Decoquinate 480 mg/scoop + Levamisole HCl 2 gm/scoop + Elevate 7 gm/scoop, Oral Powder, 30 Scoops (39cc Scoop)
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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
Decoquinate + Levamisole + Elevate Powder for EPM in Horses
Decoquinate is a 4-hydroxy quinolone coccidiostat used in veterinary medicine; it is widely used in supplementing the rations of horses, cattle, veal calves, goats, sheep and chickens. In horses, decoquinate acts on the sporozoite stage of the S. neurona life cycle. The mechanism of action for decoquinate is to disrupt electron transport in the mitochondrial cytochrome system of coccidia.3
Decoquinate is labeled for use in cattle for the prevention of coccidiosis in either ruminating or nonruminating calves, cattle, young sheep, and goats, or broilers caused by Eimeria spp. Currently, it is the only anticoccidial medication approved for use in veal calves. In horses, decoquinate is not effective for treating clinical coccidiosis and has no efficacy against adult coccidia. Decoquinate is not FDA-approved for use in food producing animals.3
Levamisole HCl was originally described for treating helminth infections, but it is also widely used for modulating immune responses. It is an antinematodal parasiticide and immune stimulant that is indicated for the treatment of many nematodes in cattle, sheep, goats, swine, and poultry. Levamisole binds cholinergic receptors found on protozoa, such as those causing EPM.3
In vivo assays in horses show that levamisole (with a half-life of 1 to 4 hours) is metabolized rather quickly. The elimination of by-products in the serum associated with the metabolism of levamisole HCl, however, can take much longer. Some by-products are detectable in the plasma for longer than 70 hours.3
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. DECOQUINATE 480 MG/SCOOP / LEVAMISOLE 2 GM/SCOOP / ELEVATE POWDER 7 GM/SCOOP (30 Scoop Jar) by NexGen Pharmaceuticals provides effective treatment in protozoan infections with easy absorption and digestion and is indicated for the treatment of equine protozoal myeloencephalitis (EPM).
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.
3Plumb’s Veterinary Drugs.