How to manage a myopathy challenged horse (similar to EPSM)

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Emma Smith

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Hello

I am looking for some help/advice. I bought my now 6 yo Warmblood gelding nearly a year ago and he was very fat and unfit. We have done lots of work and he has now trimmed down and lost the weight he needed to and is a healthy weight now. I noticed that even though he was losing the weight he still wasn't getting fit and wasn't able to do more than 10 minutes work without being totally knackered and sweating like mad. Some days he couldn't even trot, let alone canter.

I had everything checked, teeth, back, new saddle, nutritionist etc to make sure he was on the right food and amount for his age/size (he is now nearly 18hh) etc, and all re-checked again just recently. I then spoke to my vet and explained the problems I was having, who came out to see him as he got worse, and I suspected something wrong with his back as he was just so relucatant to be ridden or exercised at all, and he suggested we do a muscle biopsy to check for EPSM. This was done and the results came back that he didn't have EPSM, but he does have a genetic idiopathic myopathy affecting his muscles, meaning that they fatigued quite easily and quickly, very similar to EPSM. We are currently treating it like EPSM and have tried a course of Dantrium tablets and Equitop Myoplast to try and get his muscles working but this hasn't really helped him, and at one point made him worse and even further fatigued. I've also put him on Saracen Releve as this is supposed to be for horses that are not allowed much sugar/starch cereal based foods. I have had him on this for around 4 weeks now and haven't noticed any difference either.

I wondered if anyone else has experienced this and if so, how they have either gotten through it, or what has helped their horses?

Thank you

Emma
 
My mare has EPSM but vets are thinking there is something else going on as well as she is a noisy breather after very little work.

But as regards the maintenance of the muscle side of it- I have her on Saracen Shape Up Balancer and extra salt. I did all the diets as suggested for PSSM- the vitamin E oil, Alcar, feed completely naturally etc but nothing did a thing. After a long chat with a nutritionist, I heard that a few horses had had some success on Saracen shape up so I tried it. She is definitely miles better muscle wise, but the breathing is obviously still an issue.

I also work her in very slowly- she does 15-20 minutes walking first and then 5 minutes with short trot bursts followed by more walk. Then I can increase the trot work and start to work her normally. Unfortunately it means that a short, quick ride is out of the question. On warmer days she struggles massivel, but equally she is very tight on cold days, she is ridden in the winter with a fleece exercise sheet.

It's still very much a work in progress and until we know what is causing the breathing side of things, I'm still a little in limbo, but back at the end of last year I couldn't ride this pony for longer than 10 minutes and now she can do 40 minutes in the school.
 
Thank you for replying! It sounds very similar to my gelding. He breathes like he has just done the Grand National after about 5 minutes of trotting and excessively sweats too. He also had some bleeding from both nostrils a few times now as well when he really exerted himself (cantering round). The vet thinks this is possibly what racehorses have, think it's called EIPH. Did your mare ever have this bleeding also? I think it is the next thing we are going to look at.

He has been on the Saracen Shape Up since around June last year, and we have introduced the Releve as well to go with it in the last month or so. I am not sure it has made much difference to him to be honest as I haven't seen much change in improvement, but I may go back to them and speak to them again. Do you find that in the spring time that you had to change her routine at all in terms of turn out/riding etc? My gelding goes out in the morning first thing and comes in around 1 pm. When the sugar is high in the spring (which I think is normally in the morning), I am thinking that he will have to stay in until the afternoon when it's gone down, otherwise he will have too much sugar which will make him worse? Do you find that if she has been out she is still able to be ridden? I am finding that I can't turn him out and then ride him later as he has just no energy at all so having to keep him in if I want to ride him after work. Do you have any tips for when to do work with them?

Yes I have found that it takes a while for him to get going, but once he is, then I tend to not do so much and just do a short burst, then leave it at that.

That's really good news, I am hoping that we can get to that stage soon without him being so worn out.

Thank you for your reply.
 
She hasn't had any nose bleeds but she breathes, somedays after something as little as after half a circuit in the school of trot, like she's just gone for a blast down the beach.

She currently goes out every morning at about 8am and usually comes in between 3.30 and 4.30. She has half an hour with a bit of hay and then gets ridden. We have good days and bad days. At the start of the week, we had a session in the school and, although she got puffed, she managed much more before that happened. She also was able to work for nearly 45 minutes and didn't do what I describe as 'being like riding her through treacle'. But the next day we went out in the school and she was dead within 30 seconds of trot.

Today will be a test, as we are off for a lesson at two o'clock at my instructors yard, so she will becoming in early. Our last trip out was October when we hired an arena to use the course and I had to get off after five minutes and come home. That was when things were really bad.

I struggle to get her fit because I don't feel I can push her to maintain the trot or canter for any significant period of time. We constantly have to come back to walk so we are sort of in a stalemate. That said, in October and November last year, I had to abandon canter as she couldn't do it. Whereas now she can sustain short bursts of it.

