Equine protozoal myeloencephalitis (EPM) is one of the most serious diseases of horses in the Western Hemisphere. EPM is a disease that affects the central nervous system and is caused by the protozoan organism Sarcocystis neurona. This disease was first described in the 1960s as “segmental myelitis”,¹ but by the mid-1970s, it was determined that it was caused by a protozoan organism. Several years later, researchers discovered that the primary causative agent was S. neurona. In the late 1990s, another organism called Neospora hughesi was also shown to cause EPM in some cases.²

Occurrence and Symptoms of EPM

Many horses in the Western Hemisphere have been exposed to the S. neurona parasite. It has been reported that in some areas of the U.S., over 90% of horses will be seropositive for S. neurona. Only a very small percentage of horses that are seropositive to either the S. neurona or N. hughesi parasites will ultimately develop EPM, however.¹ Sarcocystis neuronahas a two-host life cycle which includes both a definitive host and several likely intermediate hosts. In 1995, the opossum was determined to be the definitive host of this parasite. 

The clinical signs of EPM are varied and can include:

• Ataxia (incoordination), abnormal gait or lameness
• Weakness which worsens when going up or down slopes 
• Muscle atrophy
• Paralysis of muscles of the eyes, face or mouth 
• Seizures or collapse
• Abnormal sweating
• Loss of sensation along the face, neck or body
• Head tilt with poor balance²

Levamisole carries several potential drug interactions.

NOTE: Levamisole is classified by the Association of Racing Commissioners (ARC) International’s Uniform Classification Guidelines as a Class 2, Penalty Class B substance. 

Elevate Powder was developed to provide a bioavailable source of Vitamin E to horses. Vitamin E is a powerful antioxidant that helps neutralize free radicals. Horses cannot synthesize Vitamin E, thus it is considered an essential nutrient.² Studies have shown that Vitamin E is often deficient in the diets of horses that do not regularly graze on green grass (a natural source of Vitamin E). Performance and working horses, as well as juvenile and senior horses can also be exposed to increased levels of oxidative stress and can thereby benefit from higher levels of Vitamin E in their diets.

Elevate Powder supplies horses with a highly-absorbable source of vitamin E. In helping to bolster the immune system, it is believed that the Vitamin E in Elevate Powder can help to prevent the onset of EPM in seropositive horses, as well as aiding in the recovery of horses with this disease.

Where to buy Decoquinate + Levamisole + Elevate Powder

Decoquinate + Levamisole + Elevate Powder is available in the U.S. through veterinary custom compounding companies. 

Please consult your veterinarian prior to beginning any treatment regimen.

FOR RX ONLY: A valid prescription from a licensed veterinarian is required for dispensing this medication.

¹MacKay, R., Morgan, K. Equine Protozoal Myeloencephalitis. In: J. American Association of Equine Practitioners, Jan. 2020.

²aaep.org.