Three Letters You Never Want to Hear in a Diagnosis....

E.P.M. 

Also known as Equine Protozoal Myeloencephalitis.  Sadly, it's a disease I have encountered before.  As a matter of fact, the first horse I ever saw put down suffered from EPM.  "Curtain", short for Curtain Call, was an older Thoroughbred at Robin's farm in Iowa, where I had my first job as a working student.  He was diagnosed somewhere around seven, after having two falls cross country - one in which his rider's leg was broken.  Over the years, the disease slowly progressed and attacked his neurological function.  He eventually sucumbed to colic, and it saved everyone from having to make the decision of whether he would make it through another tough Iowa winter.

That was the last time I encountered an EPM horse.  Until this morning, when I received a voicemail that Samson's titer results were back.  The vets at NC State decided to send it off after he exhibited some obvious ataxia after his seizure-like episode.  I didn't hesitate to let them send off the test, especially since he has a long history of being "wonky" - he has always had a bizarre unsoundness that could never quite be pinpointed.  In all honesty, EPM and Lyme disease have always piqued my curiousity, because either diagnosis would explain a lot of his weird symptoms over the past year.  So I let them send the test.  Then I proceeded to more or less forget about the whole thing, since I have been buried in the constant bustle of checking vitals, administering medications, trailering to follow-up appointments...it's been an endless stream of one thing after another, which I have gratefully accepted simply because he is still HERE.

But back to the voicemail.  The attending veterinarian left me a message that the panel had come back with a greater than 95% chance that he is EPM positive. 

All of a sudden, the cloudy feeling of doom I have been dragging around all day seemed to make sense.  Have you ever woken up just KNOWING things weren't going to go well?  I woke up with that feeling this morning.  Did my best to shake it, and then three hours later, the phone call comes.

I know it isn't the end of the world.  I really, honestly know that.  It is a fairly treatable disease.  But it's not cheap.  At this point, I feel like I am in so deep I don't know how to get out anymore.  I also feel like my poor boy has so many strikes against him at this point, it's just a matter of a ticking clock.  The instability in his feet that could shift at any point and cause a debilitating lameness; the EPM we have to decide whether or not to treat...How could I not treat?  I have watched a horse succumb to neurological disease.  It isn't pretty.  I don't know that I could watch my heart horse fight that kind of battle. 

I have already made the decision to fight for this guy - mainly because he keeps showing the will to fight on.  So I suppose the only obvious choice is to take this in stride with the rest of the problems that face us.  I just feel like this poor guy can't catch a break, and I wish I could just make it all go away for him.  All I can do is continue to make the best decisions possible for him.  And hope and pray that I will know when enough is enough.