Linda Turcotte sent us a recent picture of Nestle, we we’re pleased from the update. His battle with EPM was successful, in fact we owe her an “EPM survivor” bracelet! We have made a lot of progress and we are continuing to make more discoveries. What we need to continue our battle against EPM is information. We can’t stress enough how much we need a completed submission form with a vet signature and a gait score from each horse.
We often hear that the horses are doing so well the veterinarian isn’t called back for the follow up exam. Losing that data costs us, and you, dearly. Each piece of data we lose delays what we can discover. Data is how we know what we need to investigate next. The lack of quality data delays our discovery and publications. We will make less progress if we don’t get the data we need. We know you appreciate our hard work and long hours of dedicated research, please--reward us with follow up samples.
We are making progress. We give a horse a provisional diagnosis of EPM (most likely the signs are due to infection with S. neurona) or inflammatory encephalitis, IE. Each of these conditions is defined by an abnormal gait, a score of > 1. Our definition defines the difference between EPM and IE by the detection of serum antibody to S. neurona. If there are antibodies > 8 to any of the SAG’s (specific surface antigens of S. neurona—1, 5, or 6) we call it EPM. If there are no antibodies, then by our definition the disease is IE. We believe that EPM is a subset of IE horses for which we can determine the etiology (cause). We can offer treatment options for IE following EPM.
What is the ratio of EPM to IE determined by submissions to our lab? Fifty-three percent of the cases have a provisional diagnosis of EPM, 3% have another diagnosis, and 44% have IE, some are post-EPM and the rest are of unknown etiology. We should have enough cases to generally indicate that this represents the incidence in the general equine population.
The diagnosis matters because EPM and IE are treated differently with different expectations of treatment outcome. We approach all cases as though they are S. neurona related for several reasons. That is how I understand the clinical diseases. I won’t miss any EPM cases as we work to define more stringent diagnostics. We realize that serum concentrations of C-reactive protein (CRP) are more important in IE cases and can assist the veterinarian manage the cases. It is a serious state when the CRP remains elevated despite treatment.
We evaluate the data as a change over time. How did the horse respond to treatment? What is the gait assessment before and after treatment? What is the change in CRP over time? A minimum of two submissions, before and after treatment, give us the minimum data we need. We’d like more, we need two.
You may have noticed an increased number of emails from us. As we get busier, we have turned to the computer for evaluations, reporting, and industry updates. The data is at our fingertips so we can discuss your case one-on-one. Should you find the phone busy, you can send us an email, we answer them all.
EPM and IE are devastating diseases and a few horses die. We are saddened by each loss. We appreciate receiving the history on each of these cases and truly value serum from these horses. Please send us these valuable information updates and samples. We will run our battery of tests. As we define more tests, we are happy to share the data from your sample by request…we have trained our computer programs not to send mail to the bereaved.