AERC Dr. Jeannette Mero on Tying UP Syndrome Part 1
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Tying Up—Unraveling some of the mysteries surrounding this syndrome. Dr. Jeannette ( Jay) Mero, DVM, AERC # 15049, 2,560 sanctioned endurance miles, ( yes, I looked her up), Chair of the AERC Veterinary Committee, has her own veterinary clinic @https://www.facebook.com/Mariposa.Equine and in searching for contact for her I also found this: DSLD research
This seminar was a history lesson as well as the story of the progression science has made with this disorder since circa 1600! This is a very detailed seminar with Loads of information so I will do this one in two parts.
Another comment is that I am a scientist, and I teach Research Methods for graduate students; I have a scientific state of mind most of the time; science and I get along, regardless of the stress in my life; I apply a skeptical mindset most of the time. I LOVE it when presenters show me the science behind findings and practices. However, from teaching Research methods, I understand that *thinking like a scientist* is not in everyone’s toolbox right now. To those in this latter category I offer to you what I offer my students— a scientific mindset is one where the information is tentative, changeable, and mutable with new information over time; that is how science works. A scientific mindset can be also thought of as an *add on tool*; whereby you do not have to excise your regular, comfortable way of thinking and processing information, but that you CAN learn to also think scientifically. I tender the invitation to my research graduate students about every two weeks as we progress through the class. In addition to that state of mind, a skeptical, tentative state of mind, I also offer that scientific findings must be tested in the field to see if they work on your horse, your herd, your life. Skeptics are not cynics; Skeptics are people who say, when confronted with an assertion, *show me the data*; while Cynics negate all ideas uniformly.
Ok, back to the topic at hand: Tying UP!
- WHAT is it?
Medical definition of syndrome: *a set of symptoms occurring together*. Retrieved March 11, 2013 from http://medical-dictionary.thefreedictionary.com/syndrome
Tying up syndrome is a muscle disorder that has been known in equines since the 1600’s. There has been lots of science since then to focus more clearly and precisely on thus syndrome and tease out exactly what is going on.
Symptoms: Stiff limbs, trembling muscles, locked up muscles, horse does not want to move, spasm-ing, stiff travel, coffee colored urine. Back in the 19th century it was known as Monday morning disease, or Holiday disease because horses not worked all weekend would be taken out to be worked and *Tie up*. Unfortunately, back then, there was a 50% death rate due to this syndrome.
Side note—Dr. Mero started her practice on draft horses in Amish country back east and drafts have a propensity to this disease, I understand she saw a LOT of it when in practice back east. In the 20th century, the syndrome got a new name * Exertional Rhabdomyelosis*, Myositis, or Muscle cell death whereupon myoglobin is released from muscle cells and myoglobin is toxic to the kidneys.
- WHY does it happen?
It happens more to fillies and mares, across different ages and breeds and geographies ( I think that is what my notes say). From 1980 to now there has been an explosion of science and information about this syndrome due to the research, the equine genome was mapped, muscles biopsies, equine treadmills were created, and it affects lots of horses so there was/is lots of interest in this syndrome.
First, there was some establishment of normal physiological parameters. Dr. Mero credits a Dr. Stephanie Valberg and her work on this syndrome for the new research and ongoing research that is informaing equne enthusiasts and veterinarians about this syndrome. Here is a website about Dr. Valberg http://www.vdl.umn.edu/aboutVDL/staff/valberg/home.html
Dr. Valberg was honored by being the first female lecturer to give the prestigious 2012 Frank J Milne State-of-the-Art Lecture in 2012, becoming the first female practitioner selected for the honor. This lecture was given Dec. 3, 2012 during the AAEP’s 58th Annual Convention in Anaheim, Calif. Here is a link to that information http://www.aaep.org/press_room.php/images/press_room.php?term=2012&id=484
So, yes, Dr. Valberg is the person to know when talking about dealing with the syndrome of tying UP! Her research is ongoing and I understand from Dr. Mero’s seminar that she, Dr. Valberg, facilitated by Dr. Mero, is seeking participants in endurance, who ride Arabians, to participate in research on this syndrome by allowing Dr. Valberg’s team to biopsy their horses. Do please contact Dr. Mero about this since she is facilitating this. The search for a possible genetic, or cluster of genetic causes of this syndrome is oingoing. We can help the equine community by participating.
I understand that a muscle biopsy is somewhat invasive, but horses routinely return to full work in a week. Dr. Mero is the one to contact about that information.
As a scientist myself, and an educationist who teaches research methods and facilitating a scientific mindset, I would like to urge everyone to get involved, because the more data we have, the faster we can possibly isolate what is causing this syndrome in our horses.
I have not had a horse tie up at endurance ride since 1970; but, in 1970 my mare Suzy-Q tied up at the Blue Mountain ride in California. It was hotter than the bloody blue blazes in those canyons; I was a teenager and my horse was a backyard horse, someone got me started in endurance after watching my horse go. It was scary…..and I don’t remember exactly what we did except wait and watch what happened, and pray. Science can help us do better than that, now.
- What we have learned to-date.
This is one of THE most misunderstood syndromes, it is NOT lactic acidosis, it is not one disease, but likely several diseases happening at once and is due to different causes.
Here is where it gets really interesting as well as possibly REALLY confusing and where I more than likely will get something incorrect, so I am relying on folks who also attended to set the record straight.
There is Extrinsic ER ( Exertional Rhabdomyelosis) and Intrinsic ER; Extrinsic means likely we can cause it and manage it; the causes and solutions are under our control. Intrinsic ER means that the causes are not under our control but we MAY be able manage it.
Extrinsic ER: under this heading is something vets call *Sporadic ER*— the horse gets it sporadically or intermittently
Intrinsic ER: under this heading are the genetic causes: Recurrent ER, , Malignant Hypothermia, Idiopathic causes ( meaning we don’t know the cause) and a Chronic ER — under Chronic ER the causes are PSSM1 and PSSM2.
In case you want to know: PSSM stands for Polysachharide Storage Myopathy. And PSSM 1 and 2 refer to inherited dominant genes for this syndrome. Here are some FAQ’s to refer to about the PSSM. http://www.cvm.umn.edu/umec/lab/PSSM/home.html
Dr. Mero talked about Sporadic ER first as it is predominant in our sport. If a horse has ER the first time, it is labeled *Sporadic ER*, Treated with appropriate rest and attention to and management of causation events. Usually this is caused by overexertion, horses are just not ready yet for the work they are being asked to do. The etiology is usually: electrolyte imbalance, diet imbalance, Vit E and Selenium deficiency, high sugar diet. Dr. Mero was very clear in that WE control all of these causative factors.
To be continued in Part 2