SARAH: "What is the difference between Wobblers, EPM,
and Lyme?"
Oh, boy, our shortest question!
DR LYDIA GRAY: Long answer.
SARAH: Might be one of our most robust.
DR LYDIA GRAY: No, because--
I understand where she's coming from.
Unfortunately, she's probably got a horse
with some sort of gait asymmetry, or--
SARAH: Neurologic symptom.
DR LYDIA GRAY: And it's like, is it neurologic, or is it lame?
That's a big question.
There are actually talks at vet conferences that are full.
And they're only titled, is he neurologic, or is he lame?
And we're all like, we don't know.
So that's where you start.
And after you do a complete physical exam.
SARAH: Is there a game show?
Do you guys do game shows?
DR LYDIA GRAY: Jeopardy?
SARAH: Yeah.
DR LYDIA GRAY: I can't disclose that.
SARAH: (CHANTING) Is he neurologic, or is he lame?
I feel like there's, a real--
DR LYDIA GRAY: Buzzers, and stuff, yeah.
I can't disclose that.
So you do your physical exam.
And then you might do a neurological exam.
And I think Dr. Kaneps was here, and--
SARAH: He sure was.
DR LYDIA GRAY: --did neurological exams.
So that'd be a great video to watch,
because there are some specific tests that
can indicate to the veterinarian,
is the brain working properly?
And is the spinal cord, and then all the little segments
coming off of it, working?
Is the information flowing back and forth unimpeded?
And so, once you have it narrowed down to,
the nervous system is fine, now it's a lameness--
or, in the case of Lyme disease--
it's an infection.
So we should probably start after that.
Some of these are infections, and some aren't.
So the first one I think she mentioned was Wobblers.
And it might be called that.
It might be called Equine Wobbler Syndrome.
But the veterinary name is cervical vertebral
malformation, or CVM.
SARAH: I don't know why we all don't say that.
DR LYDIA GRAY: [LAUGHTER] And what
it means is that some vertebrae in the neck are malformed.
And it can happen with birth or it can be genetic,
or it can happen with an accident or injury.
And because the vertebrae are not formed right,
they compress on the spinal cord as it goes through.
So then, the communication is impeded.
And so wobbler horses--
their name, they stagger.
They look like they're drunk.
Or the word we use-- or the vets might use-- is ataxic.
So if you hear your vet talking about ataxia,
that means wobbling and staggering and acting drunk
and not having sea legs, whatever.
So that's something that, sometimes,
can be fixed with management, nutrition, and some medication.
Usually it has to go to surgery.
And they put in a basket, they call it, and stabilize
the vertebrae that are not shaped right
and that are pinching that.
So that's wobblers.
SARAH: But helpful that it has a treatment option?
DR LYDIA GRAY: It can have a treatment, yeah.
The problem is the prognosis isn't
super great for full restoration to 100% of what the horse was
before it began to show signs.
So that's-- you know, when you hear about a horse being
Wobblers, you're like, oh, that's--
because we can save the horse, but we probably
can't save the career.
And it wouldn't be safe.
So that's that one.
And then EPM-- so EPM stands for equine protozoal
myeloencephalitis.
So, equine is horse.
Protozoal is the organism that does the infection.
And myeloencephalitis-- so the "-itis" means inflammation--
SARAH: Yep.
SARAH: --and the "myeloencephalo"
is, where the heck is the inflammation?
And it's the brain and spinal cord.
EPM has been around since the '90s.
It's only an American thing, so you
tend not to see it in Europe or European horses.
It can be treated.
There's three medications now.
There's Marquis.
There's ReBalance.
And ponazeril-- Protazil--
is the third one that are all FDA
approved medications for it.
It's tricky because, depending on where the organism lands
in the spinal cord, from the brain to the tail,
you can have all different signs.
And so that's why a horse with EPM might be acutely down,
might look like a West Nile Virus.
It might look like a Wobblers.
It might look like a lameness.
I mean, until you know that this is neurologic or lameness,
and then where the lesion is, it's tough.
The EPM horses, also, when you first begin to treat them,
can get worse right away rather than better.
And that's a little scary.
So I would say, if your horse is displaying
any signs of gait asymmetry, is a really good word,
or in-coordination, the sooner, with these neurological
problems, you contact your vet, the better it
is, because when there's neurological damage,
it does tend to be permanent.
Nerve tissue is not that great at regenerating and restoring
and rebuilding like some other tissue in the body.
And then, of course, Lyme disease, also an infection--
that one is tricky-- these are all tricky diseases--
because Lyme can look-- there is a neurological component,
there's a lameness component.
Like, one of the main signs we think of with Lyme
is shifting lameness, like they have hot, swollen joints--
I swear it was the left front, and then
you come out the next day, and it's the right front.
And so it moves around.
And people can get it, too.
So it's really uncomfortable.
But they can have signs.
They can have eye inflammation and all sorts of things.
And that's a bacteria, Borrelia burgdorferi,
spread by the deer tick.
And I found out today that not everyone
knows what the name is from--
Lyme, Connecticut.
SARAH: Oh, yeah!
DR LYDIA GRAY: Yeah, yeah, because not every place
in the country-- like, if you look at the map,
there's a lot of it in New England,
there's a lot of Lyme disease in the Upper Midwest,
and then, like, the state of Washington.
SARAH: Yeah.
DR LYDIA GRAY: So I'm thinking it's states
that are near Canada is what--
SARAH: Interesting.
DR LYDIA GRAY: --is what it looks like, yeah.
SARAH: Yeah, a lot of tick-borne diseases in other areas.
DR LYDIA GRAY: Yeah.
SARAH: Different ticks, different diseases.
DR LYDIA GRAY: This is the number one tick-borne disease
of people and animals.
But I hope her horse doesn't have these.
But it can be tricky to figure out.
None of them have good tests, really,
to figure out quickly with 100% confidence what they are.
It can take a while to figure out any of these three.
SARAH: Yeah.
I think she asked what the difference was.
But in terms of what the similarities
are, incredibly frustrating, scary
if you're the horse owner.
So we hope that that's not happening to your horse.