Hi Dr. Valentine,
You read the muscle biopsy my vet took a couple of months ago and we agreed, that despite the inconclusive results to treat as though he has epsm. Up to about 4 cups of oil/day. HE is really much worse. Thought he went through his 3-4 months on the diet worse time about 2-3 months ago.
Could it be that grass is growing and increasing his nsc? What about shivers? and can this progressively get worse to where it affects him all around?
Doesn't seem to be lame moving forward, but really struggles backing and even turning now. Can't hold legs up for any period of time.
Thank you for any insight.

Growing grass is certainly higher in sugars and so if he is out on grass I would recommend a grazing muzzle. Shivers definitely causes hind leg problems backing and turning, and shivers is progressive. Most shivers horses on diet change will at least stabilize, but there are occasional horses that just don't respond. As long as he isn't gaining unwanted weight stick with the 4 cups oil. If he is getting any hay try soaking it in water for 1/2 hour or so before feeding. Try adding Quiescence to his diet - this contains magnesium that seems to help some difficult EPSM horses. And keep him out of a stall and moving and keep working him as much as possible. I'd like to hope that Monte isn't going to be one of those drafts with shivers that just doesn't respond to diet and exercise. Good luck!

Get him a grazing muzzle, it probably is the grass. They sell reasonably priced muzzles at Country Supply,http://www.horse.com/products/sku-BRK61.html, they're under $20 and last as long as the expensive ones--get an extra one, they wear out fast. My horse gets very stiff and sore on unlimited grass but the muzzle allows her to be out with the herd, move around more, and still get the satisfaction of grazing without consuming the volume she would unmuzzled. As long as I control her diet, she does very well (and she has severe EPSM with permanent muscle damage), and even if she has a bad spell, she snaps out of it fairly quickly, so don't despair too much.

Unfortunately Monte doesn't have a normal horse head.
Is there any places that sell grazing muzzles that are larger than horse size?
I also know he will probably tear every tree down, rip up his face, the barn trying to get that thing off. He has been such a challenge in so many regards. Never had any idea about sugars in grasses/weeds and how the weather affects it.
Always been lucky I guess to have horses that it didn't affect.

Kim, on Valley Vet.com they have a Large horse grazing muzzle. It is $44.95 but they are the only Large size muzzle I can find anywhere. My Belgian has an extra large head too, and even this one is snug. She hates it with a passion and tries to run when even thinks I might get it. I have duct taped it to her Halter and I have to redo it alot, but as I see it , it is the unselfish thing for me to do. I want her to stay healthy.

Hi Kim
I can relate to all you are going through. John Henry muscle biopsy was inconclusive also but he must have oil and he has a grazing muzzle on 24/7. He also got it off until I stumbled on the idea of leaving his miracle cribbing collar on and putting the strap that goes in front of the ears over one side of the halter part of the grazing muzzle and he can't get it off now and he doesn't even try. I got his at Country Supply. He is really sensitive to grass sugars and I soak his hay. My husband is in the process of cross fencing a large wooded area so we can monitor his grass even more. He definitely figured out how to eat quite a bit of grass even with the muzzle.It is a learning curve but is worth it when you figure out what their triggers are. John Henry couldn't canter at all and now we are working on lead changes. So stick with it and everyone on this site is so very helpful. Also I find upping his exercise during this time of year extremely helpful. Good luck!

Andi,
Thank you!
I read your update on John Henry. I also purchased Monte as my "laid back, confidence building, anyone can ride" horse. Has NOT at all been the case.
I had no idea about grasses, weeds and the change in levels of NSC. I've had fussy t-breds and never thought a big draft would be my biggest "problem child".
He also really struggles backing up at all.
I hope Monte does as well as John Henry has done.

You know, I have fought with people over the years about the fact that EPSM does exist. Ever since I bought the book by Dr. Beth many years ago when it first came out. I have tried to educate myself as much as possible about this terrible disease and be aware that it is real. Other's have argued with me and poo pooed the low carb and starch and adding oil. I have stuck by this diet with all my Draft's from the beginning just in case. I have been blessed so far. But hearing your stories and what you have encountered with your horses breaks my heart. I am glad that they have finally done the research on EPSM and now maybe the Vet's that before didn't believe it exists, will educate themselves.
I hope Kim, that all will work out for you and you can enjoy your Draft horse. They are such magnificent animals.

I too keep fighting the "Yes, EPSM is real" battle, and boy it gets old. When Tink started having issues from the spring grass, another horse suddenly went "off" too, lame, despondent, obviously in distress. Coincidence? Maybe. But when I suggested to the owner that different horses have different responses and maybe it was too much grass for him and he MIGHT have mild EPSM or be suffering a low grade laminitis, I was totally blown off. Another owner mentioned her horse had tied up while in training and I mentioned EPSM--same response. Not THEIR horse! I got the owner of the place to stop putting Tink out in the afternoon on grass, explained about the sugars being higher then, so between that and the muzzle she's doing well again, but the other horses are still going out on grass at the worst possible time. It's very frustrating. Not to say that I think all the horses have EPSM, of course, but that all that we've learned that is beneficial for ALL horses from managing this disease is meaningless to too many horse owners, they still keep doing the same old destructive things because that's how they've ALWAYS done it. And the horses suffer.

AMEN-