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  Discussion on Rehabing muscle damaged from EPSM
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Member:
Fpony

Posted on Saturday, Oct 4, 2003 - 8:30 am:

Hi Dr. O,

My horse had a episode of "tie up" 3 weeks ago which resulted in a band of hard flat muscle on his left hip. It crosses the pelvis/femor joint and i believe it may be the biceps femoris muscle. He was toe dragging bilaterally for the first few days after the incident then inconsistantly for that week. He no longer toe drags. The muscle area is not as large as before and seems to have two sections to it now.

Is the hard flat feeling from swelling? There was some heat in that first week. How is an injury from the effects of EPSM different from a muscle strain. Or did he stain the muscle due to the effects of EPSM on the tissue? Will the rehab be different?
Moderator:
DrO

Posted on Sunday, Oct 5, 2003 - 6:05 pm:

Without examining the horse Kim, I do not know. It strikes me as most likely that there are still areas of muscle spasm, but this should be examined by your vet for confirmation. The article on tying up gives details on how to tell if tying up is still occuring.
DrO
Member:
Fpony

Posted on Saturday, Oct 11, 2003 - 8:48 pm:

My vet examed the muscle and feels it is damaged from a tie up. When asking Dr. Valentine about the hard flat muscle she stated that muscle goes into spasm due to lack of energy and can't release the spasm without energy.

The area has gotten smaller and less painful. He has some of the same kind of tissue on the other side but not as much.

It seems you need to exercise in order to get the muscle the "fat energy" (for the EPSM horse)that it needs to release the spasm but how can a muscle in that much spasm get enough blood flow to supply it energy?

In the first week massage was difficult as it was too painful. Accupunture seemed to bring him relieve and the hard flat area got slightly smaller after the session. Once he was tolerating the massage i still didn't find the muscle responding to it with a release. Making me feel it is damaged muscle.

Good news is he is improving slowly and muscle will eventually recover. Two years ago he had this same feeling to his muscles all over his rump. That eventually disappeared.
Moderator:
DrO

Posted on Saturday, Oct 11, 2003 - 9:09 pm:

If you are seeing benefits from accupuncture I believe they are just ameliorative and not a real healing process: massage will be key to increasing circulation, blood suppply, the carrying away of the bad and the bringing in the good.

But energy processing malfunction is not the only reason for tying up. Have other possiblities been explored? Are you also supplementing vitamin E an important antioxidant involved in healing?
DrO
Member:
Fpony

Posted on Saturday, Oct 11, 2003 - 9:22 pm:

Yes, I too believe the massage is a great benefit.

He has been on SE and vit E for two years now and he just had a blood level drawn which showed his se in the mid range and vit e in the low normal range. I increased the vit e with 800iu tablets of human natural vit e.(d alpha?) He is getting 250 iu in his suppliment.

Since the tie up, he isn't getting more than a couple of hours of morning pasture due to my fear of the increased sugars in the fall grass ( my post about my pony who had laminitis the same weekend my horse tied-up) I also increased his oil abit but now we are back to the 2 cups. Does the oil make the absorbtion of vit e more difficult? Should I give even more? Thanks Kim
Moderator:
DrO

Posted on Monday, Oct 13, 2003 - 4:17 am:

Kim, I don't think the oil will interfere with the vitamin E. But to answer your question about the amount of vegtable oil depends on the cause of the tying up, the size of your horse, and to some degree the response from the horse to the diet. If you think it is EPSM we have directions for feeding at » Equine Diseases » Lameness » Diseases of the Upper Rear Limb » Tying Up, Rhabdomyolysis, and Shivers (EPSM).
DrO
Member:
Fpony

Posted on Wednesday, Jan 28, 2004 - 9:26 am:

Hi Dr. O,
I have recently posted under Equine Diseases: Urinary System: Kidney Stones: Stones?
I'm back here to my post from his first tie-up as my questions seem to keep coming back to his EPSM. He was Dx at Tufts 2 1/2 years ago. They did a though work-up ruling out everything else and were left with hard painful muscles. Also, he had been on the high fat diet for 6 weeks before going there and had shown improvement in his gait (significant decrease in toe dragging and an increase in energy). Unfortunately, we didn't do the muscle biopsy or check his mm enzymes.

Dante recovered from the tie-up in sept 03 very well then tie-up again at the end of Nov. No blood work has ever been done but two vets agreed that he had tie-up. We had only been doing 40 min rides with some trotting although every where here we have hills. Since then he had a very rough December extrememly nervous not eating well as he was always "on alert" I would have to go get him to come in to eat his grain.

No one has any answers as to why after two years he tied up again. I had my hay tested to make sure the starch levels were ok-which they were. His diet is very strict alfalfa pellets,2 1/4 cups of oil, 2mg SE, 1500 IU of vit e. Limited treats.
Now the rest of the history is under urinary system.We had started to treat him for ulcers with the gastogard (3days)because of the two "colicy" episodes and his very nervous personallity, stopped the gastoguard due to his fever. Now on Wed (5 days later) we have started the gastoguard again. In the mean time he had a rough Sat with pain-kicking at his belly swiping at his sides. (he had been given two doses of banamine on Friday trying to get his fever down- maybe the pain is ulcer related.)I haven't gotten the blood work results from my vet but they are in the mail. She stated that they were fine except one liver value AST, but she wasn't concerned about that. I asked specifically if she had done a fibrinogen level and she said no. Blood work was done prior to the fever on Friday in attempt to fiquire out what the colic episodes were from also he was very sore over his loin area. She thought his colic episode was his reaction to muscle pain from tie-up. (this didn't make sence to me as his last tie up was in Nov. and I have been hand walking ever since and haven't seen an increase in the hard flat muscles)

Now for my question! Could all the continued problems be due to electrolyte imbalance? He has been drinking normally and after the second tie-up I added some table salt to his meals to encourage drinking but only for a few days as he seemed fine. He shows no signs of dehydration, but your article makes me me feel that he could still have some issues?

Thank you for reading all this mess! Kim
Moderator:
DrO

Posted on Thursday, Jan 29, 2004 - 6:20 pm:

The electrolyte problem is fairly easy to find: you run a complete panel during an episode. One caveat however, the sample must be run quickly because the potassium leaking out of the RBC's will artifically raise the levels in a sample left too long in the back of the truck. This is an uncommon cause of tying up in my experience.
DrO
Member:
Fpony

Posted on Friday, Jan 30, 2004 - 7:19 am:

ohhh,well I miss understood. I thought the electrolyes could be off for a while after the incident making recovery difficult. Thinking about it I guess anyone with their electrolytes off would be very sick,huh? I just want to find a cause for all this difficulty-maybe one I can fix!

Since his fever has never returned and his only symptoms are extremely sore butt and loin my vet is probablly correct in that he is just having a real bad winter with his EPSM. Banamine doesn't help much but I wondered if giving him Ace would start to break up the pain cycle and get him to relax as well as gettting more blood to the muscles? I have continued to hand walk and trot him daily.
Moderator:
DrO

Posted on Saturday, Jan 31, 2004 - 5:45 pm:

Low dose ace has other benefits: it may increase circulation to the muscle by causing vasodialation, doses are in the article.
DrO
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