Bloods back - horse tied up. Any advice on managing him now?

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Christmas Crumpet

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Vet just rang with blood test results and said that clearly my horse had tied up - he was feeling very flat and puffing hard which is what prompted me to get the vet out thinking he had a low grade virus. He didn't show any of the major signs of tying up at all - he was literally just flat to ride. I certainly didn't pick up on the attack at the time so am hoping that it was a minor attack.

Horse is out in the field until Monday then I am to start riding again quietly and we will retest the bloods on Thursday night and see how he is doing.

I know he needs salt, Vitamin E & Selenium in his diet. He is only on pony nuts, unmolassed chaff (Dengie hifi) and micronised linseed with pro hoof and a hack up joint supplement plus steamed hay. He is hunting fit and goes out in the field every day, normally all day every day but due to the cold weather is only going out at lunchtime till about 6.30 p.m at the moment.

ERS Pellets have been suggested as has Saracen Relieve by the vet.

I would be grateful for any advice on how to manage this so we avoid another attack and so I can get him properly back on the road to hunting again!!
 
It takes a long time to get over tying up, even a minor bout. What are your horses CK levels? They will tell you the extent of the tie up.

Normally we do 4-5 days box rest with bute. Then 4-5 days of slow steady walking on the walker building up the time spent walking. Then we turn out for an hour and walk hack for an hour. Increasing turnout time over the week. Week 3 we redo bloods. If bloods improving add in little bits of trot, again building up the length of time trotting. They don't even begin to think about cantering til the end of week 4 and then it is very slow, steady, quietly away. By week 6-7 we hope to have them back in full work but with lots of extra warm up and cool down. Always with a 1/4sheet to keep them warm.

The worst thing you can do is rush a horse that has tied up as you could potentially screw it big style. Even if the attack seemed minor the outside isn't everything.
 
EKW said:
It takes a long time to get over tying up, even a minor bout. What are your horses CK levels? They will tell you the extent of the tie up.

Normally we do 4-5 days box rest with bute. Then 4-5 days of slow steady walking on the walker building up the time spent walking. Then we turn out for an hour and walk hack for an hour. Increasing turnout time over the week. Week 3 we redo bloods. If bloods improving add in little bits of trot, again building up the length of time trotting. They don't even begin to think about cantering til the end of week 4 and then it is very slow, steady, quietly away. By week 6-7 we hope to have them back in full work but with lots of extra warm up and cool down. Always with a 1/4sheet to keep them warm.

Not sure of the names of each thing but one was 5,000 (creatine? I know vet said normal was about 3/400) and 1,000 AST - and also not sure of what it all means. Does that make sense at all?

I am sure the problem came about as horse was kept in the yard for a week (big open yard he can walk about in) with a flint cut after hunting 2 weeks ago. Feel really bad about it as he just seemed normal but flat to ride and puffing a bit more than normal.
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CK shouldn't be that high either. Both CK and AST should be around 2-300.

What type of horse is it OP. Age etc. Any other quirks or things about him you would comment on?

There are many reasons a horse can tie up. The solution or management for each reason is different. Don't fall into the trap of listening to be people including vets, who will tell you to feed ERS pellets and selenevite e or words to that effect. If you did that with my horse she could die, her CK and AST levels were off the scale when she tied up, the scale goes up to 100,000, so that shows you how bad it was, yet her outward symptoms were mild. With the right diet and management she is a highly athletic horse who does not tie up. Had I listened to the wrong advice, from vets, nutritionists and well meaning people who think they know but don't, the outcome would have been different. You need specialist advice to try get to the bottom of the issue.
 
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Depending on the brand pony nuts can be too high in sugar/starch for horses who are prone to tying up. ERS Pellets are very good, and lots of people swear by Releve too. It is very important to watch fluid intake too, as dehydration can be implicated in some cases of tying up. Use buckets rather than auto waterers so you can check consumption, keep water scrupulously clean, add warm water to bucket if water is very chilled, give feeds wet/soaked, feed electrolytes/salt to encourage drinking. As much turnout as possible, try and not give more than one day off at a time. Don't do strenuous or fast work after a day off. Warm up and cool down properly.
 
