Histochemical and morphometric evaluation of skeletal muscle from horses with exertional rhabdomyolysis (tying-up)

Pre-race and race management impacts serum muscle enzyme activity in Australian endurance horses

Background

Marked increases in serum muscle enzyme activity can occur in endurance horses but the diagnostic certainty in predicting cases of myopathy is unclear. Improved understanding of horse management effects on serum muscle enzyme activity as markers of muscle health would assist interpretation of serum muscle enzyme activity and guide management to reduce myopathy risk.

Objectives

To investigate associations between serum muscle enzyme activity and management factors in endurance horses.

Study design

Cross‐sectional study.

Methods

One hundred endurance horses competing in four endurance events (offering distances of 20‐120 km) in south‐eastern Australia were observed. Data were collected from official horse logbooks, pre‐and post‐race serum samples, an owner questionnaire of pre‐race and race management of horses and the Australian Endurance Riders Association results database. Multivariable linear regression modelling tested associations between management factors and serum muscle enzyme activity.

Results

First leg speed, distance raced, number of rest days pre‐race, and pre‐race activity of aspartate aminotransferase (AST) and creatine kinase (CK) explained 47.3% of the variance in post‐race CK. As first leg speed increased by 1 km/h, CK activity increased by 25.8% (95% CI 11%‐35%). Race distances >80 km increased post‐race CK activity by 124% (95% CI 116%‐145%). Each additional pre‐race rest day increased post‐race CK activity by 30.5% (95% CI 11%‐42%). Modelling a 10% increase in pre‐race CK and pre‐race AST activity was associated with post‐race CK activity increasing by 7.3% (95% CI 3%‐14.4%) and 8.5% (95% CI 0.3%‐14.2%) respectively. Horses experiencing training distances >40 km and a greater number of rest days prior to race day developed increased pre‐race AST and CK activity respectively.

Main limitations

Owner questionnaires may be subject to bias. Limited data were available to model ride terrain, horse fitness, ration detail and myopathy. Muscle biopsies were not used to confirm myopathy.

Conclusions

Nearly half of the variation in post‐race CK activity observed can be attributed to management factors unrelated to myopathy, suggesting increased CK activity may not be pathognomonic for myopathy. We advise caution in relying solely on serum muscle enzyme activity for diagnosis of myopathy until the strength of association between CK and myopathy is further ascertained in future studies.

Form of Vitamin E Supplementation Affects Oxidative and Inflammatory Response in Exercising Horses

Vitamin E is an essential antioxidant that may benefit athletes by reducing oxidative stress and influencing cytokine expression. Supplements can be derived from natural or manufactured synthetic sources. This study aimed to determine (1) if supplemental vitamin E is beneficial to exercising horses and (2) if there is a benefit of natural versus synthetic vitamin E. After 2 weeks on the control diet (vitamin E-deficient grain and hay), 18 horses were divided into three groups and fed the control diet plus (1) 1000 IU/d synthetic α-tocopherol (SYN-L), (2) 4000 IU/d synthetic α-tocopherol (SYN-H), or (3) 4000 IU/d RRR-α-tocopherol (natural source [NAT]). On day 7, horses began a 6-week training protocol, with standard exercise tests (SETs) performed before and after the 6-week protocol. Venous blood samples were collected on days 0, 7, 29, and 49. Horses fed NAT had higher α-tocopherol (P < .05) at post-SET1 through post-SET2. Plasma thiobarbituric acid-reactive substance levels were lower in NAT versus SYN-L horses after SET2 (P = .02). Serum aspartate aminotransferase was lower after exercise in NAT horses versus SYN-L and SYN-H (P = .02), and less reduction in stride duration was seen after exercise in NAT as compared with SYN-L and SYN-H (P = .02). Gene expression of tumor necrosis factor α was lower in NAT compared with SYN-H (P = .01) but not SYN-L. In conclusion, feeding higher levels of natural vitamin E source resulted in higher serum α-tocopherol levels as well as some improvement in oxidative and inflammatory response and improved functional outcomes in response to an exercise test.

