The traditional drug therapy, which consists of Sulfadiazine and Pyrimethamine in a liquid base or powder base,  is usually feed to the horse at a rate of 50cc (grams if in the powder form) daily depending on the weight of the animal. Pyrimethamine is basically a folic-acid inhibitor. The protozoans that are in your horse need folic acid to reproduce. Without folic acid, the protozoans will slowly die off. This tradition blend [one which we tend to call "The Trads" short for Traditonal treatment] is not a cidal drug, it indirectly affects the reproduction of the protozoan. The catch is that some horses become extremely anemic during treatment due to folic acid inhibitors in this drug combo and may need folic acid supplementation which can greatly affect the efficiency of the drugs being used.

What is folic acid? Vitamin B9 is folic acid or Folicin. It is water soluble and it is present in the foliage of certain plants and is considered an anti-anemia vitamin.   The average horse needs approximately 20mg daily .  Folic acid is essential for the production of red and white blood cells. Folic acid is found in  fresh grass and roots. . Once a grass is dried for hay consumption, it loses its folic acid content.

What is anemia?? Anemia is a shortage of hemoglobin in the blood, and this can be as a result of a reduced number of circulating red blood cells or the reduction of hemoglobin or a combination of both. When this happens, the blood cannot carry its normal amount of oxygen and the tissues  become starved of oxygen. Oxygen is needed for energy An anemic animal is usually very lethargic, with a dull eye and poor hair coat, brittle hoofs and pale skin color.

What You Can Do !

There are several different things you can do besides giving your horse the folic acid supplements. First off, provide as much good, fresh clean hay as you can and adding some alfalfa would be helpful....

All root vegetables are very rich in folic acid, such as carrots ! Carrots are also very rich in beta carotene as well. Feed lots of carrots !!!

There are several herbs that will help with anemia. The very best herbs to help are blood purifying and blood enriching herbs. These would include Red clover blossoms, Burdock root, Chickweed, Dandelion leaf, Fenugreek seed, Hawthorn berries, Kelp, Marshmallow root, Plantain and Nettle. Nettle is very rich in iron.  We carry a good Blood Building Blend just for the EPM horse, or I can mix you up a custom blend to your or your veterinarians specifications.

Important Note!

There is an exception to every rule of course. I have received reports that some horses are becoming very ill and extremely anemic only one or two months into traditional sulfadiazine/pyrimethamine treatment. Usually anemia will start around the 4th or 5th month into treatment and some horses on the other hand, don't have any problem with anemia at all.

The horses that  have become so badly anemic that the treatment had to be stopped and folic acid fed daily to build them back up. So far, we haven't been able to understand WHY  this happens to one EPM positive horse and not another. My own horse was on 50cc daily of traditional meds for eleven months and we did run blood tests every 7 weeks and he never become anemic. He was NOT getting the folic acid supplements, but was getting 8,000iu of Vitamin E daily  and several herbal blends as well. I am assuming that all the herbs and B-12 and B-15 vitamins (which does contain a small amount of folic acid) were helping to offset this problem. He was also receiving a liquid vitamin supplement called X-Cell  two times a day as well, which contains about 7mg of folic acid. My personally opinion is that I was not over supplementing him with Folic acid. He was well under the 20mg daily allowance. But, the pure Folic acid supplements that are sold specifically for the EPM horse seem to run high, at around 40mg .

There are also reports of horses having some sort of allergic reaction to folic acid supplements themselves, and these horses seem to improve when folic acid supplementation  has been stopped.

Everyone should evaluate there own horse and decide what is best for them. Each horse is different. EPM affects each and every horse differently. Only you can be the judge of what is best for your horse