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

Thirteen horses with histories of exertional rhabdomyolysis were exercised for 20 minutes to induce clinical signs of lameness, elevated serum creatine kinase (CK), and aspartate aminotransferase (AST) activities and skeletal muscle morphologic lesions. The clinical signs exhibited by affected horses included trembling, sweating, increased rate of respiration, and restricted limb movement. Serum CK reached maximal activity between 4 and 8 hours after the exercise period and serum AST activity peaked between 24 and 48 hours. Histologically, the skeletal muscle lesions in muscle biopsies 24 hours after the exercise period consisted of segmental muscle fiber degeneration. Damaged muscle fibers were repaired by myoblastic regeneration. Horses with moderate (>1,500 U/liter) to severe (>5,000 U/liter) elevations of serum CK activity accompanied by clinical signs of muscle soreness induced by exercise, had visible muscle fiber degeneration microscopically. Frozen sections of biopsies of the gluteus medius muscle from affected (n = 13) and control (n = 11) groups of horses were processed to demonstrate myofibrillar ATPase activity. These sections were then used to determine fiber types, area percentages, and mean cross sectional fiber sizes. The mean type I, type II, and intermediate fiber sizes were significantly larger in the affected group than in the control group. In the gluteus medius muscles of the affected group, there was a significantly greater percentage of intermediate fibers and a significantly greater percentage of area occupied by intermediate fibers than in the control group. In the muscle samples with acute lesions of exertional rhabdomyolysis, type II fibers were selectively but not exclusively affected. In one horse which was subsequently necropsied 24 hours after the exercise period, lesions were present in several postural muscles, the masseter muscle and the heart. We conclude that the gluteus medius muscle fibers of affected horses are larger in cross sectional area than those of control horses and that there is preferential degeneration of type II fibers in acute lesions of exertional rhabdomyolysis.