Supplement Recommendations for an EPM Survivor?

I have a 15 YO Warmblood gelding who is an EPM survivor. He has some residual neurological issues, what do you recommend for his supplements?

Dear Kate,

EPM (Equine Protozoal Myeloencephalitis) is a challenging disease. If horses recover from it, they can still be left with temporary or permanent deficits such as you mention. Sometimes these deficits are mild (like a hind toe that drags) and don’t interfere much with riding. However, sometimes they’re more serious (like stumbling or incoordination) and result in a horse being retired from performance.

My first advice to you is work closely with your veterinarian to make sure the infectious organism (usually Sarcocystis neurona) has been completely eliminated. Use non-steroidal anti-inflammatory drugs (NSAIDs) such as phenylbutazone as directed to reduce any inflammation that treatment may have caused. Develop a physical therapy program that helps your horse regain his strength and coordination. This may include hill work, cavaletti, walking across different surfaces, massage and other rehabilitation techniques.

Supplements also play an important role in supporting a full recovery from a neuromuscular condition like EPM. As an antioxidant, Vitamin E protects tissues locally from damage by free radicals and supports a healthy immune system. Vitamin E works close with its partners Selenium and Vitamin C to safeguard the body from the oxidative stress of exercise, illness and certain medical conditions. However, only supplement with Selenium if this mineral is deficient in your particular area.

Ingredients known to fight inflammation naturally are also good choices for supplementing a horse being treated or recovering from EPM. Included in this category are Omega 3 Fatty Acids, MSM, and herbs such as Boswellia, Yucca and Devil’s Claw. Depending on how much muscle atrophy your horse experienced, you may also want to consider supplements designed to build healthy muscle. Look especially for products with the essential amino acids lysine, threonine and methionine, the building blocks of protein.

[Editor's note: To learn more about EPM, read our article in the Health and Nutrition library at]

Lydia Gray, DVM MA, is the Staff Veterinarian for SmartPak. Prior to joining SmartPak, Dr. Gray served as the first-ever Director of Owner Education for the American Association of Equine Practitioners. She has authored numerous articles in publications such as The Horse, Horse Illustrated, Western Horseman and a variety of veterinary journals and magazines. Dr. Gray is also a frequent speaker at horse expos, veterinary conventions and other events. After graduating with honors from the University of Illinois College of Veterinary Medicine and receiving her Master's Degree in Interpersonal and Organizational Communication, she practiced at the Tremont Veterinary Clinic for several years. Dr. Gray is active in the American Veterinary Medical Association and Illinois State Veterinary Medical Association. She enjoys training and showing her Trakehner, Newman, in both combined driving and dressage, and is a USDF “L” Program Graduate (with distinction). Find Dr. Gray on Google+

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2 comments on “Supplement Recommendations for an EPM Survivor?
  1. Robyn says:

    Thank you for posting this! I have an 8 yo Thoroughbred gelding who is an EPM survivor, and have been wondering if there were any supplements that would be specifically beneficial to add to his diet. This was a great article and I am quite happy I came across it. Thank you, SmartPak! :)

  2. Lauren says: I started a blog about my horse and her fight with EPM. I plan to document before, during and after treatments… including images and videos. <3

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