We have been very worried about Bailey these last 24 hours! She had a pretty serious “tying-up” episode (severe muscle stiffness and spasms) yesterday, and we were not sure if she would make it through the night. After a night of IV fluids, thank goodness she is showing signs of improvement!

It’s one of those situations that makes everything more clear. Although Bailey has not seemed sore, she has been reluctant to go forward under saddle. Some days she seemed a little stiff, but nothing out of the ordinary for a 15-year-old horse just starting under saddle. Then came yesterday…

10:00 am – About 15 minutes into a groundwork session, Bailey became very stiff, then started getting weak in her hind-end with muscle twitching. Her respiration increased. We immediately called the vet, put her in her stall, and monitored her.

11:30 am – Our vet, Dr. Asmar of Eagle Fern Equine Hospital, arrived. Bailey’s breathing and stiffness were moderately better, but her heart rate was still elevated, so she was given IV Banamine and her blood was drawn.

Afternoon – While we waited for the results of the bloodwork, Bailey got worse and worse as the day progressed. Unfortunately, there wasn’t much more we could do until we knew what was happening. Her hind-end became so cramped and weak that she couldn’t stand up for very long before it gave out on her. She was visibly hurting.

Bloodwork – Bailey’s muscle enzymes came back so high that they were off the charts on the in-house blood machines! She definitely was tying up, likely caused by PSSM (Polysaccharide Storage Myopathy) episode. PSSM is a genetic metabolic disorder that affects how glucose is stored in muscle cells. The blood was sent out to a lab where they could accurately dilute it and get a value. The muscle enzyme called CK came back as 33,077 (normal range is 45 to 360). This meant there was a tremendous amount of muscle tissue breakdown happening.

Dangers: Besides getting the muscle damage process to stop, the biggest concern was preventing major damage to her kidneys. As muscle tissue breaks down, it releases a protein called myoglobin into the bloodstream. High concentrations of this can cause kidney damage so severe it can result in death.

Plan: In order to give her a fighting chance, we had Dr. Asmar come back out and hook her up on IV fluids to help flush / dilute the protein by-products out of her system and hopefully protect her kidneys.

With the help of multiple volunteers, we hung an eyebolt in the ceiling so we could hang the IV pole and rigged a pulley system to raise and lower the bags. Dr. Asmar put in an IV catheter, and started her on fluids. By that time she had been getting up and down so many times that her hind-end was too weak to fully stand. She was given an injection of Ace to encourage her to stay down and rest.

We checked on Bailey every 2 hours throughout the night and changed her IV bags. She also got an additional dose of Bamaine. Each time we went to check, we hoped to see that she had urinated. With all the fluids going into her, we knew that if she did not pee it meant her kidneys were not working.

Then at 4 am this morning, she was laying flat out and not moving. We thought for sure that she was gone! Thankfully, she was still with us, AND she had finally peed while laying down! We think she had been trying to avoid peeing while laying down, but was just too weak in her hind-end to do it standing. After finally peeing, we bet she was so relieved that she could finally relax a little.

At 7 am she not only pooped and peed more, she was able to stand up for a minute or so. She has now done this multiple times, and her discomfort level seems to be slowly decreasing.

The vet tells us it will take her a few days to recover from this episode. She will remain on fluids through at least today.
Outlook: Once we are through this episode, barring any serious kidney damage, future attacks should be easily avoided with diet change and regular exercise. We are betting that with the diet change, her training will progress much quicker since she will probably feel so much better.

It sure seems like horses are so often quietly trying to tell us something! She actually had some ventral edema a month ago, and we took her to the vet’s for an exam and bloodwork. There was only a tiny tiny elevation in one value, the plan was to re-check it in 30 days to see if it had changed. Way to dramatically change your blood values, Bailey!! Let’s not do this again!