Equine Atypical Myopathy in the UK: Epidemiological characteristics of cases reported from 2011 to 2015 and factors associated with survival

Gonzalez-Medina, S.; Ireland, J. L.; Piercy, R. J.; Newton, J. R.; Votion, Dominique

doi:10.1111/evj.12694

Article (Scientific journals)

Equine Atypical Myopathy in the UK: Epidemiological characteristics of cases reported from 2011 to 2015 and factors associated with survival

Gonzalez-Medina, S.; Ireland, J. L.; Piercy, R. J. et al.

2017 • In Equine Veterinary Journal

Peer Reviewed verified by ORBi

Permalink
https://hdl.handle.net/2268/211057

DOI
10.1111/evj.12694

PubMed
28445006

Files (1)Send to Details Statistics Bibliography Similar publications

Files

Full Text

Gonzalez-MedinaS_EVJ_2017.pdf

Publisher postprint (714.76 kB)

Request a copy

All documents in ORBi are protected by a user license.

Send to

RIS BibTex APA Chicago Permalink X Linkedin

Details

Keywords :

Horse; Myopathy; Atypical; Survival; CK; Mitochondrial myopathy

Abstract :

[en] BACKGROUND: Equine atypical myopathy (AM) is a toxic rhabdomyolysis associated with ingestion of hypoglycin A, derived typically in Europe, from Acer pseudoplatanus tree. Despite the wide distribution of this tree species in the UK, the number of cases reported annually varies, and there has been an apparent increase in prevalence in recent years. Although AM was first recognised in the UK, epidemiological studies have never been conducted focused solely on this country. OBJECTIVES: To describe the spatiotemporal distribution, presentation, treatment and outcome of AM cases reported in the UK. STUDY DESIGN: Retrospective case series. METHODS: British AM cases reported to the atypical myopathy alert website, between 2011 and 2015 were included (n = 224). Data were obtained via standardised epidemiological questionnaires from owners and veterinarians. Factors associated with survival were assessed using logistic regression. RESULTS: Most cases reported were from England (87.9%). Survival was 38.6% (n = 73/189). Clinical factors associated with reduced odds of survival included, hypothermia (odds ratio (OR) 0.18; CI 0.06-0.57; p = 0.01), bladder distension (OR 0.11; CI 0.02-0.59; p = 0.01), tachycardia (OR 0.97; CI 0.94-0.99; p = 0.04) and serum creatine kinase activity >100,000 IU/L (OR 0.17; CI 0.04-0.68; p = 0.01) in the univariable analysis as well as recumbency. The latter was the only sign retained in multivariable analysis (OR = 0.19; CI 0.06-0.62; p = 0.006). Administration of vitamins during the disease was associated with survival (OR 3.75; CI 1.21-11.57; p = 0.02). MAIN LIMITATIONS: Reporting cases to the atypical myopathy alert group is voluntary; therefore, under-reporting will result in underestimation of AM cases; furthermore, direct owner-reporting could have introduced misdiagnosis bias. CONCLUSION: Some areas of the UK reported AM cases more commonly. Clinical signs such as recumbency, rectal temperature, distended bladder and serum CK activity might be useful prognostic indicators though should be considered in the context of the clinical picture. Treatment with vitamins increases survival. This article is protected by copyright. All rights reserved.

Research center :

FARAH - Fundamental and Applied Research for Animals and Health - ULiège

Disciplines :

Veterinary medicine & animal health

Author, co-author :

Gonzalez-Medina, S.; The Royal Veterinary College, London, UK > Comparative Neuromuscular Diseases Laboratory

Ireland, J. L.; Epidemiology and Disease Surveillance, Animal Health Trust, Newmarket, Suffolk, UK

Piercy, R. J.; The Royal Veterinary College, London, UK > Comparative Neuromuscular Diseases Laboratory

Newton, J. R.; Epidemiology and Disease Surveillance, Animal Health Trust, Newmarket, Suffolk, UK