C-Reactive Protein Is Elevated Only in High Creatine Kinase Responders to Muscle Damaging Exercise

The purpose of this study was to investigate if exertional rhabdomyolysis induced by an acute bout of plyometric exercise in untrained individuals was associated with histological characteristics of skeletal muscle, creatine kinase (CK) polymorphism or secondary damage. Twenty-six healthy male untrained individuals completed a bout of plyometric exercise (10 sets of 10 maximal squat jumps, with each standardized to achieve at least 95% of individual maximal jump height). Blood samples were taken, and perceived pain was scored immediately before the exercise intervention and 6 h, 1, 2, and 3 days post-intervention. Muscle biopsies were collected 9 or 4 days before (baseline) and 3 days after plyometric jumps. Subjects were divided into two groups, high (n = 10) and low responders (n = 16), based on a cut-off limit for exertional rhabdomyolysis of peak CK activity ≥ 1000 U/L in any post-exercise blood sample. Perceived pain was more severe assessed in squat than standing position. Low responders perceived more pain at 6 h and 1 day, while high responders perceived more pain than low responders on days three and four after exercise; structural (dystrophin staining) and ultra-structural (transmission electron microscopy) analysis of muscle fibers revealed no baseline pathology; damage was evident in all individuals in both groups, with no difference between high and low responders in either damage or fiber type proportion. High responders had significantly higher total white blood cell and neutrophil counts 6 h and significantly higher C-reactive protein (CRP) 6 h and days one and two after exercise compared to low responders. High responders had significantly greater muscle myeloperoxidase (MPO) levels in baseline and 3 day post-exercise biopsies compared to baseline of low responders. MLCK C49T single polymorphism was present in 26% of volunteers, whose CK responses were not higher than those with MLCK CC or CT genotype. In conclusion, perceived pain is more effectively assessed with potentially affected muscle under eccentric strain, even if static. High CK responders also have pronounced CRP responses to unaccustomed plyometric exercise intervention. Exertional rhabdomyolysis after unaccustomed eccentric exercise may be related to underlying inability to resolve intramuscular MPO.

Effects of a joint supplement whose main components are resveratrol and hyaluronic acid on some biochemical parameters in aged lame horses

This study aimed to evaluate the effects of a supplement that contains resveratrol and hyaluronic acid (RH supplement) in aged lame horses. A total of 16 horses of both sexes, aged between 15 and 22 years, weighing between 350-450 kg and showing lameness due to arthritis of the knee, hock, stifle, and fetlock joints and stiffness owing to ageing were used for the study. They comprised eight horses that were administered the RH supplement for three weeks and eight others that served as controls and were given only a Saccharomyces cerevisiae yeast strain used as carrier in the supplement. Blood samples were collected from each horse before supplementation (week 0) and at weekly intervals for the three weeks of the experiment. Biochemical parameters including creatine kinase, aspartate aminotransferase, urea, glucose, total cholesterol, sodium, potassium, chloride, and calcium were measured by standard methods. There was a significant (P˂0.05) reduction in values of creatine kinase and glucose in the horses administered the RH supplement. It was concluded that the RH supplement may reduce the level of these biochemical parameters and their deleterious effects especially during ageing in horses.

Histopathological muscle findings may be essential for a definitive diagnosis of suspected sharp trauma associated with ship strikes in stranded cetaceans

Ship strikes are a major issue for the conservation of may cetacean species. Certain gross and microscopic criteria have been previously reported for establishing a diagnosis of death due to ship strikes in these animals. However, some ship-strike injuries may be masked by advanced carcass decomposition and may be undetectable due to restricted access to the animals. In this report we describe histopathological muscular findings in 13 cetaceans with sharp trauma from ship strikes as the cause of death. Skeletal muscle samples were taken from the incision site and from the main locomotor muscle, the longissimus dorsi, in areas not directly affected by the sharp injury. The microscopic findings in tissues from both sites mainly consisted of haemorrhages; oedema; flocculent, granular or/and hyalinised segmentary degeneration; contraction band necrosis; and discoid degeneration or fragmentation of myofibres. We propose that skeletal muscle histopathology provides evidence of ante-mortem injuries even if the sample was taken elsewhere in the carcass and not only within or adjacent to the sharp trauma site and despite the advanced decomposition of some of the carcasses. This method helps to establish the diagnosis of ship strike as the cause of death.

