# Cross posted...Anyone dealt with EPM?



## aoconnor1 (Jun 19, 2014)

My Bella girl, the mare I brought home from the kill buyers pens back in July, that foaled a DOA full term filly because the mare was so full of infections...well, we finally went ahead and drew blood today to test for EPM, my vet suspects she may have a slow onset of EPM...I am praying we caught it before it causes serious or permanent harm. 

This is one I have never dealt with. Anyone out there been through EPM with their horse? What were the symptoms, what did it progress to, and what was the final outcome?

Thanks in advance...


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## wr (Aug 10, 2003)

I haven't but I do know we have a couple members that have so hopefully, they'll be by to offer some useful advice.


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## aoconnor1 (Jun 19, 2014)

Thanks wr, I am researching as much as possible online, have found horror stories, very few good ones. Hoping to hear better from real people who have actually dealt with this issue.


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## malinda (May 12, 2002)

Two horses here at the farm had symptoms of EPM, both were treated for it, neither recovered, both were put down. 

I've also had clients with EPM horses. The ones who weren't put down should have been. Some people are in denial about the horse's actual (lack of) recovery. They are difficult/dangerous for me to shoe, yet oftentimes the owner is hopefull they can be ridden again.


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## Irish Pixie (May 14, 2002)

I've never seen an EPM horse recover to where they were prior to infection either. I've seen several treated for a lot longer than they should have been too. 

Hopefully it's not EPM, aoconnor1.


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## aoconnor1 (Jun 19, 2014)

Thanks for the info. Bella doesn't really have anything in particular that we can pin to an EPM diagnosis, but there is definitely something just a little "off" somewhere with her. I am praying her results are negative, we should know tomorrow or Thursday. I am of the opinion, based on my vets encouraging response to treating Bella with a good end result, that IF this is EPM she can be well again. I will hold onto that hope, but I am realistic about putting a horse down if necessary. If it becomes necessary to let any of my horses go, I do it.


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## Teej (Jan 14, 2012)

Never dealt with it personally but knew a guy who did. Don't know a lot of the details but we were on a trail ride and his horse fell with him a couple of times. He had the vet out after he got home and the horse was diagnosed with EPM. I believe they put him on a course of antibiotics, sorry don't know what kind, and after treatment the guy continued to ride him without further incidence as far as I know. We saw him the next year at the same ride and the horse seemed to be fine when he rode with us. The next year we didn't go but he did and I didn't hear any reports on accidents. Then the guy passed away so I don't know what happened to his horse or if it had relapses. The horse was fairly young when he got EPM, probably somewhere around 5 years old, don't know if that makes a difference on them being able to recover from it or not.


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## SFM in KY (May 11, 2002)

I lot a TB mare to EPM a number of years ago. Treated her twice and stopped the progress of the disease but it kept coming back. Don't remember the name of the medication now, but it was not an antibiotic ... EPM is caused by a protozoa not an infection that antibiotics work on. I do know they have more effective medications now but I also understand they are expensive and don't always work. I've heard about some horses recovering but very few.

I have also been told by local vets here in KY, where EPM often does occur, that the tests are often inconclusive. Blood tests, showing titer levels that indicate exposure, are as high as 90% positive but that only indicates the horses has been exposed to EPM, not that they have it. Because of the high number of opossums here in KY, most horses have been exposed but most will not actually develop active EPM ... a spinal tap is the only accurate way to determine active EPM unless they have developed better tests in the last few years.


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## aoconnor1 (Jun 19, 2014)

SFM, I believe we will do a spinal tap if the blood test result is positive, just to confirm. 

Bella has so many things that happened to her all at one time, it really could be anything, and my bet is on something other than EPM. She is one I pulled from the kill buyer transport pen, she had pneumonia, a horrible uterine infection, and was full term with a filly she threw the next night after I got her. Filly didn't survive birth. The baby was breach when the vet checked her, Bella broke two stalls down and then ran half a mile to foal, I believe she broke the stalls trying to turn the filly, that was what she looked like she was attempting when I was watching her. She threw herself against everything she could, rubbed her rump and sides hard, literally threw herself around and against the stalls. 