Votion, Dominique ; Université de Liège > FARAH

Language :

English

Title :

Equine Atypical Myopathy in the UK: Epidemiological characteristics of cases reported from 2011 to 2015 and factors associated with survival

Publication date :

2017

Journal title :

Equine Veterinary Journal

ISSN :

0425-1644

eISSN :

2042-3306

Publisher :

Equine Veterinary Journal, United Kingdom

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 24 May 2017

Statistics

Number of views

125 (30 by ULiège)

Number of downloads

27 (22 by ULiège)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenCitations

Bibliography

Baise, E., Habyarimana, J.A., Amory, H., Boemer, F., Douny, C., Gustin, P., Marcillaud-Pitel, C., Patarin, F., Weber, M. and Votion, D.M. (2016) Samaras and seedlings of Acer pseudoplatanus are potential sources of hypoglycin A intoxication in atypical myopathy without necessarily inducing clinical signs. Equine Vet. J. 48, 414–417.
Bochnia, M., Ziegler, J., Sander, J., Uhlig, A., Schaefer, S., Vollstedt, S., Glatter, M., Abel, S., Recknagel, S., Schusser, G.F., Wensch-Dorendorf, M. and Zeyner, A. (2015) Hypoglycin A content in blood and urine discriminates horses with atypical myopathy from clinically normal horses grazing on the same pasture. PLoS ONE 10, e0136785.
Unger, L., Nicholson, A., Jewitt, E.M., Gerber, V., Hegeman, A., Sweetman, L. and Valberg, S. (2014) Hypoglycin A concentrations in seeds of Acer pseudoplatanus trees growing on atypical myopathy-affected and control pastures. J. Vet. Intern. Med. 28, 1289–1293.
Valberg, S.J., Sponseller, B.T., Hegeman, A.D., Earing, J., Bender, J.B., Martinson, K.L., Patterson, S.E. and Sweetman, L. (2013) Seasonal pasture myopathy/atypical myopathy in North America associated with ingestion of hypoglycin A within seeds of the box elder tree. Equine Vet. J. 45, 419–426.
Westermann, C.M., van Leeuwen, R., van Raamsdonk, L.W. and Mol, H.G. (2016) Hypoglycin A concentrations in maple tree species in the Netherlands and the occurrence of atypical myopathy in horses. J. Vet. Intern. Med. 30, 880–884.
van Galen, G. and Votion, D.M. (2013) Management of cases suffering from atypical myopathy: interpretations of descriptive, epidemiological and pathophysiological findings. Part 2: muscular, urinary, respiratory and hepatic care, and inflammatory/infectious status. Equine Vet. Educ. 25, 308–314.
van Galen, G. and Votion, D.M. (2013) Management of cases suffering from atypical myopathy: interpretations of descriptive, epidemiological and pathophysiological findings. Part 1: first aid, cardiovascular, nutritional and digestive care. Equine Vet. Educ. 25, 264–270.
van Galen, G., Amory, H., Busschers, E., Cassart, D., De Bruijn, M., Gerber, V., Keen, J., Lefere, L., Pitel, C.M., Marr, C., Muller, J.M., Pineau, X., Saegerman, C., Sandersen, C., Serteyn, D., Torfs, S., Unger, L., Verwilghen, D. and Votion, D.M. (2010) European outbreak of atypical myopathy in the autumn 2009. J. Vet. Emerg. Crit. Care (San Antonio) 20, 528–532.
