web site is about my experiences with Equine Protozoal Myeloencephalitis (EPM). Since then I have received numerous emails each week on the subject of EPM, its diagnosis and treatment. One of the emails I received was from someone whose horse had recently completed the lengthy course of treatment. The writer wanted to know what they could expect from their horse as far as a return to his former level of fitness and competition.

This was one of the questions that I posed to the veterinarians at at the Large Animal Hospital at Texas A&M, where my horse, Annapolis was diagnosed. At that time I was told that there was a 50/50 chance of him being safe to ride again. No mention was made of him ever being able to return to training and competition.

That was a number of years ago now and at this time, I feel able to make the following observations:

  • The chances of a successful recovery are greatly dependent on the amount of nerve damage sustained by the horse, which itself is dependent on how quickly the horse is diagnosed and how soon treatment commences.
  • The location of the damaged nerves also plays a large part in whether or not the horse can return to his former sport (damage to nerves in the hindquarters may mean that the horse will no longer be able to safely jump, but will be sound enough for trail riding)

In the case of Annapolis, it was determined that the damage was in the neck or shoulder area, since he showed signs of having lost his sense of proprioception (the sense of knowing where his feet are) to some extent in all four limbs.

Incidentally, exactly how much nerve damage there was did not become apparent until more than a year later, when an abscessed hoof necessitated extended stall rest. Even when both the vet and myself thought that the abscess should have fulled healed, Annapolis was still lame. Further examination revealed a distinct atrophy (loss of muscle tone) in the muscles of his chest and shoulder. Progressive nerve blocks showed that there was no longer any pain in the foot. The vet diagnosed that Annapolis was now suffering froshoulder sweeney, which was restricting his ability to extend his front legs an even amount while trotting. With other horses, the nerve damage, and subsequent muscle weakness, are visible much sooner, often during treatment. Some horses never show significant signs of damage.

So, more than a year after Annapolis completed his EPM treatment, I was dealing with it again. How I dealt with it was to treat every riding session as a physio-therapy session.

  • Before I even started riding him, I spent a month on short daily lungeing sessions, where I could watch carefully to see how he was moving his legs and monitoring progress.
  • Before each ride I did some gentle stretching on his front legs — concentrating on extending his range of movement on the bad (left) side.
  • The vets at Texas A & M had warned me that I could never be sure that Annapolis would not trip and fall while working on uneven ground, so all work was restricted to a flat and even arena surface.
  • The actual riding sessions were aimed at increasing the range of flexibility in the shoulder, as well as working on general fitness and suppleness.
  • The work included lots of circles and figure-eights, with an emphasis on the bad way, in an attempt to even him up. I also included lots of upward and downward transitions, my aim being to help him shift his weight back off his forehand and so free up his front end.
  • Once I started seeing some improvement, I added leg-yielding and shoulder-in.
  • Eventually, the unevenness of stride lessened and finally disappeared. And to look at him now it’s difficult to see any uneven muscle development in the shoulder (even after the enforced stall rest for his bowed tendon)

At that point, I was at a new barn with nearby trails alongside the creek. I am happy to be able to report that Annapolis is able to enjoy going on the trails (will happily go where others fear to tread), is able to safely navigate some steep up and down banks and he exhibited a love of swimming – even in winter!

Annapolis never has returned to competition, for a variety of reasons. However I would like to think he would be capable of performing an acceptable Training Level dressage test (we used to do First level). He was even back to jumping again, before he re-bowed his tendon.

So, to answer my reader’s question, “Will my horse ever return to his former level of ability?” I have to say that it all depends on the points I have mentioned above. Another horse at the barn where I board Annapolis had EPM and two years later his owner took him to an informal jumping competition at the home of the Kenada Foxhounds, just outside Houston.

It’s all about empowering yourself with as much information as possible — don’t hesitate to ask your vet for advice, seek the experiences of other EPM-owners, share your own experiences, successes or frustrations here on the EquiSearch Forum.




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