Capture myopathy in live-stranded cetaceans

A group of 51 cetaceans that had been stranded alive on the coasts of the Canary Islands, experienced human capture/rescue interactions and then died, were necropsied over a 12-year period. Of these cetaceans, 25 had haemodynamic lesions indicative of multiorganic vascular shock, degenerative muscle lesions affecting both skeletal and cardiac muscles and myoglobinuric nephrosis typical of capture myopathy (CM). Because macroscopic lesions in muscles and kidneys were not always obvious, a standard protocol was developed where the longissimus dorsi muscle was examined histologically for segmental hypercontraction, contraction band necrosis and segmental muscular degeneration and cardiomyocytes studied for hypereosinophilic wavy fibres, sarcolemmal and perinuclear vacuolation and contraction band necrosis. Light microscopic skeletal and cardiac muscle lesions in all CM animals were confirmed as ante mortem by immunohistochemical assay for myoglobin loss from and fibrinogen entry into affected myofibres. All animals had tubular nephrosis with casts and tubular myoglobin. The oxidative stress-related marker HSP70 was demonstrated immunohistochemically in tubular epithelium. Although the syndrome related to death of live-stranded cetaceans is multifactorial, this study documents that a clinicopathological syndrome comparable to CM of terrestrial wildlife has a role in stranding outcomes.

Electromyographic evaluation of masseter muscle activity in horses fed (i) different types of roughage and (ii) maize after different hay allocations

The aims of this study were to monitor electromyographic (EMG) activity of masseter muscle in healthy horses fed (i) different types of roughage and (ii) maize after different hay allocations. Four horses were offered the following three diets ad libitum: hay, haylage or straw/alfalfa chaff (SAC). In a second trial, four horses were fed cracked maize (CM) and hay in three different orders: (i) CM after a 12-h overnight fast; (ii) CM immediately after restricted hay intake (0.6 kg hay/100 kg BW); or 3) CM after hay intake ad libitum. The activity of the masseter muscle was determined by EMG (IED(®) ), and the following were measured: amplitude (muscle action potential = MAP, maximum voltage) and duration of MAP (s). The intake of hay or haylage was associated with intense masseter muscle activity (MAP: hay, 10 ± 1.7 V; haylage, 11 ± 3.3 V; and duration of MAP: hay, 0.31 ± 0.04 s; haylage, 0.30 ± 0.04 s). Similar intense chewing was measured for SAC (MAP 13 ± 3.8 V), although duration of the chewing cycle was relatively short (0.22 ± 0.03 s, diet p < 0.05), which is possibly related to the shorter fibre length. CM was consumed rapidly, with less intense masseter muscle activity (MAP 6.0 ± 1.5 V). Hay intake before CM did not affect chewing force of CM, but duration of chewing cycle was significantly prolonged by feeding hay ad libitum before CM was fed. The consumption of hay, haylage or SAC was associated with intensive masseter muscle activity that was likely to stimulate salivary flow rate. In contrast to roughage, concentrates like CM are consumed rapidly with less intensive masseter muscle activity. This situation is associated with a low salivary flow that may have an adverse effect on gastric function.

Morphological alterations in oxidative muscles and mitochondrial structure associated with equine atypical myopathy

REASONS FOR PERFORMING STUDY

There is a lack of well documented studies about muscular lesions in equine atypical myopathy (EAM).

OBJECTIVES

To characterise morphopathological changes of striated muscles and myocardium, to progress understanding of this disease.