Some good advice. Gradual return to work, as much movement as possible (mind has stable and concrete yard overnight to encourage him to move even when in overnight). Exercise should be consistent, and built up gradually. Once hes at a certain level don't go giving him 3 days off and then go back to having an intense level. The cause of the tie up is key for how to manage it (mine has RER which is totally different in terms of mechanism to PSSM) but you will never go wrong if you start with cutting out grain, stick to low sugar low starch (and don't believe vets on what that means, Outshine is 18% starch and that's what was recommended to me, I give mine a little Releve to get his meds in him but wouldn't give it to one with PSSM) and keeping muscles warm. I haven't got the hang of mine yet. He doesn't tie up in the classic way but his AST is usually up at 900 even when working normally, his movement behind gets restricted but he also has a sacroiliac injury to cope with.
 
FfionWinnie said:
CK shouldn't be that high either. Both CK and AST should be around 2-300.

What type of horse is it OP. Age etc. Any other quirks or things about him you would comment on?

He is a 15.1hh ISH but more coblike. 11 years old. Hunting fit - gets ridden every day with a day off after hunting. Normally turned out every day but had a week in the big open yard when he got a flint cut out hunting and I was trying to keep it clean. He was still being ridden every day. He is fed a handful of pony nuts and a scoop of chaff first thing in the morning. Nighttime a scoop of pony nuts and chaff with linseed & supplements. When I did turn him out after his flint cut he went in the top field which hadn't been grazed for months as I was saving it till it got really wet but I think the grass ran away with me and he is quite greedy. I don't think he's had an episode of this before but I will check with his old owners. I always ride in an exercise sheet when its cold or rainy. He gets turned out for nearly 12 hours a day normally but obviously in the frost, he's not going out till lunchtime when its not frosty anymore. Apart from that I'm not sure there is any other info really.

Oh yes - our yard set up is that his stable door is always open and he has the open yard to walk about in - about 7 metres by 15 metres - and he's been kept like this since we got him.
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Your management of him normally sounds really good - the sort of thing I do with my PSSM horse which keeps her well. That could have prevented you having an issue before, if that makes sense.

I would start feeding him Equimins vitamin e oil, 6-10mls is 6000-10000iu. That is good for any horse and covers some of the possible reasons for a horse to tie up.

As Kat says, a low sugar and starch diet is also going to help.

My horse can't tolerate linseed. It doesn't make her tie up but it does make her stiff for about ten minutes when I first get on.

I'd look into your diet a little more, what's in the pony nuts and also what is the chaff, what's lurking in the supplements. You want to avoid oatfeed, wheat feed, unnecessary sugars. You would be amazed what junk is used as fillers in horse feed and supplements.
 
i'd look into diet too. I have one that tied up and it was caused by food alergies. I was advised to switch to red mills horse care 14 and it hasn't happened since.
 
Did the flint cut weep a lot of serum? I had a mare tie up really solid once. She'd never done it before and she never did it again. The only thing that was different was that she had a cut on her forearm which was weeping maybe a pint of serum a day. I reckoned it might have completely unbalanced her electrolyte levels and caused the tie up. I was riding her because she was very fit and sound and I thought it better to keep her working. Wrong move :(
 
FfionWinnie said:
Your management of him normally sounds really good - the sort of thing I do with my PSSM horse which keeps her well. That could have prevented you having an issue before, if that makes sense.

I would start feeding him Equimins vitamin e oil, 6-10mls is 6000-10000iu. That is good for any horse and covers some of the possible reasons for a horse to tie up.

As Kat says, a low sugar and starch diet is also going to help.


My horse cant tolerate linseed. It doesn't make her tie up but it does make her stiff for about ten minutes when I first get on.

I'd look into your diet a little more, what's in the pony nuts and also what is the chaff, what's lurking in the supplements. You want to avoid oatfeed, wheat feed, unnecessary sugars. You would be amazed what junk is used as fillers in horse feed and supplements.
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I am just off to the feed shop and have already rung them to have a chat about what to feed. Horse is on Dengie unmolassed hifi chaff so hopefully that should be fine but the pony nuts do have a bit of starch in them he says. I don't need to feed for massive energy as he is a good doer who doesn't really need much feed which is why he is on pony nuts and chaff. What can I feed him to give him enough energy to hunt etc but will work for him if he is now going to be prone to tying up? I don't want to feed him anything really high energy as he just doesn't need it.