She is a very good doer so keeping weight off her is an issue, made harder when I can't work her how I want to. We have our own private farm ride at the yard so she is hacked most days, with a few gallops in there, plenty of walk in between. We may school once or twice in a week.

Leahurst are coming back in the next couple of weeks to review this breathing issue and find out if it is an EPSM symptom or indeed something else as well.
 
Yes, that's what I am finding, good days and bad days. At present the bad are outweighing the good unfortunately. It can happen within a week, so we will have a good session, and although he is puffing he is able to keep going, and then the next time we hardly manage to get into trot at all. I only school twice a week too and am trying to hack as much as possible and lunge also for variety, but it's a bit wet where we are at present to go around the fields.

Yes, I have the same, I have to try and limit his food as he tips into being overweight quite quickly and then I can't get the weight off as he can't do the work.

I am hoping the vet comes back with something else we can try and hope for the best! I will ask him about the breathing again and see if he wants to investigate that too.

I hope you have a good lesson today! Fingers crossed she is having a good day.
 
The myowhotsit is full of sugar. I would strip the diet back to medium quality hay and no supplements except natural vitimin e from equimins, and work him gently every day and see what happens. Keep a diary of every change you make and how he is that day.
 
Yes, I unfortunately found that out after he had finished the whole tub! :( My vet recommended it as he thought it may help his muscles whilst we were trying to get some work into him, but it's had the opposite effect. I will definitely keep a diary of his routine and see if I can find patterns of when he has good and bad days to see what has changed, if anything. Thank you.
 
Casey76 said:
Read this on Equitop Myoplast...

https://www.facebook.com/DrDavidMarlin/posts/594424007428491
Click to expand...

And the shameful thing is that vets are continuing to push this product when it does nothing more than a handful of oats would do!

OP so sorry to hear of your difficult problem with this horse. My two respond very well to an EPSM diet based on vitamin E and carnetine amino acid supplemented as alcar, thankfully. There are only twenty amino acids. I think in your shoes I would be testing to supplement as many as I could as a trial.
 
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Yes, I was shocked to hear how much sugar etc was in it! Initially when I thought he was just being lazy I did switch him to oats and competition mix, and wondered why this had no effect at all, now I know!

I am waiting to hear from the vet who is speaking to the Royal College of Vets in London so hoping they can come up with something else to try. Could you let me know the names of the supplements that you use so I can perhaps try them out too please ycbm? Sorry, I am not very au fait with the amino acid terms etc.
 
Unfortunately you will learn that vets and other people professing to be experts often are not when it comes to myopathies.

I cannot strongly enough suggest you need a base line of behaviour before introducing anything else especially when you are dealing with an unknown like this.

For about 8 months I was feeding micronised linseed thinking I was helping my PSSM 1 mare and later realised for whatever reason, it made her symptomatic. She also apparently cannot tolerate msn.

The only way I worked this out was from stripping right back and introducing one thing at a time.
 
Unfortunately muscle myopathies are something which are only just being researched now.

We know for certain that there is PSSM1 which is a glycogen storage disease. These horses really benefit from a very low carb diet, vitamin E supplementation (up to 10,000 IU per day) +/- ALCAR (acetyl-L-carnitine) OR high fat if weightloss is an issue.

The you have the PSSM2 "family" which is a range of muscle wastage myopathies which symptoms present in a similar way to P1. As these horses do not have the faulty glycogen storage gene, they do better on higher carb diets, but really benefit from a high protein diet (perhaps lucerne based), with added amino acids. The way you introduce amino acids is up to you. Some people supplement whey protein, which provides a whole range of AAs, some people feed "tri-aminos" which is a proportionate supplement of Lysine, Methionine and Threonine - all of which are essential amino acids (i.e. the body can't manufacture them from food), and which can be lacking on a forage only diet. Or, you can buy the amino acids separately (though, unfortunately there isn't one pace which does the whole range!) and make up your own mix.

If you go to the PSSM forum on Facebook, there is a plethora of information, and a very friendly group trying to help each other out.

My mare has PSSM1 (n/P1), and we've been trying since her diagnosis in September to figure out the best diet and workload for her. We have good days and bad... I've had to reduce my expectations of what we're going to be able to achieve, work wise, in the future; but at the moment making sure she is comfortable all the time is my top priority.
 
Emma Smith said:
Yes, I was shocked to hear how much sugar etc was in it! Initially when I thought he was just being lazy I did switch him to oats and competition mix, and wondered why this had no effect at all, now I know!

I am waiting to hear from the vet who is speaking to the Royal College of Vets in London so hoping they can come up with something else to try. Could you let me know the names of the supplements that you use so I can perhaps try them out too please ycbm? Sorry, I am not very au fait with the amino acid terms etc.
Click to expand...

Casey has given you better info than I can, mine fine on alcar, I'm very lucky as they are both badly stiff without it. I think in your shoes i'd try whey protein, by the sound of it.
 
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