Equine Polysaccharide Storage Myopathy (EPSM) and Thomas Equinas

This blog serves to chronicle my day to day struggles dealing with this metabolic disorder and how it effects my soon-to-be 13 year old dressage horse.

Friday, November 5, 2010

Day 1 On the Road to EPSM Recovery

Thomas at 5 years old
If today is Day 1, I guess yesterday was Day Zero. It sure felt that way. I had waited a week and a half for the biopsy results to come in and two weeks prior to that for the genetic test results. I had been telling myself that I wanted the result to be "positive", but when Barb, my vet, called and told me it indeed was positive for Moderate Type 2 PSSM (also known as EPSM), I can't say that I jumped for joy.

Let me go back and give you a little history. Thomas, who's show name is "Thomas Equinas" is a 12 year old 1/2 Oldenburg, 1/4 Percheron, 1/4 Heinz 57 nearly black gelding. He's big. Really big. With shoes on he rings in at 17.3 3/4". I refuse to call him 18hh. I bought him in February of 2002 as a not-quite-four year old and I had big dreams of the wonderful things we would do together. And we did. He was a good student, and although we had our trying times together we moved up the dressage levels fairly easily. I had never had a horse with so much natural ability. His gaits are big and lofty. As a youngster, he was a bit of a Baby Huey. His size and constant growth for nearly four more years tended to make him always slightly off balance, but he tried and he always improved. Steadily, we climbed up the training scale and I was trying to clean up the loose ends on the required Fourth Level movements in the Spring of 2007 when things started to come undone. We went to Dressage at Saratoga in May and had one of our best Third Level tests in front of the Grand Stands. I remember thinking, "Wow, Fourth Level is within reach." Later that weekend we had a couple of uncharacteristic incidents of shying during tests, but otherwise, he was pretty good. After we got home and Tom had a day off from work, I got on and he suddenly reared in the middle of a warm-up trot circle. I reprimanded him, sent him forward and didn't think too much of it. In the days following the rearing became more and more problematic. He would shut down and refuse to go forward. When almost 18 hands goes straight up in the air, it's not a happy place. I'd get off and lunge him in side reins and he was fine. Not lame, not lacking energy or forwardness. Nothing.

I keep Tom at home and I work him primarily on my own. I trailer to my trainer's when I can; at least twice a month, or  have my trainer come to me. Within a couple of days I had my vet give him a chiropractic adjustment and a shot of Legend. The rearing continued. I trailered 45 minutes to my trainer and he reared. Wouldn't go forward at all.

I tried a different trainer. I tried a different vet. I tried a different saddle, schedule and bridle. We'd have some days that were better than others, but generally things were not good. By mid Summer we discovered he had Lyme's Disease and treated him for that. Still rearing. By Fall he was diagnosed with a slight suspensory ligament injury. We treated that and had him on stall rest with hand walking. In the Spring of 2008 I thought we'd be starting all over with a nice new suspensory and a clean slate. The rearing continued. Had he learned this behavior to get out of work? I called in my friend Kat, who is a Natural Horsemanship graduate. She was able to get him going forward, and she recommended semi-weekly massage therapy with her friend, Cheryl. Kat and Cheryl helped Tom (and me) enormously. Cheryl made Tom feel better and was able to give me really good, regular feedback as to how he was doing. Kat showed me how important it was to make my aids super clear and then "go away" as soon he responded. She helped me to regain my confidence and start trusting my horse again.

But things still weren't right, and my vet decided nuclear scintigraphy (bone scan) might help locate his discomfort. He ended up with an injection in his sacroiliac which put him on the road to recovery for awhile. It made him comfortable enough to lunge over trotting poles and then raised trotting poles, working slowly and diligently to build his back strength back up. By the Fall of 2008 I was ready to get back on. Kat continued to help and Cheryl was very pleased with his new musculature.

In 2009 we were able to attend a couple of local dressage shows. We trotted down the centerline at Third Level, and got comments like "horse needs more engagement". I didn't mind. At least he wasn't standing on his hind legs! At that time I was completing the USDF 'L' Judges Program, so I had little time to focus on Tom's training. I just kept him going and continued to try to build his strength, and we still had good days and bad days.

In March of 2010 Tom became very foot sore, with bruising on all four feet. That was a new symptom and his sore feet definitely led to a very sore body. Rest, padded egg-bar shoes and yet another careful re-introduction to work and we were actually able to compete a little bit more successfully this summer. But still, not the old Thomas with his big, floaty gaits.

Thomas at Vt. Dressage Days 2010
Then this Fall when I was scratching my head again about why his performance was less than stellar, Thomas came in from the pasture hobbling on his left front foot. Vet said it was an abscess and I should soak, poultice and wait. I did and nothing happened. Thomas stayed head-bobbing-lame-at-the walk for three weeks! Finally, when I was finishing up the soaking for another day, a 2 inch stick popped out of his frog. So, no abscess. Just a stick jabbed into his foot! Ouch! After that he was very muscle sore. He'd look OK on the lunge, but as soon as I'd get on he was hollow and very uncomfortable. Checked his Lyme titer- normal. Checked his blood-normal. Finally, we decided to test for EPSM.

So there it is. Today the stitches in his biopsy incision were removed. It has stopped raining so I will go lunge him off the halter for a few minutes. The goal is to start slow and build daily, adding  a few minutes of work each day. I have a consultation with Barb, my vet, on Monday to discuss feeding changes, and exercise. I called my friend Penny today to set up boarding at her indoor arena just down the road as soon as the snow flies. It should be a good situation because the horses at Penny's can go in and out of the barn at will. That's the best thing for EPSMers, so I hear. I will try to keep you posted here about what's happening with Tom. We'll see if there's any improvement. Words of advice and/or encouragement are always welcomed!

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