van Galen, G., Marcillaud Pitel, C., Saegerman, C., Patarin, F., Amory, H., Baily, J.D., Cassart, D., Gerber, V., Hahn, C., Harris, P., Keen, J.A., Kirschvink, N., Lefere, L., McGorum, B., Muller, J.M., Picavet, M.T., Piercy, R.J., Roscher, K., Serteyn, D., Unger, L., van der Kolk, J.H., van Loon, G., Verwilghen, D., Westermann, C.M. and Votion, D.M. (2012) European outbreaks of atypical myopathy in grazing equids (2006–2009): spatiotemporal distribution, history and clinical features. Equine Vet. J. 44, 614–620.
Votion, D.M., Linden, A., Delguste, C., Amory, H., Thiry, E., Engels, P., van Galen, G., Navet, R., Sluse, F., Serteyn, D. and Saegerman, C. (2009) Atypical myopathy in grazing horses: a first exploratory data analysis. Vet. J. 180, 77–87.
Bowen, J.N. and Craig, J.F. (1942) Myoglobinuria in horses. Vet. Rec. 54, 354–355.
University of Liege, B. (2016). Available at: http://labos.ulg.ac.be/myopathie-atypique, Atypical myopathy alert group (Accessed February 17 2016).
Ceballos y Fernández de Córdoba, L., Ruiz de la Torre, J., Ceballos Jimenez, M. and Ruiz del Castillo y de Navascues, J. (1971) Arboles y arbustos de la España peninsular, Madrid: Instituto forestal de investigaciones y experiencias.
Herrera, C.M., Jordano, P., Guitián, J. and Traveset, A. (1998) Annual variability in seed production by woody plants and the masting concept: reassessment of principles and relationship to pollination and seed dispersal. The University of Chicago Press, Chicago, IL. p 576.
van Galen, G., Saegerman, C., Marcillaud Pitel, C., Patarin, F., Amory, H., Baily, J.D., Cassart, D., Gerber, V., Hahn, C., Harris, P., Keen, J.A., Kirschvink, N., Lefere, L., McGorum, B., Muller, J.M., Picavet, M.T., Piercy, R.J., Roscher, K., Serteyn, D., Unger, L., van der Kolk, J.H., van Loon, G., Verwilghen, D., Westermann, C.M. and Votion, D.M. (2012) European outbreaks of atypical myopathy in grazing horses (2006-2009): determination of indicators for risk and prognostic factors. Equine Vet. J. 44, 621–625.
Finno, C.J. and Spier, S.J. (2008) Prevention and treatment of equine atypical myopathy – an acute, highly fatal disease of unknown etiology. Vet. J. 178, 163–164.
Network, N.B. (2016). Available at: https://data.nbn.org.uk/Taxa/NBNSYS0000003191/Grid_Map (Accessed February 11 2016).
Boden, L.A., Parkin, T.D., Yates, J., Mellor, D. and Kao, R.R. (2012) Summary of current knowledge of the size and spatial distribution of the horse population within Great Britain. BMC Vet. Res. 8, 43.
Brandt, K., Hinrichs, U., Glitz, F., Landes, E., Schulze, C., Deegen, E., Pohlenz, J. and Coenen, M. (1997) Atypische Myoglobinurie der Weidepferde. Pferdeheilkunde 13, 27–34.
Votion, D.M., Linden, A., Saegerman, C., Engels, P., Erpicum, M., Thiry, E., Delguste, C., Rouxhet, S., Demoulin, V., Navet, R., Sluse, F., Serteyn, D., van Galen, G. and Amory, H. (2007) History and clinical features of atypical myopathy in horses in Belgium (2000–2005). J. Vet. Intern. Med. 21, 1380–1391.
Sponseller, B.T., Valberg, S.J., Schultz, N.E., Bedford, H., Wong, D.M., Kersh, K. and Shelton, G.D. (2012) Equine multiple acyl-CoA dehydrogenase deficiency (MADD) associated with seasonal pasture myopathy in the midwestern United States. J. Vet. Intern. Med. 26, 1012–1018.
