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  Discussion on Horse tyed up - ongoing issue?
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Member:
sbawer1

Posted on Tuesday, Jun 5, 2007 - 11:20 am:

My 10yo Appendix QH tyed up on 5/31. He had been acting stiff and unhappy under saddle for about a month prior to the tying up incident. A vet I had look at him on 5/18 said he had a splint and to give him 2 weeks off with turnout. At the 2 week point I got on him. I walked for 15 mins, trotted for maybe 7 minutes & could tell something was off with him. Next he started shaking, sweat was pouring off him and he could barely walk.
He was treated that night by another vet and the next day sent to the equine hospital. He came home a day later stabilized but still had elevated muscle enzymes.
The first blood test on 5/31 showed: CK 10,180, AST 9,300, LDH 14,000. The test yesterday showed CK 3,829, LDH 9,876 & AST ? (the tech couldn't find the number).
Dr. O what is normal for these numbers? He is on turnout in a tiny hospital paddock at night and stalled during the day. Should he be turned out all day/night? He is getting no food but grass and a little hay. The vet at the hospital thinks something has been going on prior to the major incident. They are going to continue to check his enzymes counts and wait until they return to 'normal' before he goes back in to any work. Any thoughts?
Thanks!!
Moderator:
DrO

Posted on Tuesday, Jun 5, 2007 - 7:11 pm:

Hello GM,
You will find most of these normal values at References » Equine Vital Signs and Laboratory Values but you will need the units from your lab test result to compare them. However if common units of measure have been used in your tests these are remarkably high values. How to interpret these levels is in the article associated with this discussion. Important is to notice the differential persistence of these enzymes levels after the tying up event.

As to specific therapy, these are decisions that must be made by those who can actually examine the horse but if they vary from the recommendations in our article you certainly should want to know why, and so would we.

Tying Up is not a diagnosis so much as a description of a set of horse's symptoms in combination with elevated muscle enzymes. There are several known and probably some unknown causes. A proper diagnosis is the key to properly managing your horse to prevent or at least ameliorate future episodes.
DrO
Member:
ilona

Posted on Thursday, Jun 7, 2007 - 11:05 pm:

I may be way off base here, but my one horse also tied up and it was related to elevated liver enzymes, according to my vet. I have him on a nutritional program specific to his needs, different from the other horses. It seems to have helped. I was also told that tying up is a symptom, not a root unto itself.
Moderator:
DrO

Posted on Friday, Jun 8, 2007 - 6:50 am:

Hello Ilona A,
I cannot figure how elevated liver enzymes would be related to tying up. For more on what tying up is and the significance of elevated liver enzymes see the article on tying up and the article on liver disease respectively. I would be interested in what your veterinarian thought the relation was between the two.
DrO
Member:
ilona

Posted on Friday, Jun 8, 2007 - 7:49 am:

Hi Dr O,
I will call him and ask for details of the connection and get back with you. It may be early next week as I have to go to Albuquerque today.
Member:
sbawer1

Posted on Thursday, Jul 5, 2007 - 10:46 pm:

Update and new question regarding how to bring my horse back into full training. His enzymes are normal now. For two weeks I lunged him working up to 30 minutes trotting on the line. I am working him under saddle starting this past Sunday, walk and trot for 30 minutes. Can anyone give me an idea of how fast or slow I should go with him? (He is a eventing horse). When can I start jumping him? Any help is appreciated.
Moderator:
DrO

Posted on Friday, Jul 6, 2007 - 7:12 am:

There is no one program that works for all horses Griffin's Mom. However by monitoring enzyme levels you can develop programs designed to detect early tying up. Elevation of muscle enzymes is normal following intense exercise but with careful record keeping and understanding the muscle enzyme half lives (see article on tying up) you can get a feeling for when you have ongoing muscle problems versus exercise related problems.

