Equine Motor Neurone Disease

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FinkleyAlex

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So I got a phone call from the Royal Vet College today, where one of the vets (after a bit of research) is convinced my old boy might have EMND. A little background info - he has lost lots of weight and muscle but bloods show all internal organs, worm counts etc are normal. His cushings test came back slightly positive but not enough to need medication or to cause such weight/muscle loss. The vet came to take a dressing off his leg on monday (he'd been kicked) and he'd happened to get a gunky eye that morning so she had a look and saw that his retinas were degenerating - he only has 70/80% vision which is quite unusual for a 20 yr old. With that and his weight and muscle loss in mind, she is sending us a specialist to do a biopsy for EMND. It seems to be pretty rare - there isn't a lot of research out there on it so I wondered if anybody had experienced a case themselves?
 
I am so sorry to hear that EMND is a possibility. I have no personal experience but, due to your post, I have read through what is available on an American veterinary research site; and it doesn't make happy reading. It seems as if plasma vitamin E levels are used as a differential diagnosis along with biopsy. There is a good article by Mike Brazil , an English vet - about extreme weight loss; maybe your vets could get in touch with him?
 
HappyHooves said:
I am so sorry to hear that EMND is a possibility. I have no personal experience but, due to your post, I have read through what is available on an American veterinary research site; and it doesn't make happy reading. It seems as if plasma vitamin E levels are used as a differential diagnosis along with biopsy. There is a good article by Mike Brazil , an English vet - about extreme weight loss; maybe your vets could get in touch with him?
Click to expand...

Thank you - is it possible to find the article online? I can't find anything about him or his article unfortunately.
 
This is a link to Minnesota university's website, with some info on EMND: http://www.cvm.umn.edu/umec/lab/vitE/home.html

I don't have any direct experience of it, but have come across mention of it when looking into what has caused my ponies to have chronic muscle problems (characterised by chronically raised CK in the blood, and varying degrees of work intolerance).

Isn't EMND meant to be because of low levels of vitamin E, in which case presumably that is being addressed already? Have you any reason to think that his vitamin E would be low (unlikely to be low in horses that have access to grazing, but more likely in horses only fed on hay/haylage because vitamin E can quickly degrade in processed forage).

This is a link to an old article by Beth Valentine (one of the top 2 American vets on equine muscle disease) in which she mentions that EMND and EPSM can appear similar: http://onlinelibrary.wiley.com/doi/10.1111/j.2042-3292.1998.tb00846.x/abstract

... which would also get me thinking about other causes of muscle problems. Do make sure you get copies of all blood reports, for your own future reference. Check what the main muscle enzyme, CK, was - whether it was elevated at all. Also AST and LDH (which can indicate muscle damage and/or liver damage. CK is the only one specific to muscle damage.

Worth addressing diet too, in case selenium deficiency is involved. There seems to be a lot of denial in equine vets about selenium deficiency, but it is very easy and cheap to test selenium content of hay/grass/haylage to find out if the diet is deficient at all (0.1mg selenium per kg dry matter of forage should be adequate according to NRC; anything less is deficient; and if the level is only around 0.04mg/kg then it is low enough to be associated with muscle disease in a wide range of species worldwide.

So worth checking selenium in a forage analysis, and also checking what amount of selenium your horse receives from vits/mins supplements, balancer and/or other hard feeds to see whether there might be a deficiency.

Has he shown any reluctance to work, or any other signs? Have changes happened gradually or suddenly.

From what I've read, EMND is thought to be becoming more common as increasing numbers of horses have limited access to fresh pasture.

It's easy enough to supplement vitamin E through human gelcaps or powdered vitamin E from somewhere like Forageplus.

Hope you get to the bottom of things. For what it's worth, I wouldn't trust blood levels of selenium to indicate whether the horse has enough or not - I don't believe the reference range is appropriate. I'd go straight to the forage analysis.

Do let us know how you get on. I had a couple of ponies muscle-tested (one a biopsy, the other at post mortem), and neither sample showed anything significant despite chronically raised muscle enzymes, so we were either looking at the wrong muscle, or wrong part of the right muscle, or the damage was only showing through enzymes and not microscopically.

Sarah
 
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