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Toltrazuril: Pioneering EPM Treatment for Horses

Updated: Feb 10

Equine Protozoal Myeloencephalitis (EPM) is a debilitating neurological disease that affects horses, caused by the protozoan parasites Sarcocystis neurona or Neospora hughesi. EPM can lead to a range of neurological symptoms, including muscle atrophy, incoordination, lameness, and even paralysis, and it has a significant impact on a horse's overall well-being. In recent years, veterinarians and horse owners have been exploring various treatment options to combat this disease, and one promising approach is the use of toltrazuril.

Understanding EPM and its Impact

EPM is a challenging disease to diagnose and treat. Horses can contract the infection by ingesting sporulated oocysts shed in the feces of opossums, which serve as definitive hosts for the protozoan parasites. These oocysts can contaminate the horse's feed, water, or pastures, leading to infection. Once inside the horse's body, the protozoa can infect the central nervous system, causing inflammation and damage to the spinal cord and brain. The clinical signs of EPM can vary widely, making diagnosis complex. Symptoms often include muscle weakness, incoordination, head tilting, difficulty swallowing, and lameness, which can mimic other neurological disorders. Early intervention is essential, as EPM can be a progressive and life-threatening condition.

Toltrazuril as a Treatment Option

Toltrazuril is an anti-protozoal medication that has gained attention as a potential treatment for EPM in horses. It belongs to the class of drugs known as triazines, and it has been used effectively to treat coccidiosis in poultry and swine. Its effectiveness against protozoa has led researchers and veterinarians to investigate its potential in managing EPM.

  1. Mode of Action: Toltrazuril works by inhibiting the development and replication of the protozoa responsible for EPM. This action disrupts the life cycle of the parasites, preventing further damage to the horse's nervous system.

  2. Limited Side Effects: In general, toltrazuril is well-tolerated by horses. Most horses experience minimal side effects, which may include transient diarrhea or mild digestive upset. These side effects are typically short-lived and do not interfere with the treatment process.

  3. Oral Administration: One of the advantages of toltrazuril is its ease of administration. It is available in oral paste, suspension, or tablet forms, making it convenient for horse owners to administer the medication as directed.

  4. Research and Clinical Success: While research on toltrazuril's effectiveness against EPM is ongoing, there is evidence to suggest that it can be a beneficial treatment option when used in conjunction with other therapies, such as anti-inflammatory drugs and physical therapy. It has shown promise in improving clinical signs and the overall condition of affected horses.

The Role of Toltrazuril in EPM Treatment

EPM treatment often involves a multi-faceted approach, which may include:

  1. Diagnostics: Proper diagnosis is crucial for developing an effective treatment plan. Veterinarians may use cerebrospinal fluid analysis, serum antibody testing, and neurological evaluations to confirm the presence of EPM.

  2. Supportive Care: Horses with EPM may require supportive care to manage their symptoms, such as physical therapy, stall rest, and pain management.

  3. Anti-Inflammatory Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation in the central nervous system, aiding the horse's recovery.

  4. Toltrazuril Treatment: Toltrazuril can be used in conjunction with other therapeutic measures to target the protozoan parasites causing EPM.

  5. Ongoing Monitoring: Regular veterinary evaluations are essential to assess the horse's progress and make necessary adjustments to the treatment plan.


The treatment of EPM in horses is a complex and evolving field, but toltrazuril has emerged as a promising addition to the therapeutic options available. It offers a relatively low-risk approach to managing the protozoal parasites responsible for the disease. However, it is essential to remember that the effectiveness of toltrazuril may vary between individual horses, and a comprehensive treatment plan should be tailored to the specific needs of each case.

Horse owners should always consult with their veterinarians to determine the most suitable treatment approach for their horse's unique situation. While toltrazuril shows great potential in the fight against EPM, it should be used as part of a comprehensive treatment strategy to maximize the chances of a successful outcome for horses affected by this debilitating neurological condition.

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