METHODS

Thirty-two horses age 0.5-7 years kept on pasture were referred for a sudden ataxia/myoglobinuria syndrome. Clinical examination (stiffness, muscle pain, muscle fasciculations, abnormal gait, recumbency, myoglobinuria, tachycardia, sweating) and plasma CPK, LDH and AST levels were consistent with extensive myonecrosis and, together with anamnestic data, with so-called 'equine atypical myopathy' (EAM), a disease of unknown aetiology reported since 1939. Macroscopic and microscopic (histology, histoenzymology, ultrastructure) lesions were evaluated.

RESULTS

Necropsic examination revealed large areas of muscle necrosis, the extent and severity of which varied between cases and muscles, but which were clearly more constant and severe in respiratory and postural muscles and in the myocardium. Histology highlighted a multifocal and monophasic process compatible with Zenker degeneration/necrosis that mostly and segmentally affected type 1 fibres. Histochemical evaluation revealed a weak and disorganised pattern of NADH tetrazolium reductase staining, the absence of calcium salts precipitates and a dramatic accumulation of lipid droplets. Ultrastructural examination often revealed fibres of which the sole modifications were altered mitochondria and sarcoplasmic lipidosis.

CONCLUSIONS

Taken together, the data suggest that a primary alteration of mitochondria should be considered, although secondary mitochondrial abnormalities have yet to be ruled out.

POTENTIAL RELEVANCE

The morphological features gathered here reveal that EAM shares most of the characteristics of toxic myopathies.

Atypical myopathy in grazing horses: a first exploratory data analysis

Over the last decade, atypical myopathy (AM) in grazing horses has emerged in several European countries. An exploratory analysis was conducted to determine horse- and pasture-level indicators or factors associated with AM in Belgium. Belgian cases of AM confirmed by histology (n=57) were compared to their healthy co-grazing horses (n=77) and to pastured horses not involved with AM as controls (n=386). The pastures where confirmed cases were grazing (42 pastures; 38 sites; 44 incidences of AM) were compared with those of the controls (216 pastures; 96 sites; no incidence of AM). Statistically significant (P< or =0.05) exploratory variables, identified by means of adjusted odds ratios, suggested that indicators or factors associated with individual horses (young age, inactivity, body condition poor to normal), management practices (permanent pasturing, spreading of manure) and pasture characteristics (humid, sloping pastures, accumulated dead leaves, presence of waterway) may increase the risk of AM. Specific interventions based on these factors might help to reduce the incidence of AM.

Effect of training duration and exercise on blood-borne substrates, plasma lactate and enzyme concentrations in Andalusian, Anglo-Arabian and Arabian breeds

Metabolic responses to exercise differ between Andalusian horses and other breeds, although changes in plasma muscle enzymes have not been reported and most useful information is obtained from animals subjected to different training programmes. The objectives of this study were to 1) describe the changes in plasma enzymes during exercise in different horse breeds in relation to other biochemical parameters (Experiment A) and 2) assess the effect of training duration on these measures (Experiment B). Twenty stallions, 9 Andalusian (AN), 7 Arabian (A) and 4 Anglo-Arabian (AA), age 5-10 years, were studied. They performed 3 exercise tests (ET), consisting of a warm-up of 800 m at 0.7 km/h and 4 workloads at 15, 20, 25 and 30 km/h, at respective distances of 1250, 1670, 2080 and 2500 m, with 5 min active recovery between each workload (Experiment A). Three ETs were performed at the beginning and after 2 and 6 months of training (Experiment B). Venous blood samples were collected during the ETs and plasma glucose (GLU), free fatty acids (FFA), lactate (LA), creatine kinase (CK), lactate dehydrogenase (LDH), alpha-hydroxybutyrate dehydrogenase (HBHD), aspartate aminotransferase (AST), Na+, K+ and Cl- were measured. AN horses responded to exercise with greater increases in GLU, HBHD, LDH, CK and AST compared to the other breeds. An unexpected result in Experiment A was the lack of interbreed differences in plasma peak LA concentrations, since it is commonly accepted that AA and A horses have greater athletic potential. Although the glycolytic response to exercise was reduced after 2 months of training in the AA and A horses, and after 6 months of training in the AN horses, at the end of Experiment B, AN horses produced more lactate than the other 2 breeds. Most of the adaptations linked to training were found in the AN breed. The more striking changes in plasma enzyme activities corresponded to CK in AN horses after 2 months of training. The attenuation of CK response to exercise was related to lower extrafibrilar GLU utilisation with LA formation and greater fat metabolism. The results show that plasma muscle enzyme concentrations for the diagnosis of equine myopathies must be interpreted in relation to breed and training.

