Page 431 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

406 CHAPTER 1

VetBooks.ir pain due to exertional rhabdomyolysis, laminitis or commonly, in association with other disturbances
NSAIDs should be administered if the horse is in
as described in hypocalcaemia and exhausted horse
colic but with caution if the horse is severely dehy-
drated. Often, one can initiate fluid therapy before syndrome.
administration of NSAIDs in order to correct some Differential diagnosis
degree of dehydration. Hypocalcaemia and exhausted horse syndrome may
produce similar signs.
Prevention
It is paramount to provide water regularly during Diagnosis
strenuous exercise and to use adequate electrolyte Typical rhythmic contractions of the flanks syn-
supplements in the water (prior to, during and after chronously with heart beats are seen on clinical
a race, for instance). Proper conditioning results in examination.
several physiological changes that aid in prevention
of exhaustion. Rider management and education are Management
also important to ensure prevention of exhausted The condition disappears if the underlying anoma-
horse syndrome. lies are treated and corrected.

Prognosis Prevention
The prognosis is usually good with adequate care, (See Prevention of hypocalcaemia and exhausted horse
but severe cardiovascular shock may lead to organ syndrome, above.) It has been suggested that food rich
failure and eventually to death. in calcium (e.g. alfalfa hay) should be avoided in pre-
disposed animals and in endurance horses.
DIAPHRAGMATIC FLUTTER
Prognosis
Definition/overview The prognosis is good if the primary problem can
Diaphragmatic flutter is caused by a synchronous be addressed.
contraction of the cardiac and diaphragmatic mus-
cles. The condition may be observed in exerted FURTHER READING
animals as a consequence of severe imbalances (see Durward-Akhurst S, Valberg SJ (2018) Immune-mediated
Hypocalcaemia and Exhausted horse syndrome, muscle diseases in the horse. Vet Pathol 55(1):68–75.
above). Foreman JH (1998) The exhausted horse syndrome.
Vet Clin North Am Equine Pract 14(1):205–219.
Aetiology/pathophysiology Kilcoyne I, Spier SJ, Carter CN (2014) Frequency
It is thought that severe metabolic and electrolyte of Corynebacterium pseudotuberculosis infection
imbalance leads to phrenic nerve hyperexcitability. in horses across the United States during a 10-year
Depolarisation of the right atrium stimulates action period. J Am Vet Med Assoc 245(3):309–314.
potentials in the hyperexcitable phrenic nerve as it Rivero JL, Piercy RJ (2013) Muscle disorders of equine
crosses over the heart. The diaphragm is therefore athletes. In: Equine Sports Medicine and Surgery,
submitted to violent contractions at each heart beat. 2nd edn. (eds K Hinchcliff, R Geor, A Kaneps)
The condition is frequent in horses after prolonged Elsevier Saunders, St. Louis, pp. 69–109.
exercise in which there are major electrolyte losses Toribio RE (2018) Disorders of calcium and phosphorus.
In: Equine Internal Medicine, 4th edn. (eds SM Reed,
from excessive sweating.
WM Bayly, DC Sellon) Elsevier Saunders, St. Louis,
pp. 1029–1052.
Clinical presentation Valberg SJ (2018) Muscle disorders affecting sports horses.
Brisk, sudden and painful contraction of the dia- Vet Clin North Am Equine Pract 34(2):253–276
phragm is visible at the costal arch and flank. Votion D (2016) Atypical myopathy: an update. In Pract
This typical sign may occur in isolation or, more 38:241–246.