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Equine Protozoal Myeloencephalitis (view source)
Revision as of 23:38, 16 July 2010
, 23:38, 16 July 2010no edit summary
====Signalment====
====Signalment====
Mostly Standardbreds and Thoroughbreds aged 1-6years.<ref name="Pasq">Pasquini, C, Pasquini, S, Woods, P (2005) '''Guide to Equine Clinics Volume 1: Equine Medicine''' (Third edition), ''SUDZ Publishing'', 245-250.</ref> Foal infection may be possible.<ref name="EPM8">Gray, L.C, Magdesian, K.G, Sturges, B.K, Madigan, J.E (2001) Suspected protozoal myeloencephalitis in a two-month-old colt. ''Vet Record'', 149:269-273.</ref>
Mostly Standardbreds and Thoroughbreds aged 1-6years.<ref name="Pasq">Pasquini, C, Pasquini, S, Woods, P (2005) '''Guide to Equine Clinics Volume 1: Equine Medicine''' (Third edition), ''SUDZ Publishing'', 245-250.</ref> Foal infection may be possible.<ref name="EPM8">Gray, L.C, Magdesian, K.G, Sturges, B.K, Madigan, J.E (2001) Suspected protozoal myeloencephalitis in a two-month-old colt. ''Vet Record'', 149:269-273.</ref>
====Differential Diagnoses====
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The disease may mimic almost any neurological disease because the parasite can localise in any region of the central nervous system (CNS).(EPM 8)
Includes virtually all diseases of the CNS (Furr)
Cervical vertebral malformation (CVM, cervical compressive myeolpathy, Wobblers) (but symmetrical gait deficits, worse in pelvic limbs (3 in Hahn p603) with spasticity and dysmetria, good retention of strength, no muscle wasting (Furr)), standing plain lateral rads of C1 to T1 (Hahn in Furr), can be concurrent with EPM (Hahn)
Infectious diseases of the CNS (systemically ill, pyrexia and changes in leukogram)
WNV encephalitis - CSF abnormal, difficult if horse not febrile and no excessive muscle fasciculations, IgM capture ELISA
EEE - CSF abnormal, abnormal motor function (Long), rapidly progressive (seino, p134)
WEE – abnormal motor function (Long)
VEE – IgM capture ELISA (Bertone)
Equine herpesvirus-1 myeloencephalopathy – sudden onset and early stabilization of neuro signs, multiple horses affected, recent fever, abortion (14 in Wilson and Pusterla p615) dysuria not often seen in EPM , PCR (Furr)
Rabies – rapid progression (Sommardahl), behavioural alterations, depression, seizure, coma (Long), post-mortem dx (Sommardahl)
Multifocal disease, ataxia and muscle atrophy also found with:
Polyneuritis equi – cranial nerve deficits peripheral with no change in attitude (6 p623 in Saville), differentiate by Western blot analysis of CSF(20 p623 in Saville)
Equine degenerative myeloencephalopathy – symmetrical signs (Nout, p606) may get increased CSF CK (3 in Nout p608) and reduced serum Vitamin E concentrations but unreliable ante mortem dx
Changes in leukogram and CSF seen with:
Verminous encephalomyelitis – acute onset, CSF analysis (Jose-Cunilleras)
Bacterial meningoencephalitis - stiff neck
CNS abscessation (Furr)
Spinal trauma (Pasq) – hx (usually acute onest nuero signs), usually spolitary lesion loclaised by neuro exa (71 p589) rads, myelography, CT, MRI, nuclear scintigraphy, CSF analysis, nerve conduction velocities, EMG, transcranial magnetic stimulation (p590)
Occipito-atlanto-axial malformation – deficits develop before 6mths (7,12, Seino)
Cauda equina neuritis
Spinal tumors – CT, MRI, definitive dx requires cytology, biopsy, histopathology, CSF analysis (Sellon)
Sorghum cystitis/ataxia (Pasq) – posterior ataxia or paresis, cystitis, hx of grazing Sorghum species (Talcott, ch22)
====Prognosis====
====Prognosis====