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SPORTS MEDICINE

SPORTS MEDICINE. THE EXHAUSTED HORSE SYNDROME Poor race performance syndrome Synchronous diaphragmatic flatter. THE EXHAUSTED HORSE SYNDROME. Exhaustion is a result of brief maximal exercise or protracted (prolonged) sub­maximal exercise.

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SPORTS MEDICINE

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  1. SPORTS MEDICINE • THE EXHAUSTED HORSE SYNDROME • Poor race performance syndrome • Synchronous diaphragmatic flatter www.drghanem.co.nr

  2. THE EXHAUSTED HORSE SYNDROME • Exhaustion is a result of brief maximal exercise or protracted (prolonged) sub­maximal exercise. www.drghanem.co.nr

  3. With maximal exertion in race­horses, there is rapid depletion of readily available muscle energy stores (creatine phosphate, ATP) produces severe metabolic lactic acidosis www.drghanem.co.nr

  4. With protracted submaximal or endurance exercise, energy is supplied by aerobic metabolism of both fatty acids and carbohydrates minimal changes in acid‑base status or lactic acid concentration. www.drghanem.co.nr

  5. occurs mostly during summer season, when the temp. and humidity are elevated. Etiology and pathogenesis www.drghanem.co.nr

  6. high-intensity short exercise. prolonged submaximal exercise: 2 types of exercise • The syndrome is associated with 2 types of exercise and www.drghanem.co.nr

  7. rapid depletion of the phosphagen pool of muscle cells (creatine phosphate and ATP) and accumulation of lactate Accumulation of lactate reduces the muscle pH from normal (7.0 – 7.1) to 6.3 or lower Interfering with Ca availability by actomyosin, reducing the contractile efficiency. Inactivation of muscle metabolizing enzymes, thus reducing the availability and production of ATP High-intensity short exercise: www.drghanem.co.nr

  8. 1- Sweating large volumes of fluid may be lost via this route producing dehydration and reduction of exercise performance Prolonged submaximal exercise Horse sweat is hypertonic, and sodium and chloride are the major ionic constituents the major signs resulting from the loss of sodium and associated fluid are due to decreased circulatory function and poor organ perfusion • . Loss of potassium ions in the sweat may occur and contribute to the exhaustion but usually transient because of the compensatory release from other cells. Oxygen with Ca in Mitochondria required for oxidative phosphorylation of ADP to ATP so reduction of oxygen or calcium produce exhaustion www.drghanem.co.nr

  9. 2- Depletion of intramuscular glycogen store during prolong submaximal exercise contributes to increasing the exhaustion Prolonged submaximal exercise www.drghanem.co.nr

  10. Profuse sweating www.drghanem.co.nr

  11. Clinical signs • There are variations in the severity of signs of exhaustion in individual horses. • All affected horses will have elevated rectal temperatures and pulse and respiratory rates, and variable dehydration on arrival. • The most reliable quantitative guides to impending exhaustion are pulse and respiratory recovery rates. • The pulse and respiratory rates take 30 minutes after rest and must return to acceptable levels, usually 60 to 70 per minute and 40 per minute, respectively. • Severely affected horses are usually severely depressed with little interest in food or water despite apparent dehydration. • Pulse pressure and jugular distensibility are often markedly decreased. • Capillary refill time is prolonged and cardiac irregularities. • Muscle cramps (lactic acid) and spasms are often evident. • Diminution or absence of intestinal sounds. www.drghanem.co.nr

  12. Diagnosis • Case history • Clinical Signs • Lab Diagnosis • Hyponatremia • Hypochloremia • Metabolic acidosis (lactic acidosis) • Hemoconcentration www.drghanem.co.nr

  13. 1 Horses manifesting depression and persistently elevated pulse and respiratory rates as their only problems Respond to rest, cooling out, and access to salt, clean feed, and water. If there is no improvement in 30 minutes, they should receive fluids orally or intravenously. Treatment --- step 1 www.drghanem.co.nr

  14. cold water is applied by a hose, sprayer, sponge, or towels over the large vessels of the distal extremities, head and neck, and over the jugular veins.. Cold alcohol leg wraps are also useful in dissipating heat 2 The rectal temp. should return to normal within 15-30 Min Treatment Step 2 • Cautions ! • Use an open area with free circulation of air, in a breeze or in front of a fan. • Avoid pouring very cold water over the large muscle masses to avoid inducing muscle spasms www.drghanem.co.nr

  15. 3 severe exhaustion requires prompt and vigorous fluid therapy Treatment --- step 3 Restoration of effective circulating blood volume by IV injection of saline (provides Na+ and Cl-). Correction of electrolyte deficits by IV saline with addition of K+. The use of non-steroidal anti-inflammatory drugs is controversial because they may produce toxicity in dehydrated, volume-depleted horses. However, they may be used after rigorous fluid therapy for their anti-inflammatory, analgesic and anti-pyretic effect. Provision of readily metabolizable energy as glucose www.drghanem.co.nr

  16. Questions www.drghanem.co.nr

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