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Horse Health - Tying Up Disease (Polysaccharide Storage Myopathy)


By Dr. Martin Adams, PAS Equine Nutritionist for Southern States

Tying up disease, which is called Polysaccharide Storage Myopathy (PSSM), is an inherited metabolic muscle problem that occurs in many horse breeds. Horses with PSSM have symptoms including exertional rhabdomyolysis or tying up symptoms when they are exercised, muscle tremors and gait abnormalities. Recent research has shown that a genetic mutation causes unregulated glycogen formation in the muscle of a horse with PSSM. This mutation is in a gene called GYS1 and it is responsible for the accumulation of excess glycogen in muscle cells and symptoms of PSSM in affected horses.

About 75% of Quarter Horses and 85% of draft horses affected with PSSM have the GSY1 mutation. However, there is a low incidence of the GSY1 mutation found in Warmblood breeds showing symptoms of PSSM, and there have been no GSY1 mutations found in Arabians, Thoroughbreds or Standardbreds affected with PSSM. So there is another form of PSSM other than the GSY1 mutation responsible for tying up disease in these horse breeds.

PSSM can now be classified into two main types: Type-1 PSSM is due to the GSY1 mutation and occurs mainly in Quarter Horse, Paint, Appaloosa, Morgan, Tennessee Walker and draft purebreds and crosses. Type-2 PSSM is the form that affects most Warmbloods as well as all Arabians, Thoroughbreds and Standardbreds. The cause for this Type 2 form of PSSM has not yet been discovered and it has been previously referred to as Equine Polysaccharide Storage Myopathy or EPSM.

A horse with its vet.Horses affected with Type-1 PSSM respond well to a low-starch diet. Southern States has feeds that can be used for PSSM horses. Use the “Soluble Carbohydrates of Southern States Horse Feeds” chart available at www.southernstates.com to find a low soluble carbohydrate feed for a horse with Type-1 PSSM. Select a horse feed with less than 10% starch for horses with Type-1 PSSM such as Legends Senior or Legends Performance Low Carb Formula.

Horses affected with Type-2 PSSM respond fairly well to a low-starch, high-fat diet but the results are not as consistent as with dietary treatment of Type-1 PSSM. Use the same feed selection guidelines for Type-2 PSSM horses as for Type-1 PSSM. Also consider adding more vegetable oil or fat to the feeding program, such as Legends Fortified Pelleted Rice Bran or Legends Omega Plus to decrease the concentrate feeding rate and reduce the amount of starch and sugar fed.

The use of nutritional calming supplements (thiamin, tryptophan or magnesium) or veterinary-prescribed drugs (acepromazine, dantroline and phenytoin) may help to reduce symptoms in Type-2 PSSM horses. And make sure that horses with both types of tying up disease have diets that are not deficient in selenium, magnesium or vitamin E, in fact, feeding supplemental levels of all three of these nutrients is recommended as performance horses may be deficient and could have deficiency symptoms that are similar to symptoms of tying up disease

There is a third type of PSSM found only in about 0.5% of Quarter Horses. It is due to a genetic mutation of the RYR1 gene and can exist in horses with and without the GSY1 mutation. The RYR1 mutation is a life-threatening condition causing malignant hyperthermia. It does not respond to a high-fat, low-starch dietary treatment and an episode with this disorder can lead to sudden death.

A genetic test for diagnosis of Type-1 PSSM is available using a hair root or blood sample for horse breeds known to have the GSY1 mutation. There is also genetic testing available for the RYR1 mutation in Quarter Horses. A muscle biopsy test can also be used for diagnosis of tying up disease, and further genetic testing will determine if it is Type-1 or Type-2 PSSM and if the horse has the RYR1 mutation. Consult with your equine veterinarian about testing if you suspect your horse has a genetic form of tying up disease.


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