Page 64 - COVER__October2020.indd

EQUINE HEALTH
like muscle biopsies or electro diagnostics like EMGs. These can maybe help localize and pinpoint the source of the problem by looking for alterations in the electrical signal we pick up from the muscles.”
Electromyography (EMG) is a diagnostic procedure that’s sometimes used to assess the health of muscles and the nerve cells that control the muscles. The EMG results can reveal nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmissions.
“This can help us figure out the area of the spinal cord that is affected, if it is in fact a spinal cord disease. There are many different diagnostic modalities that we can utilize to look for either
a primary spinal cord problem or a primary musculoskeletal problem like the pelvis. Then potentially we can address whatever it is, but sometimes we can’t, even if we know what the problems are. Sometimes the only treatment
we can provide is rest—for a pelvic fracture, for instance,” explains Johnson.
EPM, which can be caused by possum droppings, is a disease the veterinarian will check for.
Anti-inflammatory medications may be use- ful. “With many neurologic problems the horses tend to get better if you keep them moving. With a horse that is rehabbing from EPM, you want to treat for the protozoa but also include some degree of physical therapy and mild exer- cise like turnout or hand walking. Sometimes these sidewinding horses do better with exercise restriction, however. If you put them on stall rest with anti-inflammatories for a little while, and some pain control, they get better faster than if you leave them out at pasture wandering around and reinjuring themselves or continu- ally exacerbating the condition. It’s variable, however, from horse to horse, whether they get worse or improve with exercise. I generally am more apt to recommend periods of stall rest
for the sidewinders than for horses with other neurologic conditions,” she says.
Steroids can sometimes be helpful, but with older horses a person may want to avoid use of steroids because of the added risk for endocrine
s Radiographs can detect some pathology in the pelvic region, but a lot of times a good view cannot be obtained unless the horse is put under general anesthesia and that’s often the last thing you want to do with old horses with problems.
 If a test for EPM comes back negative, a bone scan or ultrasound would be suggested to look for pelvic fractures.
problems and laminitis. “If you find that the horse has arthritis in a certain location and you can target that joint with a steroid (rather than using it systemically), this might be beneficial.”
The only disease that can be specifically treated, that is commonly associated with this syndrome, is EPM. “If the cause is arthritis or a pelvic fracture or something else, we are sim- ply just managing the condition with reduced exercise and confinement, anti-inflammatories or painkillers. Thus it is important early on to investigate whether or not the horse is likely to have EPM—because if it is EPM and you put them on treatment, there is a good chance of improving that horse, even if you can’t make
it completely normal,” says Johnson.
If you determine that the horse does not have EPM, you can decide how much time and effort and money you want to invest in dealing with those less-treatable causes or supporting the horse to give it more time— especially if it’s an older horse with multiple problems. You have to weigh the option of euthanasia or trying to keep them comfortable a bit longer.
“It’s good for people to be aware of this syndrome, and for them to know that this is just a description of a gait, and not a diagno- sis in itself. Also, it is not common, and seen mainly in older horses. Some of them are retired already,” she says.
“Unfortunately, it is hard to predict which ones will respond and improve, and which ones won’t. Sometimes you just have to give them the time and see. Some horses have had severe signs and recovered temporarily. There was an old horse at my barn that had a few good years after his first episode; he was happy and comfort- able in his pasture before the problem occurred again, and then he was having trouble getting up after lying down. At that point the owners decided to put him down.”
Some people report that these horses seem dull and depressed, but this may depend on what the actual cause might be. “It’s not really a brain disease but there may be a pain com- ponent that might make some horses dull,” she says.
“The cause of the side-walking may be neurologic or musculoskeletal. I have seen more cases that are due to neurologic, spinal cord problems but have also seen a fair number that are due to musculoskeletal problems.”
62 SPEEDHORSE October 2020