Dietary control of exertional rhabdomyolysis in horses

Beth A. Valentine From the Departments of Pathology (Valentine, Freels) and Clinical Sciences (Reynolds), College of Veterinary Medicine, and the Department of Animal Science, College of Agriculture and Life Sciences (Hintz), Cornell University, Ithaca, NY 14853-6401, and Purina Mills Inc, 1401 S Hanley Rd, St Louis, MO 63166 (Thompson).

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Harold F. Hintz From the Departments of Pathology (Valentine, Freels) and Clinical Sciences (Reynolds), College of Veterinary Medicine, and the Department of Animal Science, College of Agriculture and Life Sciences (Hintz), Cornell University, Ithaca, NY 14853-6401, and Purina Mills Inc, 1401 S Hanley Rd, St Louis, MO 63166 (Thompson).

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Kristin M. Freels From the Departments of Pathology (Valentine, Freels) and Clinical Sciences (Reynolds), College of Veterinary Medicine, and the Department of Animal Science, College of Agriculture and Life Sciences (Hintz), Cornell University, Ithaca, NY 14853-6401, and Purina Mills Inc, 1401 S Hanley Rd, St Louis, MO 63166 (Thompson).

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Arleigh J. Reynolds From the Departments of Pathology (Valentine, Freels) and Clinical Sciences (Reynolds), College of Veterinary Medicine, and the Department of Animal Science, College of Agriculture and Life Sciences (Hintz), Cornell University, Ithaca, NY 14853-6401, and Purina Mills Inc, 1401 S Hanley Rd, St Louis, MO 63166 (Thompson).

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Kent N. Thompson From the Departments of Pathology (Valentine, Freels) and Clinical Sciences (Reynolds), College of Veterinary Medicine, and the Department of Animal Science, College of Agriculture and Life Sciences (Hintz), Cornell University, Ithaca, NY 14853-6401, and Purina Mills Inc, 1401 S Hanley Rd, St Louis, MO 63166 (Thompson).

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Objective

To determine whether feeding a low-carbohydrate, high-fat diet would decrease severity of exercise-induced muscle injury in horses with exertional rhabdomyolysis.

Animals

19 horses with a history of exertional rhabdomyolysis.

Design

Case series.

Procedure

Specimens of the semitendinosus or semimembranosus muscle were obtained for histologic examination, and serum creatine kinase (CK) and aspartate transaminase (AST) activities 4 hours after exercise were determined. Horses were then fed a low-carbohydrate, high-fat diet, and serum CK and AST activities 4 hours after exercise were reevaluated at approximately monthly intervals for 3 to 6 months.

Results

Serum CK and AST activities 4 hours after exercise were high before any change in diet. All 19 horses had evidence of chronic myopathic change and abnormal glycogen accumulation in muscle biopsy specimens; 11 horses also had evidence of complex polysaccharide accumulation. Adaptation to diet change required approximately 3 to 6 months. Sixteen horses did not have any episodes of exertional rhabdomyolysis after 3 to 6 months of diet change, and 3 horses had mild episodes of exertional rhabdomyolysis following either a reduction in dietary fat intake or restriction in exercise. Postexercise serum CK and AST activities 3 to 6 months after the change in diet were significantly less than initial values.

Clinical Implications

Results indicated that exertional rhabdomyolysis may be a result of abnormal carbohydrate metabolism in some horses. Feeding a diet with low carbohydrate and high fat content may reduce severity of exercise-induced injury in some horses with exertional rhabdomyolysis. (J Am Vet Med Assoc 1998;212:1588–1593).

Objective

To determine whether feeding a low-carbohydrate, high-fat diet would decrease severity of exercise-induced muscle injury in horses with exertional rhabdomyolysis.

Animals

19 horses with a history of exertional rhabdomyolysis.

Design

Case series.

Procedure

Specimens of the semitendinosus or semimembranosus muscle were obtained for histologic examination, and serum creatine kinase (CK) and aspartate transaminase (AST) activities 4 hours after exercise were determined. Horses were then fed a low-carbohydrate, high-fat diet, and serum CK and AST activities 4 hours after exercise were reevaluated at approximately monthly intervals for 3 to 6 months.

Results

Serum CK and AST activities 4 hours after exercise were high before any change in diet. All 19 horses had evidence of chronic myopathic change and abnormal glycogen accumulation in muscle biopsy specimens; 11 horses also had evidence of complex polysaccharide accumulation. Adaptation to diet change required approximately 3 to 6 months. Sixteen horses did not have any episodes of exertional rhabdomyolysis after 3 to 6 months of diet change, and 3 horses had mild episodes of exertional rhabdomyolysis following either a reduction in dietary fat intake or restriction in exercise. Postexercise serum CK and AST activities 3 to 6 months after the change in diet were significantly less than initial values.

Clinical Implications

Results indicated that exertional rhabdomyolysis may be a result of abnormal carbohydrate metabolism in some horses. Feeding a diet with low carbohydrate and high fat content may reduce severity of exercise-induced injury in some horses with exertional rhabdomyolysis. (J Am Vet Med Assoc 1998;212:1588–1593).

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