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| ==Treatment== | | ==Treatment== |
| + | ===Ancillary medication=== |
| + | '''NSAIDs''': DMSO IV as 10% solution, thought to reduce CSF pressure and improve clinical status. Recommended for severe cases of EPM or to avoid worsening inflammation that may be induced by parasite kill(Furr). Caution: DMSO may cause intravascular haemolysis(Pasq). |
| + | '''Corticosteroids''': a short course of dexamethasone may be beneficial whilst waiting for antiprotozoals to take effect. However, use is controversial because cell-mediated immunity is required to control parasites(Pasq) and stress is a proposed risk factor for EPM.(Furr) |
| + | '''Immunomodulators''': |
| + | *Levamisole influences T-cell mediated immunity and enhances phagocytosis |
| + | *Parapox ovis virus (PPOV) immunomodulator (Zylexis, Pfizer Animal Health, Kalamazoo, Mich). This vaccine has been shown to upregulate the secretion of cytokines including IFN-γ in several species (110 in Furr). IFN-γ is thought to be essential for the clearance of S neurona, thus PPOV may be useful in EPM.(Furr) |
| + | '''Multiple vitamin B supplement'''.(Pasq) |
| + | ===Supportive management=== |
| + | Box rest with deep bedding and good footing or turn out in a flat, grassy field. Ensure all obstacles are removed and avoid turning out ataxic animals with dominant herd mates. Recumbent horses will require dedicated support and a sling if available. (Furr) |
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| ==Prognosis== | | ==Prognosis== |