Severe polysaccharide storage myopathy in Belgian and Percheron draught horses

A severe myopathy leading to death or euthanasia was identified in 4 Belgian and 4 Percheron draught horses age 2-21 years. Clinical signs ranged from overt weakness and muscle atrophy in 2 horses age 2 and 3 years, to recumbency with inability to rise in 6 horses age 4-21 years. In 5 horses there was mild to severe increases in muscle enzyme levels. Clinical diagnoses included equine motor neuron disease (2 horses), post anaesthetic myopathy (2 horses), exertional myopathy (2 horses), myopathy due to unknown (one horse), and equine protozoal myelitis (one horse). Characteristic histopathology of muscle from affected horses was the presence of excessive complex polysaccharide and/or glycogen, revealed by periodic acid-Schiff staining in all cases and by electron microscopy in one case. Evaluation of frozen section histochemistry performed on 2 cases indicated that affected fibres were Type 2 glycolytic fibres. Subsarcolemmal and intracytoplasmic vacuoles were most prominent in 3 horses age 2-4 years, and excessive glycogen, with little or no complex polysaccharide, was the primary compound stored in affected muscle in these young horses. Myopathic changes, including fibre size variation, fibre hypertrophy, internal nuclei, and interstitial fat infiltration, were most prominent in 5 horses age 6-21 years, and the accumulation of complex polysaccharide appeared to increase with age. Mild to moderate segmental myofibre necrosis was present in all cases.

Potassium concentrations in muscle, plasma and erythrocytes and urinary fractional excretion in normal horses and those with chronic intermittent exercise-associated rhabdomyolysis

Potassium concentrations were measured in semimembranosus muscle, plasma and erythrocytes, and the urinary fractional excretion determined in normal horses and those that had chronic intermittent exercise-associated rhabdomyolysis. Muscle from the rhabdomyolysis horses was also evaluated microscopically. The horses with rhabdomyolysis had a lower muscle potassium concentration on a dry weight basis. Although the wet weight potassium content was also lower, the difference was not significant. Urinary fractional excretion of potassium (and also sodium and chloride) did not differ significantly between the two groups although the rhabdomyolysis group had a lower percentage excretion of potassium. Erythrocyte potassium concentration was similar for both groups. Low grade to moderate degenerative myopathy or absence of lesions was seen on microscopic sections of muscle from horses with rhabdomyolysis; only one had a vacuolar myopathy and potassium content was not determined. These results suggest that altered muscle potassium content may be a factor in rhabdomyolysis.

Muscle histopathology and plasma aspartate aminotransferase, creatine kinase and myoglobin changes with exercise in horses with recurrent exertional rhabdomyolysis

