bloodwork showed muscle enzymes up - tying up??

[LDavis104]

Freaking out a bit here, just got a call from the vet that bloodwork showed muscle enzymes are up in my horse, thinks he had a tying up episode. I google tying up (heard of it but didn't really know what it was) and see all these big things it could be caused by! Do I need to be freaking out? I'll call vet back tomorrow, as she said in the message we need to look into this further $$$$:eek:$$$$:eek:$$$$

Let me start from the beginning just to give all the information.

5 yr old TB/QH gelding
~10 months ago - torn suspensory
~1 months ago - back up to trotting however long, and up to two laps a the canter in each direction.
~3 weeks ago - horse comes up lame - vet check shows its scratches making lame & a little heal bulb slice, gets placed on stall rest for a week
~ 2 weeks ago - getting ready to get back into work and bam, huge swollen legs, high fever, stiff, sore = Ehrlichiosis = treated from classic symptoms (common in my area), no test done, improved on doxy
~1 week ago - fever gone, swelling almost gone, still stiff and sore in hind end but no where near original level of soreness. Note - still no turnout except wandering around while someone is there (no dry paddock away from others so he doesn't spread new ringworm-like face funk)
~ Monday - feeling great, comes off doxy, but has weird face funk that requires another vet visit. Vet takes bloodwork to check liver.
~Today - message from vet said liver checks out fine, but his muscle enzymes or up. She thinks a tying up episode lent itself to the stiffness and soreness. Said not to worry TOO much, but that we should definitely talk and pursue this further

So what does pursuing this further mean, what do you think he might be testes for? Seems like a long list of things it could be! Or is tying up something you can just prevent?

[Laurierace]

Step 1 for me is always to start with a low carb, high fat diet if they aren't already on that to begin with. That takes care of most cases of tying up. There are other causes as you saw but it makes sense to rule in or out the most common cause first.

[LDavis104]

Step 1 for me is always to start with a low carb, high fat diet if they aren't already on that to begin with. That takes care of most cases of tying up. There are other causes as you saw but it makes sense to rule in or out the most common cause first.

He's on Nutrena Safechoice (2 quarts twice a day), and 1 quart of Nutrena Senior twice a day. The Safechoice is the barn's grain of choice, and then I added the senior when he needed to gain weight - he's at a good weight, but that may not mean anything for what you are talking about.

Thanks for this info, that's good to know. I like ruling in or out the common stuff! Trying to get some information before talking to the vet so I might know what to expect.

[atr]

Bloodwork time--check Selenium and Magnesium levels.

(Sorry, I'm beginning to sound like a broken record this week.)

If low (or even low end of normal,) supplement with E, Se and Magnesium. I use Horsetech's Selen AT for the E and Se--it's Selenium yeast which is more bioavailable, and I buy straight Magnesium Oxide in bulk (from Horsetech at the moment, also.)

I retest my horse every 9 months or so to make sure we aren't going over the top on the Se. We've been doing this for four years now and we've had no further tie-up incidences (knocks on wood, ties garlic around neck.)

Your horse may be ouchie to the touch and very muscle sore (or he may not, some horses seem to tie up and get over it, some seem to have lingering issues of varying degrees of severity. my horse had hind end muscles that felt like knotted string, not good at all, and took a while to rebuild.) I found that a course of RVI really helped with this sensitivity to touch (google it--it's rather interesting).

An attempt at massage therapy to help things along nearly ended in a splattered therapist. He did not appreciate it at all (the horse, not the therapist--though she wasn't entirely happy...)

It is a bit scary, but it is manageable once you know what you are dealing with. Not all horses that tie up have EPSM, there are other predicating factors, especially amongst TBs.

[LDavis104]

ATR - thanks, I guess those things aren't listed on a blood chem panel? He never seems muscle sore to me on a regular basis, I guess I totally missed this tying up episode because it was at the same time as Ehrlichiosis that also made him stiff and sore, very badly...

This is good though, not sure what the vet will suggest so I want to have ideas of "easier" things to rule out first.

[dwblover]

I agree with Laurierace, put him on an EPSM diet. Low carb and lots of fat. It worked miracles for my OTTB. You can also look into the supplement Utra-Fire. Good stuff!

[jaimebaker]

I'm curious what exactly is elevated on your horse. Muscle enzymes are gauged by AST and CK levels, AFAIK. Are both of them out of whack or is it one or the other? I had a chem panel run on a mare of mine this paste summer and her CK level was high (about 100 above normal) and I was told that she could have just had a bruise somewhere, bumped a hip, etc that would elevate that. I think it has to be way, way up for tying up syndrome.