Westermann, C.M., Dorland, L., Votion, D.M., de Sain-van der Velden, M.G., Wijnberg, I.D., Wanders, R.J., Spliet, W.G., Testerink, N., Berger, R., Ruiter, J.P. and van der Kolk, J.H. (2008) Acquired multiple acyl-CoA dehydrogenase deficiency in 10 horses with atypical myopathy. Neuromuscul. Disord. 18, 355–364.
Olpin, S.E. (2013) Pathophysiology of fatty acid oxidation disorders and resultant phenotypic variability. J. Inherit. Metab. Dis. 36, 645–658.
Souvannanorath, S., Hatem, S., Becquemin, M., Zraik, N., Bittar, R., Rigal, O., Carlier, R., Carlier, P. and Laforêt, P. (2015) Exploration of muscle metabolism during exercise and muscle imaging in late-onset form of multiple acyl-coA dehydrogenase deficiency (MADD). Neuromuscl. Disord. 25, S203.
Haller, R.G., Wyrick, P., Taivassalo, T. and Vissing, J. (2006) Aerobic conditioning: an effective therapy in McArdle's disease. Ann. Neurol. 59, 922–928.
Saltin, B. and Gollnick, P.D. (2010) Skeletal muscle adaptability: significance for metabolism and performance. In: Comprehensive Physiology, American Physiology Society, John Wiley & Sons, Inc, MD.
Henriques, B.J., Olsen, R.K., Bross, P. and Gomes, C.M. (2010) Emerging roles for riboflavin in functional rescue of mitochondrial beta-oxidation flavoenzymes. Curr. Med. Chem. 17, 3842–3854.
Hoppel, C., DiMarco, J.P. and Tandler, B. (1979) Riboflavin and rat hepatic cell structure and function. Mitochondrial oxidative metabolism in deficiency states. J. Biol. Chem. 254, 4164–4170.
Karlikova, R., Siroka, J., Jahn, P., Friedecky, D., Gardlo, A., Janeckova, H., Hrdinova, F., Drabkova, Z. and Adam, T. (2016) Equine atypical myopathy: a metabolic study. Vet. J. 216, 125–132.
Lieu, Y.K., Hsu, B.Y., Price, W.A., Corkey, B.E. and Stanley, C.A. (1997) Carnitine effects on coenzyme A profiles in rat liver with hypoglycin inhibition of multiple dehydrogenases. Am. J. Physiol. 272, E359–E366.
Marley, J. and Sherratt, H.S. (1973) The apparent failure of L-carnitine to prevent the hypoglycaemia and hypothermia caused by hypoglycin or by pent-4-enoic acid in mice. Biochem. Pharmacol. 22, 281–284.
Lemieux, H., Boemer, F., van Galen, G., Serteyn, D., Amory, H., Baise, E., Cassart, D., van Loon, G., Marcillaud-Pitel, C. and Votion, D.M. (2016) Mitochondrial function is altered in horse atypical myopathy. Mitochondrion 30, 35–41.
Roe, C.R., Millington, D.S., Maltby, D.A., Bohan, T.P. and Hoppel, C.L. (1984) L-carnitine enhances excretion of propionyl coenzyme A as propionylcarnitine in propionic acidemia. J. Clin. Invest. 73, 1785–1788.
Stumpf, D.A., Parker, W.D. Jr and Angelini, C. (1985) Carnitine deficiency, organic acidemias, and Reye's syndrome. Neurology 35, 1041–1045.
Von, H., Chang, J., Von, H. and Boehm, H. (1964) Metabolism and metabolic effects of hypoglycin. Biochim. Biophys. Acta 90, 611–613.
Stanley, H., Sherratt, A. and Osmundsen, H. (1976) On the mechanisms of some pharmacological actions of the hypoglycaemic toxins hypoglycin and pent-4-enoic acid. A way out of the present confusion. Biochem. Pharmacol. 25, 743–750.
Wenz, A., Thorpe, C. and Ghisla, S. (1981) Inactivation of general acyl-CoA dehydrogenase from pig kidney by a metabolite of hypoglycin A. J. Biol. Chem. 256, 9809–9812.