Equine Emergency: "Tying Up" or Azoturia?

Many people are around horses for years without ever seeing this happen - but once you see it you'll never forget it. If caught early it's very treatable, but the longer it lasts the worse for the horse.

Several years ago an owner gave instructions on a filly I didn't feel was ready for the work being given her. The filly, DD, was a pastured horse recently returned to conditioning. She would self exercise in the arena or in a paddock, and had been overcoming a foot problem so she'd been inside. She had been in the indoor arena for about 20 minutes, trotting and cantering around trying to see the horses outside. Put back in her stall a co-worker with less experience but a longer time at the barn came in saying the filly was to be put on the walker. I went on doing what I was doing and about ten minutes later the filly was being hosed off - the co-worker came in saying she was walking funny. "What do you mean by "walking funny?"" met with a wave to come look. As I rounded the corner to the arena the filly was dragging both back legs and she said she would try to walk her out of it. I told her do not under any circumstances move her. I opened the doors for ventilation, gave her a bucket of water to sip, gave her some banamine paste to help with the cramps, sprayed her back and sides down with a 50-50 mixture of Absorbine liniment and Bigeloil and placed saddlepads over her back and rump. By this point she was trembling from the muscle spasms. I ran in and called the vet who promptly said he was unavailable to come and I'd already done everything he would have done anyway - there was nothing more that could be done but wait. While quick action within minutes was good seeing a horse in severe distress is tough - and being told there's nothing more to do but wait is not what most want to hear whether it's their horse or not. It was advised that, because I'd given paste form of banamine, to give her 5 cc injected to get through her system faster and help ease the muscle spasms.

For those who haven't seen this it can be prevented but once a horse has had it they'll always be much more inclined to have another attack. The horse, if trotting, begins moving "off" - as if something is interfering with movement. They may appear short strided or stiff. If pushed on they'll start dragging a toe, then without relief both legs. Severe cases, because it's a serious issue affecting the muscles can result in death - the heart is also a muscle.

A proper warm up is noted in almost every basic horse book - and far too often we get lucky with a few laps around a circle and consider it warmed up. In the case of this filly she'd had 20 minutes of free exercise before about 5 minutes trotting on a walker. While one would think she would be warmed up it was unsupervised free exercise - she might have been running.

Normally when lactic acid is produced in the muscles the body flushes it through - when problems occur is when the lactic acid isn't flushed and accumulates in the muscle - it begins destroying muscle cells. Aside from damage to the muscle there can also be kidney issues - and the urine will be dark colored. It can't be stressed enough that if a horse begins showing signs of stiffness during exercise - especially when they started out fine - STOP. Each step does more damage! Get the horse out of a dangerous situation (such as on a highway) but don't force movement any more than absolutely necessary. Aside from the signs above, and as the attack gets worse, the muscles will tremble and tense. If you've ever had a "charlie horse" you know what muscle cramps are - and having that all over is some indication of what the horse is going through. Painkillers can help (thus the use of banamine) but ultimately it takes time. The horse will often sweat excessively, have a rapid pulse and difficulty controlling the hindquarters.

If an attack happens, as this one, do not even put the horse in a stall until recovery begins. As with the filly in the intro - there was no problem with her being held in the arena. A call to a veterinarian is advised - even if you have the things on hand to begin treatment (which is absolutely a case of the sooner the better) it's best to have the horse's vet aware of what is going on. For horses that remain standing, not forced to move after initial signs and whose pulse returns to normal prognosis is good. A horse that goes down is a bigger risk but if he can sit upright and get up within 24 hours he has a chance. Horses that are forced to move, and who go down and remain down have a grim prognosis. The chance of kidney damage combined with laying down can choke off blood supply to the muscles - and again the heart is a muscle.

In the case of DD, the filly of this story, because fairly quickly it was recognized, she wasn't moved until the problems began subsiding and she had fast treatment within minutes, an hour or so after the onset she was beginning to look a little better. She was very slowly and very carefully walked about 20 feet to her stall and received only hay and a handful of grain that night with all the water she wanted to drink. It was several days before she was really herself again and a long and very slow program of building her fitness back up so as to not trigger another attack. Diet should be regulated and reduced when a horse is not active. This filly was lucky - she recovered completely and as far as I know never had another problem with it. Many aren't so lucky.

The fast action did several things - the use of a liniment mixed with bigeloil (both items found at most tack supply stores) is something I keep on hand for legs as well as an after work spray for horses who have worked hard. Spraying her down with this and covering with blankets helped retain some heat to ease the muscle cramps. Unlike a leg cramp where we can put a heating pad on it - there's not that option for a large area so this is the next best thing. The use of painkillers to try to make the horse more comfortable can help but ultimately it's an excruciating waiting game. Someone has to stay with the horse to make sure he doesn't try walking around. Towels to wipe down the horse can help if he starts sweating but other than that it's just waiting. Being aware of the onset of symptoms can help ease further attacks but better than that is further steps to prevention. Diet, management and being very aware of a proper warm up and cool down time - and under normal circumstances most people can have horses a lifetime and never see this. I've seen it twice - and after the first time it was years before seeing the onset in DD. It's truly something you won't forget when you see it once.

Prevention is absolutely better, but if you see the onsight of signs and immediately stop the horse you can increase your horse's chances of maintaining a long and productive life.