Tying Up Or Azoturia

The areas typically affected are the neck, back, shoulders, zones of previous trauma and areas where other muscles have attempted to compensate for those already affected.
What are the symptoms?
Obvious discomfort, muscle stiffness
Difficulty in movement. The horse may refuse to move
Muscle hardening/contracting with hindquarter spasms, mostly in croup area
Elevated pulse and respiration
Sweating
Short, stiff gait
Brown colored urine


Where does it come from?
The cause is not fully understood but is thought to be related to the buildup of glycogen in the muscles of a horse that is fed a high energy ration. During exercise, the glycogen in the muscles is used up and lactic acid replaces it. This causes swelling and damage to the muscle tissue.

Conditions that cause a horse to tie up include: exertional stress, nutritional deficiencies, plant toxins, and genetic defects of carbohydrate metabolism (Polysaccharide Storage Myopathy or PSSM and Equine Polysaccharide Storage Myopathy or EPSM).

How is it diagnosed?
A blood test will show elevated levels of the muscle enzymes creatine kinase (CK) and aspartate aminotransferase (AST) during or immediately after a tying up episode. Strenuous exercise can elevate these enzymes up to 4 times normal while most tying up episodes result in a 10 fold rise or greater.

How is it treated?
If you suspect Azoturia, stop exercising the horse and move her to a box stall. Do not force her to walk.
Call your veterinarian.
Provide fluids.
Remove grain and feed; provide only hay until signs subside.
Your veterinarian may prescribe pain killers, muscle relaxants, corticosteroids and/or tranquilizers.
If the problem recurs, have the horse evaluated for a specific cause of recurrent exertional rhabdomyolysis.

How is it prevented?
Warm up and cool down your horse properly with at least 15 minutes of walking.
Don't exercise the horse to a point where he becomes stressed.
Provide turnout as frequently as possible.
Feed a low or no-carbohydrate diet with high fat.
Keep electrolyte levels in balance and at at optimal levels through good nutrition or supplementation.

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