Highlights of recent clinically relevant papers

Abstract

and colleagues from Europe have recently published their findings of a large European study of atypical myopathy in grazing horses (2006)(2007)(2008)(2009).This large scale European study (van Galen et al. 2012) aimed to improve diagnosis and treatment of atypical myopathy (AM) through recognition of risk factors and factors affecting prognosis. This study differs from previous studies by the inclusion of cases with similar signs, which were unlikely to have AM in order to assist in defining AM cases and to provide prognostic indicators. Six hundred cases were allocated to AM cases (n = 354) and non-AM cases (n = 69), with the remainder not being included due to insufficient data. The clinical signs strongly associated with the AM group compared to the non-AM group were pigmenturia, normothermia, congested mucous membranes and increased serum CK activity, the latter being variable in early cases. Positive prognostic indicators (survival rate 26%) for AM cases were cases which remained standing, normothermia, normal mucous membranes and defaecation. Poor prognostic indicators included recumbency, sweating, anorexia, dyspnoea, tachypnoea and tachycardia. The only treatment that had a significant effect on survival was the administration of vitamins and antioxidants. This study has allowed preventative measures to be advised, these include: stabling/limited grazing during high risk periods (autumn/ spring), removal of dead leaves and wood, use of flat pasture without trees and provision of supplementary food during high risk periods.Cases with similar clinical signs to AM can be considered more likely to have AM if they have pigmenturia, normothermia, congested mucous membranes and increased serum CK activity. Those which remain standing, with normal mucous membranes and pass faeces are more likely to survive and the provision of a vitamin and antioxidant supplement is associated with survival. Highlights of recent clinically relevant papers