Abstract
The purpose of this study was to evaluate the biochemical alterations in horses with exertional rhabdomyolysis (ER) and those with myositis and to characterize the progressive changes of both diseases by using ultrasonography (US). For this reason, 40 horses with various symptoms of musculoskeletal disorders were studied. Based on the competent case history, clinical symptoms, and in combination with clinicopathological findings as well as ultrasonographic alterations, the investigated horses were allocated into two main groups: ER-group (n = 7) and myositis group (n = 33). Blood samples were drawn from all investigated horses for laboratory assessment. The obtained findings revealed that horses with mild and severe forms of ER had a statistically significant (P < 0.05) high serum enzymatic activity of creatine phosphokinase (CPK), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST), with significant (P < 0.05) low values of serum calcium compared with those of myositis as well as a control group. Horses with severe ER also demonstrated a statistically significant (P < 0.05) high value of blood urea nitrogen, serum magnesium, phosphorus, and potassium, with significant (P < 0.05) low values of serum chloride and sodium compared with other groups. Ultrasonically, it appeared that horses with severe ER have had hypoechoic loss of muscle texture, while mildly affected cases showed small hypoechoic cavities replacing the affected muscles. Small hypoechoic cavities separating muscle fibers were also observed in mild cases of myositis, but fibrinous hyperechoic dots prevailed in severe cases. From the results obtained, it can be concluded that the sole use of US for the diagnosis of ER and myositis in investigated horses was not really conclusive, but a combination of serum biochemical analyses, clinical examination findings, and US could facilitate early diagnosis of the studied diseases.
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References
Aleman M (2008) A review of equine muscle disorders. Neuromuscul Disord 18:277–287
Anderson FL, Secombe CJ, Lester GD (2013) Case report and clinical review Clostridial myonecrosis, haemolyticbanaemia, hepatopathy, osteitis and transient hypertrophic cardiomyopathy after intramuscular injection in a thoroughbred gelding. Aus. Vet J 91:204–208
Banasik M, Kuźniar J, Kuszta M, Porazko T, Weyde W, Klinger M (2008) Myoglobinuria caused by exertional rhabdomyolysis misdiagnosed as psychiatric illness. Med Sci Monit 14:CS1–CS4
Beech J (2000) Equine muscle disorders: chronic intermittent rhabdomyolysis. Equine Vet Educ 12:163–167
Boutin RD, Fritz RC, Steinbach LS (2002) Imaging of sports-related muscle injuries. Radiol Clin N Am 40:333–362
Carlström B (1932) Über die Ätiologie und Pathogenese der Kreuzlähmung des Pferdes (Hämoglobinämiaparalytica) Skan. Arch Physiol 63:164–169
Clarke JC, Nolan RL (2003) Resident's corner. Answer to case of the month #93. Exercise-induced rhabdomyolysis. Can Assoc Radiol J 54:310–312
Cole F, Mellor D, Hodgson D, Reid S (2004) Prevalence and demographic characteristics of exertional rhabdomyolysis in horses in Australia. Vet Rec 155:625–630
El-Ashker M (2011) Acute kidney injury mediated by oxidative stress in Egyptian horses with exertional rhabdomyolysis. Vet Res Commun 35:311–320
El-Ashker M (2012) Diagnostic efficiency of selected biochemical variables to predict the clinical outcomes of exertional rhabdomyolysis in draft horses. Comp Clin Pathol 21:1103–1108
Fornage BD, Nerot C (1986) Sonographic diagnosis of rhabdomyolysis. J Clin Ultrasound 16:389–392
Freestone JF, Carlson GP (1991) Muscle disorders in the horse: a retrospective study. Equine Vet J 23:86–90
Gabow PA, Kaehny WD, Kelleher SP (1982) The spectrum of rhabdomyolysis. Medicine (Baltimore) 61:141–152
Gissel H (2006) The role of Ca2+ in muscle cell damage. Ann N Y Acad Sci 1066:166–180
Hunt LM, Valberg SJ, Steffenhagen K, McCue ME (2008) An epidemiologic study of myopathies in warm blood horses. Equine Vet J 40:171–177
Jeffcott L (1980) Disorders of the thoracolumbar spine of the horse—a survey of 443 cases. Equine Vet J 12:197–210
Kaplan GN (1980) Ultгasonographic appеarenсе of rhabdomyolysis. Am. J Radiol 731:375–377