Important is the preventive aspect that depends on determining the cause of the tying up and then managing to prevent the problem: has a reason for the problem been postulated?
DrO
Member:
sbawer1

Posted on Friday, Jul 6, 2007 - 9:15 am:

We are treating him as if he has PSSM. He is now on a high fat/low starch diet. On the recommendation of my vet I decided to hold off on doing a muscle biopsy unless he ties up again. I've read everything I can find on the subject.... it is still confusing!
Member:
ilona

Posted on Saturday, Jul 7, 2007 - 9:01 am:

Dr O,
I am so glad to find this thread. I have been looking for it so I could give you the info that my vet gave me.
It seems I may have got things backwards. What he said was that elevated liver enzymes are often blamed on the liver and that indeed it may be a nutritional problem and that the elevated enzymes and tying up are symptoms of this and not of liver dysfunction. He mentioned that in different areas the hay may be significantly deficient and this results in cellular enzyme corruption in the muscle, liver, etc and shows up in tests in the liver. Hence the tying-up is a corroborative symptom of this. He went into great detail with he bio-chemistry. I tried to take notes as he was speaking but did not feel comfortable putting them up here as I may gave taken it down incompletely. If you want I will be happy to go to his office and get these details. He is SO busy that getting him on the phone for an educational consult was hard. However he shows up unfailingly for emergency treatments, on the 4th of July, right after his sons death etc..(my own experience) I can't speak highly enough of him. I have been very fortunate with the quality and dedication of my equine vets in Arizona and here in New Mexico...can't say the same for California.
Moderator:
DrO

Posted on Sunday, Jul 8, 2007 - 7:28 am:

Got it G'sM,
The article on tying up has a rehab schedule for horses recovering from PSSM just pick up where ever you are in the training schedule and see how far you can go carefully monitoring for future signs of tying up.
DrO
Member:
sbawer1

Posted on Friday, Sep 14, 2007 - 9:08 am:

Hi there. Update on my boy and new issue with him. Re his tying up. He seems to be doing very well on the food that Dr. Valentine helped Frederick Feed Coop (Frederick MD) design. It is 20% fat, 4% starch. He is also on cool calories from smartpak. He looks very healthy, shiny and dappled.
New issue: Upper hock joint bone spurs. He has been stiff and a little off. I thought maybe he was tying up again but blood tests say no. So I had xrays done yesterday. (He had the lower joints injected 2 weeks ago. There was one week of very good movement, then back to the same old stiff, slight lameness.)
I use this horse for Novice and Training level eventing. Can I hope that he will hold up (I know I am pushing with this question) for this use? I took him to two events over the past month and got terrible dressage comments and scores based on his lack of movement. Any thoughts? (Also, He is already on adequan & recovery eq, glucosomine supplements). Thanks!!
Moderator:
DrO

Posted on Saturday, Sep 15, 2007 - 8:51 am:

Delighted to hear about the PSSM GM, what is the name of the feed you are using and what is in the Cool Calories?

Concerning the DJD we have lots of ideas and would suggest you save your money on IM Adequan. For more on this, management, and other treatments see, Diseases of Horses » Lameness » Joint, Bone, Ligament Diseases » Arthritis and DJD: An Overview. Be sure to study the links to the individual medications and double check your dosage rates of chonDrOprotective drugs.
DrO
Member:
sbawer1

Posted on Saturday, Sep 15, 2007 - 6:07 pm:

"Cool Calories" is a 100% granulized fat product It looks like little white balls and smells like cherry. My horse decided he did not like the taste of liquid oil so I found this product and he will eat it as long as it does not outweigh the grain. The feed is the "HIGH Fat" feed from Frederick Feed Coop in Frederick MD. It does not have a fancier name than that. I will take my boy off Adequan. I don't think it has helped him at all, anyway. His supplement has 10,000 glucosomine and 10,000 MSM.
Member:
sbawer1

Posted on Sunday, Aug 3, 2008 - 9:59 am:

My horse tied up again. His blood enzymes showed CK 12400, AST 900. Symptoms were not as bad as my original posting. He was at a lameness specialists for a couple of days for a full body scan when this happened. Prior to going he had several days off work, but turned out in huge paddock at night. Since the original posting I have kept him in constant novice eventing level work and on his diet, etc. He has been doing fairly well. He also has uveitis and is being treated for leptosporosis which he tested positive for. His scan showed inflammation in every major joint and his heels. He was injected in his cannons, hocks and sacrosiliac. I feel like my boy is in bad shape. He is only 11. He will be going to a shoeing specialist in a month. Otherwise, I am following all suggestions of his various docs. Any thoughts, suggestions? I am getting worn out by it all! To top it all off another horse kicked him in the face last December and he need to have surgery to repair the damage!
Moderator:
DrO

Posted on Monday, Aug 4, 2008 - 7:16 am:

Hello SueB,
What were the symptoms of the lameness before going in for the bone scan? What is the current diagnosis for cause of the polyarthritis? At what point was the tying up discovered?

I am suspicious of a finding of "inflammation in every major joint" on a full body scan. When you say scan I presume we are talking about a radioactive tissue scan following an injected radioisotope. This type scan does not measure inflammation, it measures blood flow. Inflammation and other conditions are associated with increase blood flow. A scan measures normal against abnormal radioactive uptake by comparing the background uptake against the particular area of interest. If every joint is dark compared to the background the only interpretation that makes sense to me is that is this is the normal scan density of the joints. This can be explained by the amount of time that passes between the injection and sampling of the radioactive isotope. At different times the radioactive can be differentially concentrated into different tissues. Largely we can divide this into the tissue phase and the bone phase. But the tissue phase can be broken down further based on the type tissue. It is possible your horse got exposed during a time the radioactivity was higher in joints. One thought occurs to me however: what antibiotic is your horse on for leptospirosis?
DrO
Member:
sbawer1

Posted on Monday, Aug 4, 2008 - 11:58 am:

Hi. They did nuclear scintigraphy due to lameness in right front and right hind. Symptoms prior to scan were lameness at trot from rf. When it started it was on and off for a week then became continuous. The local vet did radiographs and thought it was either side bone or a heel fracture. He recommmended the scan. I will email you the report of the results. They injected him and then did the scan several hours later. They are a top facility and work with some of the olympic horses so I trust the results.
My horse is on doxycycline (50 pills, 2x day). He has been on it since June 20. He is on polyacetate, 1 DrOp per day for uveitis.
The tying up occured after they lunged him I told them to do an enzyme blood test because they said they could see signs of past damage due. That is how we found up he tied up again after they worked him. Thanks for looking at this!
Member:
sbawer1

Posted on Monday, Aug 4, 2008 - 9:17 pm:

Afternoon update: Grif's PSSM gene testing results came back P/N for the disorder. So, I guess the result of this is that he must be worked 7 days a week... I don't really know what to do when/if he's ever injured and needs time off. Vet took blood enzyme test today and results show that the episode is not getting worse.
Moderator:
DrO

Posted on Tuesday, Aug 5, 2008 - 9:13 am:

Hello Sue,
It is not a matter of trusting the procedure it is a matter of understanding what useful information can be obtained from such a scan. Concerning the use of oral doxycycline if this is for the possibility of Lymes disease you should review the article Diseases of Horses » Lameness » Joint, Bone, Ligament Diseases » Lyme Disease, Borreliosis, in Horses.
DrO
Member:
sbawer1

Posted on Tuesday, Aug 5, 2008 - 9:59 am:

Thanks, the doxy is for leptosporosis which we think is the cause of the uveitis. I emailed the scan results to you yesterday. Your feedback would be appreciated. They injected 3 areas, cannon, sacrosciliac and hocks. Can some of this pain and inflamation be from the pssm? I am trying to figure out if all this is related somehow.
Moderator:
DrO

Posted on Wednesday, Aug 6, 2008 - 8:31 am:

Good job SueB, your description of the disease is consistent with PSSM including the supporting muscle enzyme levels.
DrO
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