| AZOTURIA (TYING-UP) Causes, Prevention & Treatment |
Azoturia, or Equine Rhabdomyelosis (ER), is a condition that affects the muscles of horses, ranging from stiffness and mild
cramps to the horse becoming unable to stand with discolored urine. Terminology for the disease is variable and includes
Monday Morning Disease, Tying-Up, Azturia, Paralytic Myoglobinuria, Myositis and Setfast. It is unlikely that a single process
can explain all the clinical types, but the term Rhabdomyelosis is often thought to be the more accurate description.
Equine Rhabdomyelosis can affect any horse of any age but is much more common in fillies and mares than geldings and
stallions. Young animals tend to have one or two episodes and then no further problems. It can affect just one individual in a
group which are all under the same management regime. There does not seem to be a single cause that triggers ER 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.
*
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. However, the most common cause
of ER is an imbalance between the animal's diet and his workload, especially when he has a high-grain diet.
Signs vary widely depending on the extent of muscle damage.
*
A horse developing ER will usually begin showing signs right after the beginning of exercise, although for mild cases, signs
may not be seen until after the horse is cooled out. Signs include reluctance to move, stiffness or shortened gait when the
animal is forced to move, and muscle spasms or cramps, with hard, painful muscles (especially the hindquarters) when
palpated.
*
Signs of a severe bout of ER may include: sweating, elevated heart and respiratory rates as a result of pain, anxious
expression, shifting of weight from side to side, standing hunched and tense, passing reddish-brown urine, dehydration, shock,
and inability to rise.
*
If signs of ER are seen, DO NOT MOVE THE HORSE. Movement can cause further muscle damage. If the animal is far from
the barn, it is best to trailer him back than to move him.
*
After a bout of ER, blood levels of CPK and AST rise.
In mild or moderate cases the horse should receive several days of a non-steroidal anti-inflammatory, rest, and grain or pellets
should be withheld. To improve blood flow to the muscles and help with muscles, heat therapy and Equine Massage may be
beneficial, as well as hand-walking if the horse is comfortable walking. Turn-out in a pasture or paddock will encourage
movement. A horse should be moving normally within 12-36 hours after the attack.
In severe cases a horse may need fluids, especially if his urine is colored, the horse is receiving non-steroidal
anti-inflammatory drugs, or if he is dehydrated. Fluids will increase the production of urine that will in turn help flush out the
excess, and potentially damaging, myoglobin from the kidneys and will reduce non-steroidal anti-inflammatory-produced kidney
damage. Fluids should be administered until the urine is clear, which usually takes from a few hours to a few days.
Except to get a horse to his stall, a horse showing signs of severe ER should not be moved until he is comfortable enough to
do so eagerly. This may take several days. After this point, it is important to either hand-walk the horse a few times each day,
or to provide him with a few hours of turnout in a pasture or paddock.
For mild to moderate cases of ER, the prognosis is excellent, with the horse successfully returning to its former level of
competition. However, if the vet's recommendations for preventing ER are not followed, ER may likely occur.
Horses who experience a severe case of ER (muscle degeneration is significant) are less likely to return to their previous level
of competition, as fibrosis may have occurred which would result in loss of muscle function. The prognosis is guarded for these
horses.
Prevention:
1. Diet - Reducing any extra energy in a horse's diet is essential to maintaining a horse that has experienced ER. Decreasing
carbohydrates and increasing the daily intake of hay or pasture can usually accomplish this. Grain should be reduced or
removed from a horse's ration on days when he cannot be worked.
2. Exercise - Proper conditioning is very important in preventing ER. Beginning with a base long, slow distance work will ensure
that the horse has a foundation before proceeding on to more strenuous work. It is best that a horse receive daily exercise , or
possibly twice a day, to prevent the recurrence of ER. If possible, avoid breaks of the horse's exercise schedule. If for some
reason the horse cannot receive training, he should at least be ridden, driven, lunged, or turned out. Daily pasture turnout is
ideal for horses likely to suffer from ER, as it provides exercise and adds roughage to the animal's diet.
3. Supplements & Drugs - As with any supplements and drugs, it is best to confer with your vet as to the recommended
dosages. Adding potassium and salt to the diet may be beneficial to horses that suffer from recurrent bouts of ER. Horses in
hard training may need a vitamin E supplement, as their requirements are higher than horses in more moderate work. The
horse may also be deficient in selenium, and need a feed supplement. Selenium can be dangerous if overfed, so it is best to
have a blood test to confirm that the horse is in need of supplemental selenium.
4. Functional Feeding - A special feed program with nutrients designed to support digestive structure and function can help
ensure the digestive tract absorbs the starches in high grain processed feed. One such product, SUCCEED Digestive
Conditioning Program (SVesty@freedomhealthllc.com), includes polar lipids and beta glucan, which enhances nutrients
absorption and helps ensure grains are digested in the small intestine. This helps keep the grain from reaching the hind gut,
where it can be converted to lactic acid which may contribute to tying up.
