Re: RC: Q. about a cramp vs. tying up

[CMKSAGEHIL@aol.com]

In a message dated 12/20/99 7:11:12 AM Pacific Standard Time, 
tina@liveonthenet.com writes:

<< Is there just a matter of degree between a cramp/tight muscle and tying
 up? Or is there actually a clinical difference between the two? And if
 so when does a cramp turn into tying up? >>

Yes, there is a difference, but you can't tell by the degree of cramping.  
Bloodwork will tell you whether it IS a tie-up, and also the severity of a 
problem.  In acute cases, the CPK (creatinine phosphokinase) goes up 
abruptly, and can go to dangerously high levels with very little muscle 
stiffness (although you usually see a definite reluctance to continue).  The 
SGOT goes up slightly later, and peaks later, so a couple of days after the 
episode, you may be seeing the peak in that rather than the peak in the CPK.

Three examples of extremely varied cases--

1)  An endurance horse was pulled from a ride a few years ago.  He was 
somewhat reluctant to move out and his heart rate hung (which was what 
initiated his being pulled).  He was not palpably stiff anywhere.  His CPK 
was over 200,000 (high end of normal is around 500).  This is a severe 
"tie-up" even without the muscles being stiff!

2)  One of our own stallion, this summer--a case I've already related.  He 
comes from a family of top endurance horses who are known to need careful 
calcium management.  He was not campaigning as hard as the previous year, and 
I was not feeding him as we had the previous year--he was on half alfalfa, 
and I had neglected to be consistent with selenium supplementation (a biggie 
where we live).  He tied up half a mile into a training ride--stiff as a 
board, and about as bad a clinical presentation as you will see.  All 
metabolic parameters just fine, other than a somewhat elevated heart rate 
(running around 56 to 60), but VERY obvious cramping of multiple muscle 
groups.  CPK something over 6000.  Removed alfalfa hay from his diet and 
administered an E-Se shot.  CPK back to normal in less than a week, training 
resumed, and completion on a 50-miler (not far out of Top Ten and a good time 
for his conditioning level) 3 weeks later with no particular rise in CPK.  
Clinically, one would have thought Case #2 to have been FAR more severe than 
Case #1, but causes were different, and blood work certainly told a different 
story!

Case #3--Mare presents with obvious cramping of multiple muscle groups, but 
not as severe as Case #2.  She has been turned out, but tie-up is suspected 
as she is a QH with some history of it and has had a feed change.  Only 
parameter out of whack is slightly elevated HR (in 50's).  Blood work reveals 
a CPK of 97 several hours into the problem.  This is not a tie-up at all!  I 
would expect a rise in CPK due to the cramping if it does not subside, but 
not much of one.  Tentative diagnosis is that mare has perhaps fallen or 
received some other traumatic injury.  She was helped by chiropractic 
treatment and was fine.

Take-home lesson--if in doubt about any muscle cramp or reluctance to move, 
do the blood work and find out whether it is a tie-up or not before just 
"assuming" it is or isn't....

Heidi


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