I will report back once I've talked to shop man. Have emailed old owner to see if she was aware of anything like this happening before.
 
I really rate coolstance copra as a safe feed. It's can be hard to get them to eat it as its a bit different, that's the only issue!

Is the chaff made from oat straw?
 
Once he his back in work it is vital to work him in slowly and the same after work - walk him off. I had a very good show jumper that tied up and I spent many a cold half hour walking around the horse box park after everyone else had long gone home but worth it to prevent an attack and subsequent weeks/months off work. Never let his muscles get cold - keep well rugged at all times.
 
My mare has a history of tying up, but she ties up very mildly, she tied up twice with her old owners and only had to have the vet out one of those times and has tied up 1 time with me in 6 years and the vet was called the next day and it was found she had a respiratory infection that had caused her to tie up as she was already under the weather.

She's a Welsh D so good doer and on the ERS pellets, I find this gives her enough energy without making her silly and stupid. She only gets a feed when she does work, if she's not ridden then she doesn't get anything, just ad lib soaked hay - this cuts out any excess starch and sugars. She just gets pellets and light chaff when she is fed - keep feeds basic and as simple as possible, really read packaging and ingredients. I feel like I'm constantly reading feed packets both horse and human as I'm a coeliac and the mare is also allergic to garlic! :D

Warm up and warm downs also are a lengthy process, especially when cold and quarter sheets are a must to keep that hind end warm! I also make sure she gets as much turnout as possible and if she has to stay in for a day (rarely) then she's ridden and also gets a walk and a jog out in hand for at least 20 minutes. I also dot haynets around her large stable to encourage her to move around at night.

Hope this helps! I find it quite easy to manage but it does depend on how bad a reaction your horse has.
 
Loads of good advice given by others. Take it slowly, even more slowly than you originally think.
My mare had an extraordinary attack of azotoria, as it was called then, in the middle '90's. Vet said she should have died.
I have a record of a first day blood count that says '237000'. This was taken after she collapsed. Unfortunately it is so long ago I have no idea what it counted.
Mare was off work for 6 months but recovered and never had an attack again.
So, take it slowly, be prepared to be careful at all times and you should be fine.
Hope all is well.
 
carolineb said:
Vet just rang with blood test results and said that clearly my horse had tied up - he was feeling very flat and puffing hard which is what prompted me to get the vet out thinking he had a low grade virus. He didn't show any of the major signs of tying up at all - he was literally just flat to ride. I certainly didn't pick up on the attack at the time so am hoping that it was a minor attack.

Horse is out in the field until Monday then I am to start riding again quietly and we will retest the bloods on Thursday night and see how he is doing.

I know he needs salt, Vitamin E & Selenium in his diet. He is only on pony nuts, unmolassed chaff (Dengie hifi) and micronised linseed with pro hoof and a hack up joint supplement plus steamed hay. He is hunting fit and goes out in the field every day, normally all day every day but due to the cold weather is only going out at lunchtime till about 6.30 p.m at the moment.

ERS Pellets have been suggested as has Saracen Relieve by the vet.

I would be grateful for any advice on how to manage this so we avoid another attack and so I can get him properly back on the road to hunting again!!
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My mare had Myopathy which is a lesser form of azutoria and with muscle relaxants from vet she took 3 months to recover
 
What is really concerning me is that he clearly tied up (now I realise what the lethargy and puffing was) 2 weeks ago on Sat and I've continued to ride him quietly thinking he was just under the weather. I've only ever seen horses properly tying up and it didn't even occur to me that a fit pony who lives off hay and pony nuts could or would tie up.

Feel like such a dreadful owner. And bless my lovely horse - he's just pootled along a bit slower but bright and seemingly normal. There was nothing remotely dramatic about it - just a lethargic horse it seemed.

Thank god I didn't take him hunting on Sat to "brighten him up" like oh suggested...
 
Like I said mine was at death's door internally and externally she was a little grumpy and not tracking up behind when she usually over tracks. The vet diagnosed colic initially and it wasn't until I saw her urine we realised it was a severe tie up. Even then the vet was still saying it probably wasn't serious!!

Don't beat yourself up.
 
