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Date:4/17/2014 6:20:26 AM
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New Treatment for EPM
Equine Protozoal Myeloencephalitis (EPM) is a progressive, degenerative disease of the central nervous system of the horse. The disease is characterized by asymmetrical ataxia with or without muscle atrophy. There are several diseases of the central nervous system that can mimic EPM. It is important for the veterinarian to do a thorough neurological examination with appropriate laboratory diagnostic support such as a cerebrospinal (CSF) analysis. Early, accurate diagnosis and treatment offer the best chance for success.
Until recently there were no approved treatment products for EPM. Veterinarians, out of necessity, had to use products that had not been evaluated for efficacy or safety when used in treating horses with EPM. In July of 2001, the FDA approved Marquis® (15% w/w ponazuril) Antiprotozoal Oral Paste, the first medication for the treatment of EPM in the United States. Marquis is manufactured by Bayer in Shawnee Mission, Kansas.
Marquis is a prescription medication. It is a unique paste formulation with a gel-like consistency. The active ingredient of Marquis is ponazuril, an anticoccidial compound with cidal activity against the protozoal parasite that causes EPM. The dosage regimen is 5 mg/kg (2.27 mg/lb) body weight given orally, once per day, for 28 consecutive days. This product is packaged with four syringe barrels of paste per box and a calibrated dosing ring for accuracy and ease of administration. Each syringe contains enough paste to treat one, 1200 pound horse for seven days. The four syringes comprise the entire 28 day treatment program. Marquis should be stored at controlled room temperature, between 59 and 86 F. This product has a 24 month shelf life.
Marquis has demonstrated activity against Sarcocystis neurona (the causative agent of EPM) in both the laboratory and field setting. Efficacy studies were conducted in five states by seven different investigators. These studies demonstrated the effectiveness of Marquis against naturally-occurring cases of EPM. Marquis has also been demonstrated to be safe when used according to label directions. Target animal safety studies* at up to six times (6X) the label dose for two times (2X) the label treatment duration, produced sporadic inappetence, occasional loose stools and, in three of four study mares, moderate uterine edema. The safe use of ponazuril in horses intended for breeding purposes, during pregnancy, or in lactating mares, has not been evaluated.
It is important to note that while Marquis may effectively clear the horse of S. neurona, it will have no effect on irreparable, central nervous system damage caused by the parasite prior to treatment. The prognosis for animals treated for EPM may be dependent upon the severity of the disease and the duration of infection before treatment. Early and accurate diagnosis followed by immediate treatment are critical for best clinical results.
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