After she foaled I was able to get her to the barn, but she broke down her stall and ran back to where we had just buried the filly. Since it was dark I had to wait until the next day to go find her again, and by then she had a raging fever. Got her home, rinsed her down, started her on bute. She spiked at 104.9, which of course wound up foundering her. She has very thin soles anyway, and after the founder the tip of the coffin bone came through her sole on her left front hoof. That is being taken care of now, but she had so much happen all at once, I think all that is what's wrong with her more than anything. At least that's what I'm praying is the case.


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## Irish Pixie (May 14, 2002)

Aoconnor, did the EPM test result come back yet?


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## aoconnor1 (Jun 19, 2014)

Irish Pixie, no not yet:-(. Bella is doing fine, I see a few things off about here, but I am still holding on to her foaling troubles a couple of months ago, as well as when she was bred, the stud horse really tore her vagina up badly. That poor mare, she has just had so much...

Thank you so much for asking. I will definitely keep you posted. One thing, I spoke to my farrier about it today, he said "that can be fixed". I love his positive outlook! Hopefully he is right


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## goodhors (Sep 6, 2011)

Yes, we had a horse with EPM and he recovered well.

I would not spend the money to do a spinal test, they are REALLY expensive and way too easy to contaminate with blood. Folks way back used spinal testing because it was the only definite way to diagnose EPM. But when you need two samples to test, at over $400 EACH, it cost more than the medication back then.

Present diagnosing methods are more numerous, here is a site listing them:

http://www.atlantaequine.com/pages/client_lib_EPMdx.html

Here is more information about EPM from a Dr. at Rood and Riddle in KY, top notch clinic at any kind of health issues. I am just not sure when the paper got written, so might be a little behind what is now known.

http://www.roodandriddle.com/images/files/THE LATEST ON EPM-Spring 2011.pdf

And lastly, UC Davis site for the IFAT testing, which is considered the most accurate for EPM among COTH folks. Price is more reasonable than the older Spinal in our area, something to consider.

http://www.vetmed.ucdavis.edu/vmth/lab_services/clinical_labs/Featured_tests/epm.cfm

Our horse was "off" way back in the early days of EPM. Just not himself, and we knew him very well. I only had him tested to remove another problem from a list that could be causing his issues and after reading of the MANY peculiar ways EPM presented in various horses discussed on their Forums. Our older Vet took a blood sample, just like any blood sample. He said they found EPM in the sample, which doesn't always mean horse HAS EPM, just that horse has been exposed to EPM. Vet also said that probably most horses in MI were exposed, since wild animals would cross pastures to contaminate them. MSU Vet School was unable at that time, to find a herd of horses kept outside that was not contaminated for a Study, including the Vet's own lovely herd of broodmares!!

Our (old but VERY experienced, up-to-date) Vet recommended we order and use Marquis for treating, see if horse was improved after a week of treatment. He said what he had seen showed horse mentally and physically better in the 7days of treatment if he was going to get better. The month long treatment program back then, was about $700. Not sure of present cost of Marquis for treating a horse.

We did the first week of treatment, the horse was HIMSELF AGAIN!! His grumpiness was gone, he was friendly with the other horses in his turnout, not rubbing his hind ankles together any more. The ankle rubbing was the weirdest thing husband and I had seen, never saw any other horse ever do that. Vet said horse was PROBABLY trying to feel his feet, with nervous system out of kilter. Horse had some other things he did, which he had NEVER done before, but since we three users of him hadn't talked together, we each thought it was a one-time oddness.