FfionWinnie said:
Like I said mine was at death's door internally and externally she was a little grumpy and not tracking up behind when she usually over tracks. The vet diagnosed colic initially and it wasn't until I saw her urine we realised it was a severe tie up. Even then the vet was still saying it probably wasn't serious!!

Don't beat yourself up.
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Have to say that doesn't fill me with huge confidence!!!! I dread to think how bad it was and what the outcome will be. I was hoping because the symptoms were so mild/vague that it wasn't that bad!!!
 
My horse tied up over new year. He's not done it with me before, but did with previous owner, 3yrs ago. I think once it's happened before they are more susceptible?

There was an online article on H&H a week or so ago about feeding for tying up? I've always been careful to feed low sugar and warm up/down well. I think this attack was my fault due to intermittent work load over Xmas period. Got to keep everything very consistent. I made mistake of not cutting feed enough when he had a few lighter days as he was only on 1 scoop of unmolassed chaff, some copra and a handful of pony nuts and I got complacent thinking this was not much.

One thing vet did recommend, other than management type advise already outlined by previous posters, is a D&H supplement, Azodine. Not a magic cure, obviously, but vet rated it and it's relatively inexpensive. So, have also put him on that, (cause what else would I spend my money on 😂). Also, vet said that the following 10 days after an attack is the time to be the most careful. Be guided by vet about rehabbing back to full work as tying up can cause a lot of muscle damage and you need to be super careful bringing them back. Hope it recovers well, X
 
carolineb said:
Have to say that doesn't fill me with huge confidence!!!! I dread to think how bad it was and what the outcome will be. I was hoping because the symptoms were so mild/vague that it wasn't that bad!!!
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I thought you said his CK was 5000 and his AST was 1000? That's really my point. My horse was over 100,000 for both and had hardly any symptoms. Your horse was a lot less badly affected but had more symptoms.

The symptoms are irrelevant it's the blood work that tells you what's going on. 5k and 1k isn't catastrophic. Especially if they drop quickly.

Hopefully tweaking a few things diet wise will prevent you having to deal with it again.
 
FfionWinnie said:
I thought you said his CK was 5000 and his AST was 1000? That's really my point. My horse was over 100,000 for both and had hardly any symptoms. Your horse was a lot less badly affected but had more symptoms.

The symptoms are irrelevant it's the blood work that tells you what's going on. 5k and 1k isn't catastrophic. Especially if they drop quickly.

Hopefully tweaking a few things diet wise will prevent you having to deal with it again.
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Thank you for writing that - when you feel overwhelmed and can't see the wood for the trees, it really helps when someone (you) put it so simply and you have put my mind at rest... A bit!!!
 
carolineb said:
Thank you for writing that - when you feel overwhelmed and can't see the wood for the trees, it really helps when someone (you) put it so simply and you have put my mind at rest... A bit!!!
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It's a scary position to be in. It's about a year since my horse tied up now so I've learned a lot about it all since then.

Knowing what I know now, I would consider getting a DNA test done with animal genetics (you can pull the hair out of his tail) to test for type 1 PSSM. It's only £30.

Whether that's positive or negative, that will give you a starting point even if you don't want to do a biopsy at this stage. The diet for RER and PSSM 2 vary a bit from type 1.

My horse is also a cob and is type 1.

Unfortunately a lot of the information available for "tying up" is out of date and this goes for vets too. Educating yourself is power tho and it's not as complicated as it first seems.

Are you taking blood to see how things stand in a few weeks?
 
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FfionWinnie said:
It's a scary position to be in. It's about a year since my horse tied up now so I've learned a lot about it all since then.

Knowing what I know now, I would consider getting a DNA test done with animal genetics (you can pull the hair out of his tail) to test for type 1 PSSM. It's only £30.

Whether that's positive or negative, that will give you a starting point even if you don't want to do a biopsy at this stage. The diet for RER and PSSM 2 vary a bit from type 1.

My horse is also a cob and is type 1.

Unfortunately a lot of the information available for "tying up" is out of date and this goes for vets too. Educating yourself is power tho and it's not as complicated as it first seems.

Are you taking blood to see how things stand in a few weeks?
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Next bloods next Thursday evening. Vet said to walk him out from Monday and he'll do bloods on the thurs but am now wondering whether I should just turn him out till then
 
Is he likely to run about like an idiot? If not I would return him to his usual living conditions (not the really grassy field, the one he was in before he hurt his foot).

