AZOTURIA

Dr Sonam Bhatt

Asstt Prof

Veterinary Medicine

BVC, Basu

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• Exertional rhabdomyolysis
• Tying-up
• “Cording-up” Syndrome of Horses
• Paralytic myoglobinuria
• Monday Morning Disease

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• Multifactorial myopathy
• Mainly affects draft horses
• Metabolic muscular disorder of horses
• Clinically characterised by –
• Stiffness in gait & reluctance to move
• Lameness
• Hardening of massive muscles
• In severe cases ----myoglobinuria

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• Disease occurs during exercise after a period of atleast 2 days of complete rest on a full working ration

• During exercise the large store of glycogen formed during the period of rest in the muscles metabolized to sarcolactic acid
• 2- Accumulation of lactic acid leads to:
• a- Degeneration of the muscles and liberation of myoglobin (muscle haemoglobin)
• b- Swelling of muscle because lactic acid is hydrophilic

PATHOGENESIS

Clinical Signs

• In very mild cases: only poor performance
• Mild cases: stiffness in gait
• Severe cases:
• Profuse sweating, stiffness in gait & reluctance to move
• Horse assumes a dog-sitting position followed by lateral recumbency, laying down & repeated attempts to rise, often with nervous signs

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• Rapid respiration, weak pulse & temp. may rise to 40.5 C
• Hard board like muscles particularly of hind legs
• Dark-red brown urine (myoglobinuria)

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Red color urine

Dog sitting posture

Sweating

Prognosis

• Good if animal remains standing
• Death occur in recumbent horse due to decubital septicemia or myoglobinuric nephrosis & uraemia

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DIAGNOSIS

1. History
2. Clinical signs
3. Laboratory diagnosis:
1. Determination of muscle specific enzymes CPK & AST
2. Histopathology:
3. Hyaline degeneration of heavy muscles (Zenker’s necrosis), myonecrosis

TREATMENT

• Animal should be kept as quiet as possible, and attempts should be made to keep it standing
• Good nursing care & precautions taken to prevent development of decubital ulcers
• Nervous, restless animals, or those showing evidence of pain, should be given sedatives such as chloral hydrate or tranquilizers

• Give Na bicarbonate IV or orally for alkalization of urine to minimise nephrotoxicity

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• I/V injection of large quantities of fluids and electrolytes to maintain high rate of urine flow to avoid renal tubule blockage and subsequent uraemia

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• I/M injection Thiamine daily to increase the tolerance of blood to lactic acid by increasing lactic acid metabolism

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• NSAIDs such as Flunixin and Phenylbutazone may be used to control the pain

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• Antihistaminics, Vit. E & selenium may be useful