Vet himself said he could SEE nothing wrong with horse doing a soundness check. Husband said horse had probably just developed some old-age issues, he had been used a lot, was 18yrs. Husband had seen EPM horses before, but they were all the sudden onset type. He shod a couple in the AM, horse suddenly got weird, falling, staggering, so they were put down before evening. Our horse was nothing like that, so he couldn't have EPM! Positive blood test was kind of a shock to him. 

Vet said not to use the horse during Marquis treatment, keep him as quiet as possible so he was not stressed. Stress is what allows body changes to allow Protozoa to escape the spinal cord, spread damage thru the body. Horse had changed his life that Spring as DD joined 4-H, got hauled alone, did MANY things he was not used to, so stress was easily a factor to cause the EPM.

We did our daily Marquis dose, horse was stalled and turned out with his friends. At the end of treatment, Vet said use him, see what you have. DD climbed on, he went perfect for her. Did everything she asked, was quite pleasant, really back to himself, no awkward movement as I had seen before. She did do some extra work, building his muscling, working to redevelop any nerves that could have been damaged. 

He was back 100% within a few weeks, nothing left to see of his being 'off'. Horse did well for a number of competitive years after, in Driving, Jumping, Pleasure both English and Western, Games. He did earn Team points for School Equestrian Team in whatever they wanted done. He won plenty of ribbons for her, was a delight to haul and enjoy using.

Vet said we probably benefitted from his EXTREMELY early diagnosis of EPM. Horse had very minor physical issues, he stepped of a shoe sidepassing. He didn't want to back up, he didn't hang with friends during pasture turnout, had a grumpy attitude when handled. Nothing you could pinpoint, but he wasn't himself. We had him for 10 years previous, never lost a shoe, EXTREMELY athletic in all requests made of him. A happy worker, always glad to see you or get used. He evidently got used to travel alone, didn't mind going places. So he didn't stress again, didn't relapse. He died at the age of 24yrs. Still sound, never did get any old-age wear and tear problems! We sure miss him being around.

We lucked out with him, no issues ever afterward. No second sessions of EPM to treat.

I have not seen any good results with sudden onset EPM. It pops up out of no place, horse is healthy and a couple hours later he can't even stand. They all had to be put down as dangerous to themselves and people trying to handle them.

Slow onset EPM has had better results with treatment, depending on how early they catch it to minimize nerve damage. If horse is already moving badly, he probably will not improve to what he used to be. Not sure I would treat one like that, nerves heal, but maybe never get back to normal movement. Then he is not usable for years to come, still costing you money. You want to help them, but you might not be able to afford to keep such a unusable horse for many years to come if you only can afford one animal in your life.

You can order the Marquis, give horse a week of treatment, oral like wormer. See if horse is improved. If I remember this horse is not easy to handle, might be dangerous to try oral treatment daily. Marquis is NOT cheap, for the course of treatment. Probably more expensive than when we used it almost 12 years ago. Horse has to keep it in their mouth to get good benefit from the medication. We crosstied ours in the aisle each morning before stalling to see if he dropped it or swallowed it, to insure he got it into himself while we waited. He was EASY to handle, medicate, so no problems for us.

For us the Marquis did fix the EPM. Other folks talk of other treatments, maybe do several different kind of treatments, all costing a lot of money. Seems to be a heartbreaker of a problem. Some horses relapse, get it again. As the horse owner you have to decide what you can afford, not put yourself into the poor house fixing a horse who might/will never be sound again or who keeps relapsing.


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## aoconnor1 (Jun 19, 2014)

goodhors, thank you SO much. You described almost exactly what Bella has been like. Not moving awkwardly, no stumbling or failing muscles, but just off somehow. Since she was in such bad shape when she arrived (and talk about stress, run through 3 auctions, was in the kill pens with the other sad sacks all shoved together and fussing for each blade of hay). She foaled the next night, lost the baby, had all the nasty infections everywhere, then foundered. I can't imagine a horse NOT being off after all of that. But this has been a very slow progression to actually seeing something amiss, and even my vet said that. What caught her eye was when Bella had her teeth floated last week, she was dribbling urine. A sign of muscle weakness somewhere. But...Bella had laid back really hard twice after being tied in the trailer, panicked in my trailer (a first), and fear peed afterward. I think she strained or pulled something inside when she did all that.

