EPM Alternative Medicine Summary

Western veterinary medicine in the US does not study the affects of alternative medicines such as herbs, acupuncture, chiropractics, massage, or probiotics.  There are few articles to reference for this site.  Some information is available through studies performed in Europe, and more information is available through individual practitioners.  The lack of clinical trials makes this subject challenging to write about.

Photograph horse and rider
   © Amanda Manfredi  Between The Lines
I find that I must switch to a first person writing style to accommodate equine alternative medicine.  This is a non-scientific approach, and perhaps appropriate for discussing the equine as a whole, not just addressing individual symptoms.

For my family I choose a mix of Western medicine, Chinese medicine, and occasionally homeopathic remedies.  Using Alternative medicine requires having at least a basic understanding of the principals that you are trying to follow.  As such, when I take herbs, or have acupuncture performed by a Chinese medicine practitioner, I rely on the practitioner to instill some wisdom in me.  Not an
easy job, and probably not long-lasting (I like to have my chocolate cake, and eat it too).

My professional Chinese medicine practitioner tells me that an infection means a stagnation of Chi in a meridian, and an imbalance between yin and yang.  It took a long time to get that far out of balance, and it will take time to acquire balance again.  Herbs and acupuncture might take months to help balance the body.  If Chinese medicine is good enough for my family, why not use it to cure equine EPM?

EPM does not allow the horse an extra month, week, or day to heal.

For every day the protozoa S. neurona is in the horse’s CNS, it is causing damage to the neuro pathways.  The longer it takes to kill the infection, the more damage will be done to the system, and the greater the number of deficits.  Early diagnosis and treatment is imperative.

Any remedy used to treat EPM must be able to accomplish two things.  First, it must be able to cross the blood-brain barrier to attack the active infection in the CNS.  Second, it must be able to enter individual cells in the CNS to kill the protozoa when they live within other cells (intracellular).  If the remedy you choose does not do these two things, then it won’t kill the infection.

Utilize a drug known to kill the protozoa, and consider using alternative medicine in conjunction with the drug or after the course of treatment.  There are no FDA approved herbal or acupuncture remedies for EPM, and no large study has been carried out for these treatments.  It takes time to cure an infection using alternative medicine – time that your horse doesn’t have.


The horse’s immune system has been severely stressed and suppressed by the infection.  The horse’s liver will process large quantities of drugs to fight the infection.  Herbs or herb blends can help these conditions and others.  Herbs can be potent pharmaceuticals, so use the same care in selecting an herbal specialist as you did with your veterinarian.


Equine acupuncture is practiced by a number of western trained veterinarians, and Chinese animal medicine practitioners.  It is practiced with the understanding of a different type of medicine; one that utilizes meridians, not neuro pathways.  Acupuncture may be helpful to the horse’s immune system, body functions, and emotional state during and after the infection.

Equine Chiropractic and Massage Therapy

Anecdotally, manipulation of the spine or muscles near the spine is not recommended by equine chiropractors during an active infection of the central nervous system.  Wait for the EPM infection to clear before utilizing these alternative therapies on your horse.


Western medicine is starting to acknowledge the benefits of using equine probiotics.  As in humans, the first immune response to a microbe is in the digestive tract.  A healthy digestive tract has naturally occurring microbes that limit the ability of infectious bacteria, viruses, and protozoa to attach to the intestinal wall.  EPM drugs such as Navigator and sulphonamide combinations can disrupt the digestive tract and suppress the immune system.  Probiotics can be helpful before, during and after an infection of EPM.

January 2012


Bonner, Laurie. "Probiotics Explained." Equus July 2009:35-41.

"Probiotics in Veterinary Medicine."




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