EPM was certainly discussed at AAEP. In one class with Dr. Reed and Dr. MacKay, Dr. MacKay said he would wait for FDA approval to use the Oroquin-10. Dr. MacKay also promotes the use of Marquis at 7X the dose for loading, or at higher doses, longer duration, or mixed with sulpha/pyrimeth.
Marquis is only approved by FDA at 1X for 28 days. Dr. MacKay is using and publishing protocols that are not FDA approved. Why? Because Marquis at 1X doesn’t work very well. The FOI will tell you that 5X doesn’t work any better. At 10X the FDA approved dose Marquis does have a marginally better success rate. The published CNS values of Marquis are not high enough to kill at 1X.
Dr. Andrews is using a protocol with Sulpha/pyrimeth at a 2X dose. This was shown in the Rebalance trials (FOI) to be toxic. It is not FDA approved. Why is he using this? Because sulpha/pyrimeth at 1X for 270 days doesn’t work very well, and causes anemia. A 2X dose makes the anemia worse.
Protazil, using the blinded observers, was only 42% effective at 1X dose (it’s on the insert). MacKay suggests diclazuril be used at 7X the FDA dose, or for longer periods, or mixed with sulpha/pyrimeth. Only 1X for 28 days is FDA approved.
Dr. Reed suggested to me by consultation, that I use a higher dose of Marquis on Charlie. This is not an FDA approved protocol. He certainly did not let me know that.
Dr. Johnson said on the latest Intervet-sponsored EPM Webinar, they would only talk about FDA-approved drugs. Less than a minute later, Dr. Andrews is answering web questions about higher, longer drug protocols that are not FDA approved. (Intervet makes Protazil)
None of these used/published protocols are FDA approved. The veterinarians are not collecting information in a trial. They do not collect titers after the treatment to see if the horse’s immune system is winding down. They are simply throwing drugs at the problem, and hoping it will go away. Does this sound scientific to you? It shouldn’t. If your vet has prescribed one of these
protocols to you, they are running a non-FDA-approved mini field trial, with no back-up of proof that it works. Why? Because the existing FDA-approved drugs don’t work well.
At least the Oroquin-10 drug trial indicates ‘TRIAL’, is measuring titers before and after the treatment, provides support to vets, and is working its way through the FDA process. Oroquin-10 is based on a study of decoquinate by Dr. David Lindsay. This study shows a very high kill rate. Adding levamisole to the mix seems to help.
If MacKay, Andrews, Johnson and Reed want to use only FDA approved drugs, why are they promoting, using, and publishing non-FDA protocols? Seems like the pot is calling the kettle black.