Six horses with a history of recurrent exertional rhabdomyolysis (RER) (Horses A-F) and 7 control horses performed a submaximal and later a near-maximal treadmill exercise test. Blood samples were obtained before, during and after exercise and muscle biopsies were taken before and after exercise. At rest, plasma aspartate aminotransferase (AST) activities in horses with RER were above 95% confidence intervals for control horses. During submaximal exercise, 3 horses with RER (A, B and C) had much greater increases in plasma AST, creatine kinase (CK) and myoglobin concentrations than did Horses D, E and F and control horses. Clinical signs of muscle stiffness and pain were only obvious in Horse A. During near-maximal exercise, only Horse C showed a substantial increase in CK activity and myoglobin concentrations without any associated clinical signs of rhabdomyolysis. Muscle biopsies from Horses A, B and C contained necrotic type II fibres which, on electron microscopic examination, contained disrupted myofibrils and swollen mitochondria. These results suggest that, in RER, subclinical episodes of muscle fibre necrosis and associated increases in plasma AST, CK and myoglobin occur with exercise more frequently than could be detected clinically. Furthermore, the pattern of increase in muscle enzymes and myoglobin concentrations in the 6 horses with RER suggested that the high plasma AST and CK activities commonly observed at rest in symptom-free Standardbred horses are probably a result of repeated subclinical episodes of rhabdomyolysis after exercise, rather than leakage due to abnormal sarcolemmal permeability.

Caffeine contractures, twitch characteristics and the threshold for Ca(2+)-induced Ca2+ release in skeletal muscle from horses with chronic intermittent rhabdomyolysis

Muscle from horses with intermittent exercise associated rhabdomyolysis was examined to determine if calcium regulation was abnormal. In vitro studies on semimembranosus muscle fibre bundles showed the time to 50 per cent relaxation of caffeine-induced contractures was shorter and the electrically elicited twitch longer in horses with exercise associated rhabdomyolysis. Substitution of strontium for calcium eliminated the difference in caffeine contracture between the normal and rhabdomyolysis horses. The threshold of calcium-induced calcium release was lower than normal in terminal cisternae-containing fractions of muscle from horses with rhabdomyolysis. Thoroughbreds with rhabdomyolysis had a shorter time to peak twitch tension than standardbreds, and normal thoroughbreds had a shorter caffeine contracture than normal standardbreds. There was no difference in fibre typing between breeds or groups. Either no histological changes or low grade to moderate degenerative myopathy was seen in muscle from horses with rhabdomyolysis. These results suggest horses with intermittent exercise associated rhabdomyolysis have abnormal calcium regulation.

Blood chemistry and skeletal muscle metabolic responses to exercise in horses with recurrent exertional rhabdomyolysis

Six horses with a history of recurrent exertional rhabdomyolysis (RER) and 7 control horses performed both a 55-min submaximal and later a 10-min near-maximal exercise test on a treadmill. Blood samples were obtained during exercise and gluteus medius muscle biopsies were obtained before and immediately after each exercise test and at 24 h after completion of the submaximal test. Rhabdomyolysis was developed by 3 of 6 RER horses during submaximal exercise and in 1 of the RER horses during near-maximal exercise. Concentrations of potassium, glucose, free fatty acids, ammonia, lactate, cortisol, adrenaline and noradrenaline in the blood were measured. None of these variables appeared useful in predicting which RER horses would develop rhabdomyolysis. The RER horses that developed rhabdomyolysis (RERa) had higher cortisol and blood glucose concentrations but otherwise had blood chemistry and muscle metabolic responses during submaximal and near-maximal exercise similar to those of RER horses which did not develop rhabdomyolysis (RERb) and to controls. At rest, muscle glycogen concentrations were significantly higher (> 650 mmol/kg dry wt) in RERa and RERb horses than in controls. Lactate concentrations in muscle after submaximal and near-maximal exercise were similar or lower, respectively, in RERa horses compared with controls. The results of this study indicate that, although horses with RER had high resting intramuscular glycogen concentrations, rhabdomyolysis did not appear to be caused by an excessively rapid rate of anaerobic glycolysis with lactate accumulation.

