I think I found what I was looking for.

If only Vitamin E could solve this problem alone. We again added the shots for hind end strength (not expensive) and it seemed to work. He was trotting out in the field, moving around, and while still "crooked" he wasn't "tilting dangerously."

I'll take it.

But I was troubled by the fact that while I hoped the E would support his health and while the shots supported his hind end, nothing was being done to address the neurological symptoms that keep coming and going.

In a late night internet search using the word "Sidewinders," I came across a blog post that got me excited.

Dr. Ellison at the Pathogenes lab in Florida used the term Sidewinders to describe a horse named Dusty-Pal. The breakdown is that EPM may be part of a larger equine ataxic syndrome that includes SIDEWINDERS!

Read the blog post here: http://pathogenes.com/blog/page/3/

I think the post uses the word Sidewinders ONCE, but that's how I found it. Dr. Ellison believes she can help these horses who have ataxia and that crooked gait with EPM treatment. Her signature treatment - Oroquin 10 - has HUGE (or should I say YUGE in this election cycle? Sorry) success rate for horses with mild to severe EPM.

So what if sidewinders is just a version of EPM? Can it be treated like EPM? What is this magical drug Oroquin?

This was especially mind blowing to me because 20 years ago when I bought Blue, if I horse got EPM, it died. End of story. I did not really think to search for EPM because Blue was still very much alive. So I called my vet and she came out to do another neuro exam on Blue (stop pulling my tail!) and take some blood. Ironically, this was at the time when he was doing much better and had just started the Vitamin E. We pulled his tail anyway and shipped the blood samples to Dr. Ellison for the ELISA test. This tests for the three parasites known to cause EPM.

A positive test (and C-Reactive Protein) supports the diagnosis of EPM and puts us on the path to Oroquin 10.

What is Oroquin 10?
Oroquin-10 (10 day therapy, consisting of 0.5mG/kG decoquinate and 1.0 mG/kG levamisole) is compounded exclusively by Francks Veterinary Compounding Lab for the treatment of protozoal disease in horses. Oroquin-10 or Oroquin-10E (with 8000 u of Vitamin E) is part of an effective strategy to eliminate the risk of severe neurological disease in horses.

1. Oroquin-10 is rapidly absorbed 
2. Kills the Sarcocystis neurona and Neospora stages that reside in cells.
3. Superior killing at lower concentrations of anti-protozoal agents.
4. Elimination of triazine resistant SAG 1 and SAG 5 phenotypes.
5. Levamisole is a non-specific immune modulator that may facilitate recovery.
6. Oroquin-10 was used in 172 horses with no adverse effects.
7. 93.3% of horses treated with Oroquin-10 resolve clinical signs within treatment period. 
8. Less virulent strains are treated with a daily prevention dose that induces immunity.
9. Decoquinate at 0.05 mG/kG for 28 days prevents intestinal infections in most species when fed for at least 28 days when development of coccidiosis is likely.
10. Use of Oroquin-10 distinguishes horses with inflammatory disease or triazine resistant sarcocystosis. These cases require alternate therapy. 

See what I put in bold? Yeah. That's the moneymaker statistic. That's what had me writing the check before the vet handed me the bill.

I had a million questions:
Side effects? Few to none.
Is his age an issue? No.
And most cases in Blue's category show major improvement by day 5 of the 10 day treatment.

We ordered the ELISA test. This tests for SAG 1, SAG 5 and SAG 6. Remembering that most horses will have a low but measurable result that does not indicate a positive EPM diagnosis. We also tested his C-reactive protein (which measure inflammation) and (because I was curious) we tested for his Vitamin E level, just to make sure he was absorbing the Smart Pak supplement.

The wait was on.