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Understanding Polysaccharide Storage Myopathy (PSSM) and Equine Polysaccharide Storage Myopathy (EPSM)
PSSM and EPSM can affect Quarter horses, Paints, European Warmbloods, Appaloosas, Morgans, Welsh ponies and draft breeds
In draft horses this disorder has been called EPSM.
PSSM and EPSM involve increased storage of glycogen and abnormal polysaccharide in skeletal muscle. In PSSM and EPSM there is some evidence that a reduction in dietary starch and sugar and/or and increase in dietary fat are beneficial in the management of affected horses.
Signs of PSSM and EPSM include:
- exertional rhabdomyolysis (ER)
- exercise intolerance
- muscle stiffness
- back pain
- shifting lameness
- gait changes
- muscle atrophy
- a cramped out stance and colic like signs.
Detection of amylase-resistant polysaccharide in muscle of horses with a history of recurrent ER is considered diagnostic for PSSM and EPSM. However the accumulation of polysaccharide may be a gradual process.
Clinical signs in draft horses with EPSM include muscle soreness of the hindquarters and back, stiffness, muscle atrophy and occasionally overt ER. In Belgium draft horses EPSM may occur simultaneously with “shivers” a disorder characterized by muscle tremors and hind limb hyper flexion that may progress to muscle atrophy, weakness and recumbence.
Diet and supplementation can modify symptoms of PSSM and EPSM. The frequency and severity of ER episodes were higher when PSSM and EPSM affected horses received little exercise and were feed energy concentrates containing moderate amounts of starch and sugar such as straight grains (oats, barley, corn) and sweet feed mixes.
Research has shown feeding a ration with restricted starch and sugar content (on a total diet basis less than 8% digestible energy (calories) from starch and sugar) and added fat (greater than 10% of total digestible energy (calories) from fat) resulted in improvement of affected horses.
Reports have shown that draft horses with EPSM can show improvement with diet modifications alone. Studies in Quarter horses and Warmbloods have shown that both a change in diet and daily exercise (including turnout) were necessary for a good response.
The cause of excessive muscle glycogen storage may be related to enhanced insulin sensitivity and uptake of glucose into the skeletal muscle.
Some dietary recommendations to manage horses with PSSM and EPSM include:
- Feeding a minimum of 1.5% of body weight as forage per day, the best is a grass or oat hay as these forages have lower nonfiber carbohydrate content when compared to legumes (alfalfa, clover).
- Remove all concentrates containing grain and molasses. Using a forage based pellet grain is better.
- Use alternative energy sources such as vegetable oil, rice bran, soybean and coconut oil and/or non-molasses beet pulp when digestible energy (calories) are higher than that provided by forage alone.
In some cases improvement may also be dependent upon the addition of fat to the diet. It has been reported that signs of muscle dysfunction can persist when affected horses are fed an all forage diet with low starch and sugar content whereas signs of muscle dysfunction abated when even a small amount of oil is added to the diet.
As mentioned earlier the implementation of daily exercise is also important for successful management of Quarter horses and Warmbloods with PSSM.
A proper diet and supplementation program can go along way in reducing symptoms of PSSM and EPSM.
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