We will see. The blood sample was sent to UC Davis, I know they know what they are doing at least! And my Equine vets are rated one of the top 5 clinics in the country, so I am positive they will do what is necessary for Bella as much as they can. If at any time one of my vets think treatment won't work for one of my horses, they have no problem telling me to put one down. I fully trust them in this situation, and am so thankful I have them.


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## Annsni (Oct 27, 2006)

I would consider chiropractic for that mare too - just in case. 

We had a horse come in from a dealer who was diagnosed with EPM (through Davis) and so since the woman only had him for a week before diagnosis, she contacted the dealer and sent him back and got another horse. The dealer then brought the horse straight to Camelot saying that he had been a lesson horse (big lie - this horse was NOT lesson horse material) and a woman picked him up. I was able to follow the sale and contacted the lady to let her know about the EPM diagnosis so she can get him treatment. She had her vet out and they retested him and he tested negative this time and he never showed any signs of illness at all. She's put a lot of work into him and he's now doing dressage with him and looking great! That was my only experience with EPM and it makes me think that the tests aren't 100% maybe??


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## aoconnor1 (Jun 19, 2014)

Annsni, thanks for the good suggestion! One of my vets is also an Equine Chiropractor, I will definitely speak to him about Bella and see what he suggests.

Thanks again!


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## aoconnor1 (Jun 19, 2014)

Well, she has tested positive. Meds starting either tonight or tomorrow, depending on when my vets can get them together.


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## Irish Pixie (May 14, 2002)

I'm sorry. I hope everything goes smoothly for you both.


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## aoconnor1 (Jun 19, 2014)

Thanks Irish Pixie. My vet is very confident Bella will recover since she has a fairly mild, slow onset. We are putting her on Protazil, a new drug I think. Will keep updating as things go on.


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## Irish Pixie (May 14, 2002)

aoconnor1 said:


> Thanks Irish Pixie. My vet is very confident Bella will recover since she has a fairly mild, slow onset. We are putting her on Protazil, a new drug I think. Will keep updating as things go on.


Please keep us updated on her progress.


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## Teej (Jan 14, 2012)

Hoping Bella has a full recovery. Sounds like the poor thing has been put through the ringer enough already, she needs a break.


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## RLStewart (Sep 10, 2006)

I have a gelding that has/had EPM. The newest and most believe best treatment is Oroquin from Pathogenes. My gelding also was "just off" and it took awhile to figure out that it was EPM. When tested his titers were never really high enough to really be sure that was the problem but I treated him anyhow and he improved within days. So I feel that was the problem. He has however had an issue with relapsing.  Seems fine if I don't ride him but if I start working him again, in about a month he will start to seem just a bit off. First time I ignored it, thought maybe he was just a bit sore from getting back in shape, and then he went over backwards on me one day. He's not that type of horse so I knew we had an issue and within days of that happening he was crossing his feet while walking. So treated him again but it just keeps flaring up when worked. If I had more time and money I would treat him again and put him on some immune boosting supplements and see if that might help him kick it. Even though I haven't had great success with the Pathogenes treatment it is cheaper than most and has a better success rate than anything else. I've done hours and hours of research on treatments. The only other thing I've heard of as being very successful is IV diclurazil. That may be misspelled. Its not an approved treatment and none of my local vets know anything about it but I've heard its used a lot in Oklahoma and those parts.