Polysaccharide storage myopathy associated with recurrent exertional rhabdomyolysis in horses

A polysaccharide storage myopathy is described in nine Quarterhorses, Quarterhorse crossbreds, American Paints and Appaloosa horses which had a history of recurrent exertional rhabdomyolysis. Muscle biopsies were characterized by high muscle glycogen concentrations with up to 5% of type 2 muscle fibers containing inclusions which stained positively with the periodic acid Schiff (PAS) stain. The inclusions were classified as an acid mucopolysaccharide, based on their histochemical staining characteristics. Ultrastructural studies revealed that the inclusions were composed of beta glycogen particles interspersed among arrays of filamentous material. In addition, many type 2 fibers contained multiple subsarcolemmal vacuoles. These vacuoles stained lightly with eosin and did not stain positively with PAS. Centrofascicular atrophy and necrosis of scattered type 2 fibers were present in biopsies from some horses. No glyco(geno)lytic enzyme deficiencies were identified using a biochemical screening test for anaerobic glycolysis. Attempts to measure branching enzyme activities in both affected and control samples were unsuccessful, employing methods developed for human muscle. The polysaccharide accumulation in these horses may represent a hereto yet undefined metabolic disorder of skeletal muscle.

Exercise induced alterations in the serum muscle enzymes, erythrocyte potassium and plasma constituents following feed withdrawal or furosemide and sodium bicarbonate administration in the horse

Six thoroughbreds were used in each of three trials to examine the effect of potassium depletion on exercise-associated muscle damage. Horses were exercised after a control period (Treatment 1), a 72-hour fast (Treatment 2), and furosemide and sodium bicarbonate (Treatment 3). During the preexercise period, feed withdrawal for 72 hours caused decreases in body weight, plasma sodium, chloride, and serum calcium. There were no changes in plasma potassium, erythrocyte potassium, or serum creatine phosphokinase (CK) activity. Furosemide and sodium bicarbonate administration resulted in a decrease in plasma potassium, chloride, serum calcium, and magnesium in the pre-exercise period. Erythrocyte potassium and serum CK activity were unchanged. Body weight initially decreased following furosemide and sodium bicarbonate and then increased upon access to water. In all three treatment groups plasma sodium, potassium, L-lactate, serum calcium, and magnesium were increased immediately following exercise. There was a significant increase (P less than 0.05) in serum CK activity in the furosemide and sodium bicarbonate-treated horses compared to control and withholding feed treatment groups by 30 minutes following exercise. Erythrocyte potassium was decreased immediately following exercise in the furosemide and sodium bicarbonate group but not in the other treatment groups. Potassium depletion may play a role in exercise-induced muscle damage but could not be implicated as the sole cause of the serum CK activity increase in this study.

Muscular dystrophy-like disease in a thoroughbred foal

A 1-month-old male thoroughbred foal, which had difficulty in walking, was killed and examined by histological, histochemical and ultrastructural methods. The muscles of the trunk and upper hind limbs were chiefly affected, and changes in the affected muscles resembled those in muscular dystrophy in man. The type of muscular dystrophy present in this foal and the significance of this disease in thoroughbred horses are discussed. The dystrophy in this foal resembled the limb-girdle type or myotonic dystrophy of muscular dystrophy in man.

Creatine kinase isoenzyme profiles after exercise in the rat: sex-linked differences in leakage of CK-MM

Changes in creatine kinase (CK) activity and CK isoenzyme profiles in plasma after exercise were studied in rats in order to establish the source of the exercise-induced rise in CK activity. Male and female rats ran on a treadmill for 2 h and blood samples, taken before and after exercise, were assayed for total CK, CK isoenzymes and aminoaspartate transaminase (AST) activity. These enzymes were also assayed in homogenates of liver and several muscles. We found that the isoenzyme composition of liver, plasma and muscle did not differ between the sexes. However, the exercise-induced CK and AST responses did differ: CK and AST increased after exercise in males (101% and 15% resp.), but much less in females (47% and 1%). Although the isoenzyme profiles in rest did not differ, significant differences were observed after running: in males CK-MM increased with 678%, but females only showed a 114% increase. In contrast, CK-BB showed a small increase that was about the same for both sexes (males 41%, females 35%). We conclude that both males and females show a small and similar increase in CK-BB activity after exercise, and that a large release of CK-MM from skeletal muscle, observed only in males, accounts for sex-linked differences reported earlier.