As with all health related issues concerning your horses, you should consult your veterinarian. The feeding and management
of susceptible horses is crucial. Each case will need expert advice from a veterinary.
cramps to the horse becoming unable to stand with discolored urine. Terminology for the disease is variable and includes
Monday Morning Disease, Tying-Up, Azturia, Paralytic Myoglobinuria, Myositis and Setfast. It is unlikely that a single process
can explain all the clinical types, but the term Rhabdomyelosis is often thought to be the more accurate description.
Equine Rhabdomyelosis can affect any horse of any age but is much more common in fillies and mares than geldings and
stallions. Young animals tend to have one or two episodes and then no further problems. It can affect just one individual in a
group which are all under the same management regime. There does not seem to be a single cause that triggers ER 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.
*
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. However, the most common cause
of ER is an imbalance between the animal's diet and his workload, especially when he has a high-grain diet.
Signs vary widely depending on the extent of muscle damage.
*
A horse developing ER will usually begin showing signs right after the beginning of exercise, although for mild cases, signs
may not be seen until after the horse is cooled out. Signs include reluctance to move, stiffness or shortened gait when the
animal is forced to move, and muscle spasms or cramps, with hard, painful muscles (especially the hindquarters) when
palpated.
*
Signs of a severe bout of ER may include: sweating, elevated heart and respiratory rates as a result of pain, anxious
expression, shifting of weight from side to side, standing hunched and tense, passing reddish-brown urine, dehydration, shock,
and inability to rise.
*
If signs of ER are seen, DO NOT MOVE THE HORSE. Movement can cause further muscle damage. If the animal is far from
the barn, it is best to trailer him back than to move him.
*
After a bout of ER, blood levels of CPK and AST rise.
In mild or moderate cases the horse should receive several days of a non-steroidal anti-inflammatory, rest, and grain or pellets
should be withheld. To improve blood flow to the muscles and help with muscles, heat therapy and Equine Massage may be
beneficial, as well as hand-walking if the horse is comfortable walking. Turn-out in a pasture or paddock will encourage
movement. A horse should be moving normally within 12-36 hours after the attack.
In severe cases a horse may need fluids, especially if his urine is colored, the horse is receiving non-steroidal
anti-inflammatory drugs, or if he is dehydrated. Fluids will increase the production of urine that will in turn help flush out the
excess, and potentially damaging, myoglobin from the kidneys and will reduce non-steroidal anti-inflammatory-produced kidney
damage. Fluids should be administered until the urine is clear, which usually takes from a few hours to a few days.
Except to get a horse to his stall, a horse showing signs of severe ER should not be moved until he is comfortable enough to
do so eagerly. This may take several days. After this point, it is important to either hand-walk the horse a few times each day,
or to provide him with a few hours of turnout in a pasture or paddock.
For mild to moderate cases of ER, the prognosis is excellent, with the horse successfully returning to its former level of
competition. However, if the vet's recommendations for preventing ER are not followed, ER may likely occur.
Horses who experience a severe case of ER (muscle degeneration is significant) are less likely to return to their previous level
of competition, as fibrosis may have occurred which would result in loss of muscle function. The prognosis is guarded for these
horses.
Prevention:
1. Diet - Reducing any extra energy in a horse's diet is essential to maintaining a horse that has experienced ER. Decreasing
carbohydrates and increasing the daily intake of hay or pasture can usually accomplish this. Grain should be reduced or
removed from a horse's ration on days when he cannot be worked.
2. Exercise - Proper conditioning is very important in preventing ER. Beginning with a base long, slow distance work will ensure
that the horse has a foundation before proceeding on to more strenuous work. It is best that a horse receive daily exercise , or
possibly twice a day, to prevent the recurrence of ER. If possible, avoid breaks of the horse's exercise schedule. If for some
reason the horse cannot receive training, he should at least be ridden, driven, lunged, or turned out. Daily pasture turnout is
ideal for horses likely to suffer from ER, as it provides exercise and adds roughage to the animal's diet.
3. Supplements & Drugs - As with any supplements and drugs, it is best to confer with your vet as to the recommended
dosages. Adding potassium and salt to the diet may be beneficial to horses that suffer from recurrent bouts of ER. Horses in
hard training may need a vitamin E supplement, as their requirements are higher than horses in more moderate work. The
horse may also be deficient in selenium, and need a feed supplement. Selenium can be dangerous if overfed, so it is best to
have a blood test to confirm that the horse is in need of supplemental selenium.
4. Functional Feeding - A special feed program with nutrients designed to support digestive structure and function can help
ensure the digestive tract absorbs the starches in high grain processed feed. One such product, SUCCEED Digestive
Conditioning Program (SVesty@freedomhealthllc.com), includes polar lipids and beta glucan, which enhances nutrients
absorption and helps ensure grains are digested in the small intestine. This helps keep the grain from reaching the hind gut,
where it can be converted to lactic acid which may contribute to tying up.
As with all health related issues concerning your horses, you should consult your veterinarian. The feeding and management
of susceptible horses is crucial. Each case will need expert advice from a veterinary.
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