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## aoconnor1 (Jun 19, 2014)

RLStewart said:


> I have a gelding that has/had EPM. The newest and most believe best treatment is Oroquin from Pathogenes. My gelding also was "just off" and it took awhile to figure out that it was EPM. When tested his titers were never really high enough to really be sure that was the problem but I treated him anyhow and he improved within days. So I feel that was the problem. He has however had an issue with relapsing.  Seems fine if I don't ride him but if I start working him again, in about a month he will start to seem just a bit off. First time I ignored it, thought maybe he was just a bit sore from getting back in shape, and then he went over backwards on me one day. He's not that type of horse so I knew we had an issue and within days of that happening he was crossing his feet while walking. So treated him again but it just keeps flaring up when worked. If I had more time and money I would treat him again and put him on some immune boosting supplements and see if that might help him kick it. Even though I haven't had great success with the Pathogenes treatment it is cheaper than most and has a better success rate than anything else. I've done hours and hours of research on treatments. The only other thing I've heard of as being very successful is IV diclurazil. That may be misspelled. Its not an approved treatment and none of my local vets know anything about it but I've heard its used a lot in Oklahoma and those parts.


I appreciate your response. I don't think Bella was as advanced in the disease as your guy, she hasn't had a lot of outward symptoms, just a few little things that didn't add up to a healthy horse! She is on Protazil (sp?) and sees a little better. I will ask my vet about Oroquin, and since I am in North Central Texas, if the need arises, I will also ask about the IV treatment, Diclurazil. 

I hope your boy is doing well. Thanks again for your input.


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## TheFarmerMommy (Mar 21, 2014)

Yes, my shire gelding had it. He had a previously undiagnosed A-fib that the vet discovered in the process of trying to figure out why he was so sick. Because of the risk to human bystanders posed by the A-Fib, i never put him back in work. But he did appear to make a full recovery from the EPM. For background, he was at a boarding facility while I was in the middle of a scary and contentious divorce and custody situation. I would have noticed much of this sooner if he'd been home with me. A couple observations:
-There is a new drug protocol in use that is a fraction of the cost of the old one and not very difficult to administer. Without that advance in pharmaceuticals, I couldn't have afforded to treat him.
-I administered a high-potency Vitamin E supplement for months, until the nerve sheaths were fully regenerated. 
-In hindsight, the first warning of the EPM was that he choked several times. That was followed by weight loss and a general change in personality. The horse that always had to be in the middle of the hubbub suddenly wanted nothing to do with humans and was markedly buddy sour.
-I had this hunch that I had to get him out onto grass. Problem? No one wanted to take in a 2000 pound horse with a serious illness. Through persistence and a small miracle at the 11th hour I got him a spot at a fantastic retirement/layup farm. They were wonderful. They even let him come with the bare minimum of vaccines as not to unnecessarily tax his system. (after consultation with two good vets) They shared my hunch and made a 5 acre field of lush pasture available to him. (Hay was out of the question due to the choke) at the vet's directive, he also received huge quantities of a senior feed. 

I knew he was back to normal when the farm owners reported that he had taken it upon himself to "visit" the TBs in the field next door by pushing down the gate :0. Up to then he'd been so preoccupied eating that he'd ignored the neighboring horses. 

Sounds like the mare has a long road ahead. But a substantive recovery is possible. Especially as it sounds like you've caught it early. The further progressed the disease the worse the prognosis.


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## aoconnor1 (Jun 19, 2014)

Update on Bella:

Bella has been on the meds for over 30 days now and she is doing fantastic. She still dribbles urine at times, but that could well be more from the issues she had when she foaled. She is gaining muscle again slowly, she eats well and continues to drink well, and she is back to herself. We think she will need one more round of medication though since she was a high percentage risk on her blood panel. Out of 100 % infected, she was 86%. We can't do titers again for 3 months because she will still titer positive, so I will be watching her closely for any symptoms until we can do a titer again. 

Thanks for the positive feedback a lot of you gave, it is a relief to read that many horses are able to overcome EPM and live normal, healthy lives. 