Kinnunen S, Atalay M, Hyyppä S, Lehmuskero A, Hänninen O, Oksala N (2005) Effects of prolonged exercise on oxidative stress and antioxidant defense in endurance horse. J Sports Sci Med 4:415–421
Knoepfli AB (2002) Exertional rhabdomyolysis in a 4-year-old standardbred filly. Can Vet J 43:293–295
Koh ES, McNally EG (2007) Ultrasound of skeletal muscle injury. Semin Musculoskelet Radiol 11: 162–173
Kramer M, Gerwing M, Hach V, Schimke E. (1997) Sonography of the musculoskeletal system in dogs and cats. Vet Radiol Ultrasound 38:139–149, SONOGRAPHY OF THE MUSCULOSKELETAL SYSTEM IN DOGS AND CATS
Megliola A, Eutropi F, Scorzelli A, Gambacorta D, de Marchi A, de Filippo M, Faletti C, Ferrari FS (2006) Ultrasound and magnetic resonance imaging in sports-related muscle injuries. Radiol Med 111:836–845
Murphy DB (1980) Clostridium chauvoei as the cause of malignant edema in ahorse. Vet Med Small Anim Clin 75:1152–1154
Peek SF, Semrad SD, Perkins GA (2003) Clostridial myonecrosis in horses (37 cases 1985–2000). Equine Vet J 35:86–92
Perdrizet JA, Callihan DR, Rebhun WC, Shin SJ (1987) Successfulmanagement of malignant edema caused by Clostridium septicum in a horse. Cornell Vet 77:328–338
Perkins G, Valberg SJ, Madigan JE, et al (1998) Fluid, electrolyte and renal abnormalities associated with acute rhabdomyolysis in four neonatal foals. JVIM 12:173–177
Rebhun WC, Shin SJ, King JM, Baum KH, Patten V (1985) Malignant edema in horses. J Am Vet Med Ass 187, 732–736
Reef V (1998) Musculoskeletal ultrasonography. In: equine diagnostic ultrasound. Philadelphia PA: WB Saunders
Rinard J, Clarkson PM, Smith LL et al (2000) Response of males and females to high force eccentric exercise. J Sports Sci 8: 229–236
Sharma N, Winpenny H, Heymann T (1999) Exercise induced rhabdomyolysis: even the fit may suffer. Int J Clin Pract 53:476–477
Songer JG (2010) Histotoxic clostridia in: Gyles, CL, Prescott JF, Songer G, Thoen CO. (eds). Pathogenesis of bacterial infections in animals.4th ed. Blackwell Publishing, Ames 2010:203–209
Stadhouders AM (1981) Cellular calcium homeostasis.Mitochondria and muscle cell disease. In: Busch HFM, Jennekens FG, Scholte HR (eds) mitochondria and muscular diseases77–88
Turner TA (1989) Hind limb muscle strain as a cause of lameness in horses. Am Assoc Equine Pract Proceed 35:281–290
Valberg SJ, McKinnon AO (1984) Clostridial cellulites in the horse: a report of five cases. Can Vet J 25:67–71
Valberg SJ, Mickelson JR, Gallant EM, MacLeay JM, Lentz L, De la Corte F (1999) Exertional rhabdomyolysis in quarter horses and thoroughbreds: one syndrome, multiple aetiologies. Equine Vet J 30:533–538
Valberg S (2002) A review of the diagnosis and treatment of rhabdomyolysis in foals. Am Assoc Equine Pract Proceed 48:117–121
Valberg SJ (2006) Immune-mediated myopathies. Am Assoc Equine Pract Proceed 52:354–357
Valberg S (2009) Exertional rhabdomyolysis: diagnosis and treatment. Proceedings of the 11th International Congress of the World Equine Veterinary Association 24–27 September, Guarujá, SP, Brazil
Vanholder R, Sever MS, Erek E, Lameire N (2000) Rhabdomyolysis. J Am Soc Nephrol 11:1553–1561
Walmsley EA, Steel CM, Richardson JL, Whitton RC (2010) Muscle strain injuries of the hindlimb in eight horses: diagnostic imaging, management and outcomes. Aust Vet J 88:313–321
Wilberger M, Mckenzie E, Payton M, Rigas J, Valberg S (2015) Prevalence of exertional rhabdomyolysis in endurance horses in the Pacific northwestern United States. Equine Vet J 47:165–170
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MAY and MRE designed and coordinated the study. EES is responsible for samples collection. SAE performed statistical analysis. MRE wrote the manuscript. All authors contributed equally in data collection, analyses, and interpretation. All authors approved the final version of the manuscript for publication.
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The field study complies with institutional, national, or international guidelines, and the local ethics committee.
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Youssef, M.A., El-Ashker, M.R., Samaha, E.E. et al. Biochemical and ultrasonographic evaluation of exertional rhabdomyolysis and myositis in draft horses. Comp Clin Pathol 27, 829–839 (2018). https://doi.org/10.1007/s00580-018-2668-7
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DOI: https://doi.org/10.1007/s00580-018-2668-7