EPM Rehabilitation Summary
There are no published clinical studies, or protocols to
follow when rehabilitating the EPM horse. It’s going to take
creativity, patience, and intuition on the part of the owner or
trainer. Each individual horse will follow a different
timetable, and have a different outcome. Making sure that the
horse is ready to move forward is imperative, so go through this
checklist:
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The horse has finished the recommended treatment protocol.
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During turnout the horse shows improving movements and gaits
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The owner has diligently tried to determine the extent of
deficits
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The owner has conferred with their veterinarian
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Diet and stress factors have been reviewed to improve immunity
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The horse has been ground worked and is ready for more
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The owner is not rushing to fulfill their own schedule
One of the most important items from this list is gaining
accurate knowledge of the horse’s physical deficits. Use the
Tellington TTeam as a Compliment in the Rehabilitation of Horses
with Neurological Deficits book to help uncover deficits and
begin the recovery process.
If the horse shows many uncoordinated movements, trips often, or
has other deficits that make him unsafe to ride, continue to
ground work the horse, adding new tasks only when they are ready
for it. Consistently asking the horse for more than what it can
physically deliver can create stress and promote a relapse.
Rehabilitating the EPM horse is a long term process. While the
horse may learn to compensate for the loss of feeling in a few
weeks, allow at least one year for the damaged nerves to
regenerate.
When the horse is unable or unwilling to perform a movement or
desired behavior, the owner must consider three reasons why the
horse is not performing at pre-EPM levels. First, that the horse
has been out of work for months, and is not accustomed to
requests by the owner. Second, that the horse has physical
deficits in weak muscles, or limited muscle control. Third, that
lesions in the brain have caused mental behavior changes.
Defining the Performance Problem
Chances are good that your recovering EPM horse is not going to
perform to the standards he held before EPM. Figuring out why he
can’t perform is important to helping him recover. For each
problem or deficit, think through the possible causes below to
find a solution.
Have a second person video the training. Review of the video
will help the trainer to see how all parts of the horse are
responding to a request, and will show balance problems from a
different vantage point. Videos taken at specific intervals can
become an informative diary of progress.
Training Tune-Up
If the horse has been out of training for months, he is going to
be rusty and perhaps slow to respond to requests by the owner.
Fortunately, this is the easiest of the issues to fix. Through
slow ground work exercises, ask the horse to respond to your
commands. Start with the commands that he performs well, and
slowly build the list of moves you request. Use the same
patience that you had in training him originally. Frustration
and anger will not help the horse.
Pull out the dusty videos or CD’s from your favorite trainer,
and spend some time perfecting your approach and timing.
Consistent work over a few weeks should show improvement in the
horse’s response, if it is training related. The recovering
EPM’r will not physically improve in a consistent manor, so be
flexible enough to end the training early if the horse tires.
Physical Deficits from EPM
Both weak muscles from time-off and lack of neurological control
of muscles form the majority of problems for the recovering EPM
horse. The horse can learn to compensate for the lack of
feeling, or may eventually generate new nerve pathways, when
dealing with deficits in movement. The issues of weakness and
control are connected. Giving the horse more turnout time will
allow more gentle exercise, more firing of the muscle synapses,
and better mental health.
Consider that the horse may have deficits in areas of the body,
or layers of muscle that are not visible. The connecting muscles
from the neck, chest and vertebrae are important to functions of
gait and transition. Atrophied muscles don’t just cause
weakness; they can cause stress in other parts of the body as
the horse tries to compensate by using different muscles.
Mental Changes from EPM
Autopsies of EPM positive horses show that lesions sometimes
form in the brain. Anecdotal stories of subtle changes in
personality come from owners and trainers. This aspect of EPM is
hard to define, and harder to diagnose. EPM lesions in the brain
can affect any body system controlled by the brain, and
therefore many mental and physical health issues.
Typical EPM Rehabilitation Issues
Round Pen and Lounge Line
The most commonly reported symptom of EPM is asymmetrical ataxia
(uncoordinated) movement of the rear legs. Toe dragging and
missteps on sloped ground are two examples of this. This
physical deficit makes it hard for the horse to turn tight
circles. Work the horse by hand walking uphill to build strength
in the hind end.
If the horse has improved in coordination, and can turn without
problems, the lunge line or round pen can be utilized for short
periods. Watch carefully for tiring, stumbling, or other signals
indicating you should stop. If the horse cannot be worked safely
in both directions, revert to hand walking.
Changes in Eyesight
Deficits in the eyesight may be caused by lesions in the optic
nerve or brain, making them hard to diagnose with a standard eye
exam. Episodes of spooking, especially outside of the horse’s
normal work area, may indicate problems with eyesight. Long term
observations of the horse may be more diagnostic than an eye
exam.
Resistance to the bit
If the horse had deficits to the jaw, lips, tongue, or cheeks,
his reaction to his usual bit may change. He may not be able to
feel it, or it may cause unaccustomed pain. Have an equine
dentist perform an exam before making changes to the bit.
Shoeing
EPM horses with limited sensation in one or more legs may have
toe dragging, stand with a leg cocked at an angle, or have
changes to their gaits. Have the farrier check for unusual wear
patterns. Whether the horse is shod or barefoot, make sure the
farrier knows of any physical deficits.
Many EPM horses can’t stand for long periods with a hoof lifted.
A few are unstable months after treatment. Try placing the horse
next to a solid wall to trim or shoe. This may help limit
swaying. The horse may become defensive of legs he can’t feel,
and kick, pull away, or jump to regain balance.
Locking Stifles
This problem has been reported in some EPM horses. It is not
known if the ‘locking’ comes from weakness due to time off, lack
of feeling in the muscle, or possibly related mineral
deficiencies. Some veterinarians recommend strengthening the
stifles by backing the horse. Start with a few steps at a time,
working on level ground. Build up to backing many steps, several
times per day, and some steps backing uphill.
Downward Transitions
Sometimes the first symptom of EPM is trouble in downward
transitions. If the horse can’t feel its rear feet, and the
rider is using the bit to ask for a downward transition, the
horse can become unbalanced. The horse may have problems
compensating for requests to slow down, until he has full
feeling of all four feet.
This is one area where the skill of the rider comes into play.
The rider’s body position, balance, use of hands, and focus are
needed to help the horse. Using a pre-signal such as breathing
or an auditory cue will help the horse to know that a request is
coming. Consider learning the Centered Riding techniques to help
your horse while ground working and under saddle.
January 2012