Change the diet to ultra low sugar and starch (also referred to as NSC).

Feed the Equimins vitamin e oil at a high dose.

See what the bloods say.

AST needs movement to get rid of it. It took a long time for my mare to return to normal levels, and I rested her during that time, which would actually not be what I would do now I know she has PSSM.
 
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Hello Carolineb...(((hugs))). It's a nasty thing. My old boy (now 23!), first tyed up as a youngster, major, couldn't even walk from school to stable, then had a few mild bouts until we found the 'source'. Every horse is different and medical science much progress from when I had to deal with his first attack. There is some good advice here, but work with your vet.
My vet was just fab, we found out that in his case, it was due to a low immune system and he had a low grade virus at the time. He also doesn't retain calcium, which of course aids muscle repair.

Way back then, my vet stated management is the best for of treatments. He got give aloe Vera in the autumn when the grass went off to boost his immune system and we give him calcium daily ( which is what a lot of the supplements contain).
Like others have said, keep quarters warm at all times. My boy has more clothes than I do!

Warm up and cool down always. And in days too...if I want to give him a day off, I decrease his work slowly, day by day, and pick up in the same way. I cannot do a long hack and then do nothing the next day.
Turnout is essential.

You can invest in a magnetic rug which helps with blood flow ... Use pre and post exercise.

It's manageable, that's what you have to remember.

On the flip side, it makes an all weather rider out of you if nothing else!!!
 
Slowly, slowly catchy monkey really. I haven't read thread though but here's my tuppence worth. I've realised this has turned into an essay, oops!

Basically muscles fibres have ruptured and/or died, certainly an element of necrosis is present, this releases muscle proteins/enzymes into the bloodstream allowing a diagnosis. The AST (Aspartate transaminase) and CK (Creatine kinase) are checked via bloods. The levels recorded to not always directly correlate to the severity of symptoms presented, however I'd probably describe the pain as severely tearing muscles then nasty cramp setting in. Some horses are more stoic than others.

Regardless, significant muscle damage has been done. The aetiology of Azoturia/ER/Tying Up/Monday Morning disease is still largely understood, similar to Laminitis.

The term Monday morning disease was coined when many years ago work horses came out stiff and lethargic on a Monday morning (obvs!). The cause being that Sunday was their day off however they were still fed the same amount of grain they had during for the other 6 days of their working week.

This is why there is the saying to 'only feed a horse for what it's done, not what it's going to do'. So if a horse has a day off, or a day of light work, you feed less hard feed. If it's had a harder days work, feed slightly more. If a horse is out competing the next day, don't 'feed up' in preparation.

Due to the above, I'm not going to recommend what to feed, as often it isn't about what is fed but rather how much, when and why. That said when dealing with rhabdomyolysis , high potassium/starch levels aren't the best idea and fluid balance is highly important, electrolytes are worth considering.

Other causes are still debated, age, sex and endocrine influence is felt to be relevant as well as breed. For example a TB/WB/QH filly is thought to be of a higher risk group but again the qualities of any affected horse can be diverse.

With regards to returning to exercise, it must be appreciated that significant muscle damage has occurred. Normally collagen forms a fairly uniform pattern but once trauma has been experienced collagen is rapidly laid down to reinforce remaining fibres in a more haphazard fashion, forming scar tissue, the extent can vary.

As an aside, quality protein in the diet will assist collagen repair and tissue damage however it will not ultimately determine the formation of collagen structure. I wish to stress that small amounts of high quality protein would be far more beneficial than larger amounts of poorer quality protein.

Luckily muscle has one of the best blood supplies which is very important to muscle recovery. Encouraging blood flow appropriately is an excellent way forward. A gentle but slightly higher blood flow would be excellent, so keeping a horse comfortably warm in general would be ideal. Never allow a horse to become even chilled under the circumstances.

So really a horse recovering from Azoturia should be treated as a physio patient at minimum. Double to triple warm-up/cool down with VERY gradual physically demanding exercise in between. It must be played by ear really for no lasting damage.

Scar tissue can be broken down in other ways once your horse has fully recovered but the above are my suggestions in the interim.

Oi! *nudges you to wake you up again!* :)
 
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