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LMK1975

Elevated Muscle Enzymes

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We had bloodwork done on my horse for a possible bladder or urinary track infection. The bloodwork came back mostly normal. Liver levels were fine. Blood cell counts were fine. However, got a message on my voicemail that said that his muscle enzyme level was very slightly elevated.

He is not being worked right now. I did move him to a new barn 2 weeks before Christmas and it has taken him awhile to adjust. He doesn't love being in the stall, but they don't have run ins or shelter in the pastures so they bring them in when it is raining, snowing, etc. as well as at night so they can get out of the elements for a while. He ca't stay out all the time with no shelter. At the previous barn I was at he stayed out all the time. At the barn before that he did come in the stall at night as well but they did have run ins so he was out even if the weather was bad. So maybe he is a little stressed by having to be in a little more since we have had nothing but rain and snow since a week before Christmas.

So, the vet ran it by the internist at the clinic and he just said to re-check it next month when they are out doing shots.

Can anyone tell me what a high muscle enzyme level could mean? Especially on a horse not being worked?

Edited by LMK1975

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I really like this veterinarian's website....

http://www.shady-acres.com/susan/cbc.shtml

The following excerpt was taken from the "The Pride Project--How to Speak CBC in one Easy Lesson" and is worth checking out in its entirety. But here's the section on muscle enzymes.

MUSCLE ENZYMES - CPK, LDH, SGOT/AST Levels of specific enzymes help indicate the presence of muscle injury or disease, its severity and progression. Measured blood levels, along with the observation of other clinical signs, such as lameness, pain or dark urine, help tell the veterinarian whether, when and to what extent muscle damage has occurred. It is extremely important to consider whether any increased enzyme levels were measured before, during or after exercise; as well as whether any other stressful events (a ride last weekend, an unplanned midnight gallop through camp, even recent vaccinations) may have contributed to chemistry results. High---even very high---enzyme levels after a long ride are not necessarily the voice of doom in predicting muscle damage. In some cases, however, obtaining a consultation with your veterinarian and possibly a follow-up blood panel to measure subsequent increases or decreases is often a good idea.

CPK - refers to creatine kinase (also called CK), a muscle enzyme produced during exercise. While horses suffering from exertional rhabdomyolysis (tying up) will demonstrate increased levels, other studies have shown that prolonged endurance exercise can result in very high levels (> 30,000 IU/liter) without signs of clinical muscle damage(1). Distance and intensity of exercise are significant factors, so that one horse who completes slow 100 miles may have higher CK levels than an equally fit horse who finishes a brisk 50, with neither suffering clinical damage. An elevated level during or following an endurance ride (or other stressful event) indicates the horse has had a long, hard day, but should not necessarily be interpreted as "muscle damage" without considering other clinical signs. Elevated levels in a resting horse that has not exercised intensively for several days, however, may indicate disease such as infection, electrolyte imbalances or chronic rhabdomyolysis(2).

AST/SGOT - refers to aspartate aminotransferase (the SGOT refers to an earlier term for the same enzyme), an enzyme released by both skeletal and cardiac muscle, as well as the liver as the result of protein metabolism. As with CK, AST levels may rise significantly as a result of prolonged exercise without necessarily indicating damage(1,3). AST levels rise more slowly, and remain for a longer period, than do CK levels. Elevated ASTs in a horse with normal CK would suggest that the horse has undergone intense muscular stress sometime during the prior week. High AST and CK levels in a horse that has not recently exercised at an intense or prolonged level may indicate an ongoing disease process occurring in the muscles. High AST levels in a horse that has not exercised recently, without a concurrent increase in CK levels, may be indicative of liver disease(2,4).

LDH - refers to lactate dehydrogenase, yet another enzyme released by both cardiac and skeletal muscle cells during stress. Although LDH levels are used to diagnose cardiac disease, elevated levels without other characteristic signs of heart trouble are almost certainly due to itsrelease from skeletal muscle(2). As with the other muscle enzymes, increased levels may only indicate that the horse has undergone an intense and prolonged bout of exercise, without necessarily indicating damage. Interpretation of enzyme results should include consideration of other clinical signs such as muscle pain or myoglobin in the urine, as well as the horse's immediate and past clinical history. Likewise, clinical signs similar to tying-up without concurrent increases in enzyme levels may be indicative of other diseases such as laminitis or colic.

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Slight elevation is nothing to worry about, particularly with no instance of a recent bout with tying up in his history.

I wouldn't worry about that unless you have higher levels with subsequent blood work ups.

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