So, do you know the exact levels your horse is at on both of those? Or did the vet just say the muscle enzymes were elevated without giving you a copy of the bloodwork or going over it? I don't know a ton about what all the different things on the chem panel mean, but I know I freaked out about my mare's CK levels and was told it was normal for her age (17) and/or that she could have a bruise or some sort of muscle trauma somewhere like a mentioned.

[LDavis104]

I'm curious what exactly is elevated on your horse. Muscle enzymes are gauged by AST and CK levels, AFAIK. Are both of them out of whack or is it one or the other? I had a chem panel run on a mare of mine this paste summer and her CK level was high (about 100 above normal) and I was told that she could have just had a bruise somewhere, bumped a hip, etc that would elevate that. I think it has to be way, way up for tying up syndrome.

So, do you know the exact levels your horse is at on both of those? Or did the vet just say the muscle enzymes were elevated without giving you a copy of the bloodwork or going over it? I don't know a ton about what all the different things on the chem panel mean, but I know I freaked out about my mare's CK levels and was told it was normal for her age (17) and/or that she could have a bruise or some sort of muscle trauma somewhere like a mentioned.

I haven't spoken with the vet yet actually, she left a message that I didn't get until last night, I called the office this morning and left a message but haven't gotten a return call yet...

[LDavis104]

I agree with Laurierace, put him on an EPSM diet. Low carb and lots of fat. It worked miracles for my OTTB. You can also look into the supplement Utra-Fire. Good stuff!

If he's never had a tying up episode that I could tell before, how will I know if something is improving, would it be with blood tests? I can't tell that anything is wrong or different (I guess unless he showed symptoms that he did before that I assumed to be the Ehrlichiosis which also causes stiffness). Does that make sense? Not questioning the diet or your suggestion or saying just because I can't tell something is wrong that there isn't something, but not really sure how to tell if he gets better if I can't tell anything is wrong... What did the EPSM horses have that improved with the diet, continual tying up episodes? Oh, and is it lowering carbs or adding more fat that is most important or both? He's on a really low carb grain, 8% fat I think it is grain, do you just cut out grain all together? He won't eat his beet pulp anymore, but lost too much weight when he was off grain previously, even with all the hay he could eat and bp.

[jaimebaker]

I haven't spoken with the vet yet actually, she left a message that I didn't get until last night, I called the office this morning and left a message but haven't gotten a return call yet...

I'd get a copy of the bloodwork and see what it shows. Might be nothing to worry about at all.

[LDavis104]

I'm curious what exactly is elevated on your horse. Muscle enzymes are gauged by AST and CK levels, AFAIK. Are both of them out of whack or is it one or the other? I had a chem panel run on a mare of mine this paste summer and her CK level was high (about 100 above normal) and I was told that she could have just had a bruise somewhere, bumped a hip, etc that would elevate that. I think it has to be way, way up for tying up syndrome.

So, do you know the exact levels your horse is at on both of those? Or did the vet just say the muscle enzymes were elevated without giving you a copy of the bloodwork or going over it? I don't know a ton about what all the different things on the chem panel mean, but I know I freaked out about my mare's CK levels and was told it was normal for her age (17) and/or that she could have a bruise or some sort of muscle trauma somewhere like a mentioned.

Spoke with the vet - she couldn't remember the exact numbers off the top of her head (she was out when I talked to her on her cell phone), but she said CK levels were 4000, AST was 3000. She's having me send a hair sample to the Univ of Minnesota vet diagnostic lab to test for PSSM. I know we'll do more bloodwork at some point, I'll have her tell me how his Selenium and E (and i think there was one other I can't think of at the moment) levels are.

[jaimebaker]

Spoke with the vet - she couldn't remember the exact numbers off the top of her head (she was out when I talked to her on her cell phone), but she said CK levels were 4000, AST was 3000. She's having me send a hair sample to the Univ of Minnesota vet diagnostic lab to test for PSSM. I know we'll do more bloodwork at some point, I'll have her tell me how his Selenium and E (and i think there was one other I can't think of at the moment) levels are.

Yeah, those are WAY high. Hope you can figure out what's going on.

[LDavis104]

Yeah, those are WAY high. Hope you can figure out what's going on.

Thanks - I guess first thing is to rule in or out PSSM and go from there...

[dwblover]

Glad you are getting the testing done. I would start the diet now anyway. If horse is already on a low carb grain, then just add fat to it. I use a canola/corn oil mix. I worked up to two cups per day. My horse was never lame either, just stiff and a bit akward behind. Now he floats over the ground. I'm guessing you will see a major difference in the way your horse moves, and yes, the bloodwork in a few months should show an improvement in the levels.