Azoturia One of the most painful and distressing conditions that can befall a horse during exercise is equine rhabdomyolysis syndrome ERS — also known as tying up , azoturia , setfast and Monday morning disease. It describes a tissue-level breakdown of muscle fibres, usually in the large muscle masses of the horse, around the croup, loins and thigh area. ERS often appears within half an hour of the beginning of exercise, particularly after an enforced period of rest. Typically, a horse will become anxious and sweat profusely, its gait will stiffen and it may be reluctant to move. The affected muscles become stiff, swollen and painful to the touch, and the pulse and respiration rates rise. The severity of the attack ranges from mild stiffness and a shortened stride to total muscle seizure and even death.

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Possible exposure to potassium, halothane, and caffeine may cause muscle sensitivity Polysaccharide storage myopathy Research still being conducted Diagnosis of Exertional Rhabdomyolysis in Horses If you suspect your horse may be suffering from exertional rhabdomyolysis, make an appointment with your veterinarian.

He will begin by performing a complete physical examination of your horse, taking preliminary blood samples, and possibly conducting a biochemistry profile. Your medical professional will perform a serum blood test and will be using the results of this test to give him much information on his diagnosis.

Evaluated will be serum AST aspartate transaminase, a vital enzyme and CK creatine kinase , especially in cases of recurrent exertional rhabdomyolysis. Your veterinarian will take a closer look at the enzyme elevations from the muscles and will generally be conducted when the CK levels peak, which is approximately four hours after physical activity. This laboratory test will be repeated the next day as well, after exercise for accurate results. Your veterinarian may perform a muscle biopsy to investigate the fibers of the muscle to aid him in a definitive diagnosis.

He may also choose to perform genetic testing by sending blood samples or hair samples to a genetic laboratory. Genetic testing is typically not performed for sporadic tying up, as this condition occurs intermittently and is not inherited.

Treatment of Exertional Rhabdomyolysis in Horses There are several different options for exertional rhabdomyolysis in terms of treatment. The type of treatment is dependent upon whether your horse is suffering from the sporadic or chronic form. Treatment methods may include: Medications for Pain Medications such as acepromazine, xylazine, detomidine, or other tranquilizers help with analgesic therapy and sedation.

Medications such as these are given for horses in severe pain from tying up. Often, these medications may be combined with others at a consistent infusion rate. Fluids Your horse may need extra fluids in order to prevent dehydration or to rehydrate your horse, especially after medications are given.

Specific types of fluids may also be given in conjunction with solution to prevent potassium levels from becoming abnormally high or too low. Muscle Relaxers Methocarbamol is a muscle relaxer that may be effective on your horse, depending on his condition. This also depends on the dosage given. Dantrium sodium may be administered to aid in the reduction of contracting muscles and severe tightening from cramps.

Your veterinarian will determine the dosage amount and how often it needs to be repeated, if necessary. Recovery of Exertional Rhabdomyolysis in Horses Recovery depends on the condition of your horse after treatment, and how well he responds.

Fortunately, there is much research being conducted on this condition, and with recurrent or chronic cases, more genetic tests are being researched. Your veterinarian may recommend lifestyle changes in order to decrease his bouts of exertional rhabdomyolysis.

Your horse may require rest for a specific amount of time recommended by your veterinarian; he will need to begin exercising once this time period is over, as moderate exercise can help horses in the recovery. Your medical professional may also recommend a decrease in the amount of carbohydrates and grains while increasing his amounts of hay and fresh pasture.

Your veterinarian may also recommend supplements to add to his diet, such as potassium. Be sure to ask your veterinarian any questions about the addition of supplements in terms of the types and amounts. If your veterinarian recommends any other decrease in activity or ways to gradually begin increasing his activity, be sure to follow his instructions. If you see any new symptoms develop, contact him with any questions or concerns.


Exertional Rhabdomyolysis in Horses

Exercise is seen in every case, but exercise is always accompanied by another factor. It is likely that several factors must act together in order to cause an ER attack. Other possible factors include: The overfeeding of non-structural carbohydrates grain and pellets, for example Poor conditioning or fitness, sudden increase of workload The work of a horse after a period of rest, if the concentrate ration was not reduced Electrolyte or mineral imbalances, especially seen with potassium A deficiency in selenium or vitamin E Imbalance of hormones, including the reproductive hormones in nervous fillies and mares and thyroid hormones in horses with hypothyroidism Wet, cold, or windy weather conditions The more factors that are present, the greater the likelihood that the horse will develop ER. ER occurs when there is an inadequate flow of blood to the muscles of an exercising horse. The muscle cells, lacking in oxygen, begin to function anaerobically to produce the needed ATP.


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