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  Discussion on Fatigue and Muscle Waisting
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Member:
Jwsmith

Posted on Thursday, Jul 10, 2003 - 4:39 pm:

I have a 13 year old App gelding that just recently has shown significant signs of fatigue. I noticed change’s in “Justin” in late May where I started to think that something wasn’t quite right. Justin has been worked throughout the winter and spring months about one hour per day 3 – 5 days per week with more frequency in April and May preparing for a 4H horse show. In late May, Justin was not holding up to the workload and “burning out” easily. At this point I really didn’t recognize that there was a real problem, thinking that he just needed an extra day off. This seemed to help some, but not like I thought that he would respond to the extra rest. On June 7th the problem became most obvious in the show ring. Shown English in flat classes he performed ok for the first class, but had a significant decrease in energy in the next two classes. His hindquarters looked “loose” and disengaged, his headset was low and his top line was flat. He had to be pushed to stay in any gait. At that point he was removed from the show and I called the vet the next Monday.
My Vet ran blood work and did a selenium workup. All came back normal, selenium was low normal (16). After no improvement, I took him to Cornell for evaluation. Before I report Cornell’s findings, I would like to also mention that he was DrOpping off in muscle tone, especially at the shoulders, withers, spine and hip/flank area - slight DrOp-off but something that an owner would notice. He keeps good weight and all other vitals are good.
At Cornell they watched him move. They had him fast walk in tight circles both directions (EPM?). They watched him under saddle. They found a slight lameness in the right hind. Prescribe a course of bute for 2 weeks to see if the lameness goes away. That way they can rule out the lameness connection to the lack of energy and muscle wasting. After a week and a half of bute, his lameness is significantly reduced and his energy level, I feel is getting worse.
They tested his enzyme level after exercise and found it normal. They tested for Cushings and Lyme, both normal. Did a regular blood work up and found everything within normal limits.
My plan is to take Justin back to Cornell in one week. When I left there they were still waiting for the Cushing and Lyme test results, so they could not give me an idea as to what the next plan of action is.
Another thing that Justin has done over the past year and more frequently recently, is that he will spook at odd things. He looks like he is dazed when spooking – it is only brief but weird. When we move the object that we think he is spooking at he stares at the space. He is not normally a spooky horse. This is uncharacteristic of him.
Do you have any suggestions as to what Justin may have or what tests you would suggest? I have been reading on Lou Gehrig’s disease and Justin has some of the characteristics of that disease. I appreciate any information that you may be able to share.
Moderator:
DrO

Posted on Friday, Jul 11, 2003 - 6:17 am:

Jeanne,
Are there other horses that get the exact same management: same water, feed, pasture, etc...

Concerning LG's disease there is a very similar disease in horses see, Equine Diseases » Nervous System » Equine Motor Neuron Disease (EMND). However this disease was first characterized at Cornell, I would be surprised if they miss this one. On the other hand Apps are predisposed. The article lists the diagnostic protocol and other rule outs for similar appearing diseases.
DrO
Member:
Jwsmith

Posted on Sunday, Jul 13, 2003 - 10:07 pm:

I have 3 other horses with the same basic care, although one horse was newly purchased last summer. My other horse's do not have any of the symptoms. I did read quite a few of your posted articles on EMND - and yes, after speaking with Dr.s again at Cornell, they did consider EMND but are not leaning that way. The Chief Vet co-authored many of the EMND articles and is on top of it.

Justin's Lyme and Cushings came back normal. After calling them back we are going to try to change his diet - increase the fat (the EPSM diet). I am going to have a muscle biopsy to see if he may have EPSM. I have since found out that some horse have this condition but do not exhibit the "tie up" symptoms that are common with the condition.

Still unsure what's going on, but this is our next step.
Member:
Jwsmith

Posted on Sunday, Aug 3, 2003 - 12:31 pm:

My results are in from the muscle biopsy test (I sent the tissue to Oregon State). The test came back positive for EPSM. My local vet faxed me the results. The good news is that it is a mild case. The recommendation from Oregon is to start the high fat diet, reduce starch and sugar. Continue this for 4 months and expect the changes for improvement to be slow after that. The outlook is positve. There was no muscle damage. I don't understand the technical terminology so I will be getting clarification from my vet when she visits next week for stitches removal. If you are interested in my final report, I would be happy to send it to you.
Moderator:
DrO

Posted on Monday, Aug 4, 2003 - 10:18 am:

Hmmm, I have to admit to being a bit skeptical with normal muscle enzymes. I have read where this is possible but also have read where horse's without disease have had muscle biopsy findings consistant with "EPSM". If this is all that is found I quess you should go with it. Yes I would like to see the final report.
DrO
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