As for the negative items that some brought up, I am happy to say that my farrier, who is a Master Farrier and hugely sought after in our area, still wants to own Bella should I ever let her go That speaks volumes! She has had absolutely no issues picking up her feet for extended periods of time for the farrier. No wobbling, leaning, etc. She stands just fine. Sh his not stumbling around at all, has no outward signs of EPM, and is growing more lovely each and every day.

Thanks for the good advice and encouragement


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## Teej (Jan 14, 2012)

Thanks for the good news update.


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## RideBarefoot (Jun 29, 2008)

Life is quite busy right now, so I don't get to drop in as much, but glad to hear Bella is doing well!

Two of my neighbor's horses were treated last summer, caught early and both recovered. One was already retired, but the other went back to work as a search and rescue horse quite quickly.


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## aoconnor1 (Jun 19, 2014)

RideBarefoot said:


> Life is quite busy right now, so I don't get to drop in as much, but glad to hear Bella is doing well!
> 
> Two of my neighbor's horses were treated last summer, caught early and both recovered. One was already retired, but the other went back to work as a search and rescue horse quite quickly.


Thanks for the encouragement!! Wow, so glad your neighbors horses recovered so well! Bella is also recovering from a bad founder, her left front coffin bone rotated and actually came through her really thin sole. She just got the pads off yesterday and is recovering miraculously well from that, too. This mare is a FIGHTER!!!


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## wr (Aug 10, 2003)

aoconnor1 said:


> Thanks for the encouragement!! Wow, so glad your neighbors horses recovered so well! Bella is also recovering from a bad founder, her left front coffin bone rotated and actually came through her really thin sole. She just got the pads off yesterday and is recovering miraculously well from that, too. This mare is a FIGHTER!!!



Did she come to you foundered?


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## aoconnor1 (Jun 19, 2014)

wr said:


> Did she come to you foundered?


We don't know if she had already started, or if the retained placenta and the resulting very high fever foundered her, but either way she foundered immediately after she came to me so I am fairly certain she was already on the way. She had double pneumonia, a bad uterine infection, foaled a filly that died immediately, retained a portion of the placenta, it would have been a miracle if she didn't founder really. Plus, she had been on very rich grass in the region she came from, so we just really don't know.


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## aoconnor1 (Jun 19, 2014)

Two more weeks of rest and healing, and Bella is doing extremely well. She is off all meds now for the EPM, there are no real noticeable signs that she was infected with it. I asked my vet about a recurrence, she said that once the protozoa that cause EPM are killed off with the meds, they don't return and there are no actual "relapses" of EPM, only re-infestations if the horse remains in the same situation where it contracted the disease but the cause of it hasn't been removed (carriers). Down the road, if I chose to ever breed her, which I am 99% certain I never will since she has been so sick and now foundered, but should I decide to breed her I would not have to worry about a pregnancy bringing the EPM back again. I was pretty thankful my girl came along so well, she seems to be on the road to good health finally, after being here for coming on 6 months. 

Her founder has resolved and she is walking normally with regular shoes, no pads. I hope she will recover fully enough that I can get her in a Western Pleasure ring someday. She is built beautifully for that discipline, and I am anxious to get her broke and going Plus, I believe that show ring work is on soft enough footing to sustain her ability to work. Obviously I wouldn't want to trail ride on her heavily, at least I don't think I can do that with as bad of a founder as she had. But it would be fantastic to get her where I could do that as well as show. But for now, I just want to start her, get her going well, and then finish her in a fairly gentle discipline.

She is finally getting less head shy. When she first came here I was not able to approach her from the front and reach to her face, she would immediately move away from me and wouldn't let me approach her again for a while. Now I can walk up to her, rub her face and ears, pat her neck and chest, and she looks at me like I am a spook (ghost), but she doesn't move away She just gets big eyes for a minute, then relaxes. I can kiss her cheek and she stands still while I do that, and then she actually nuzzles into me for a split second before she lifts her head away. Silly, sweet girl


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## RideBarefoot (Jun 29, 2008)

Bella, the journey may have been rough, but you landed in the perfect spot


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