PSSM—What Is It, Can It Be Cured?


Horses with this condition need the right diet plus exercise to minimize episodes of tying-up.'


I run a small boarding business. IA new boarder owns a 5-year-old Paint gelding with PSSM, and his diet has to be managed. What exactly is this condition and can he be cured?

KATIE MOORE, California


 Polysaccharide storage myopathy (PSSM), a muscle disease in horses, has two types. Type 1 is found in more than 20 breeds and commonly affects Quarter Horses; Quarter Horse-related breeds, such as Paints and Appaloosas; Morgans; some draft breeds; and some warmbloods. Type 2 is found in Quarter Horses, Arabians, Thoroughbreds, and potentially other light breeds.


PSSM is characterized by the abnormal accumulation in muscle tissue of a normal form of sugar (glycogen) and an abnormal form (polysaccharide). Both Type 1 and Type 2 are related to this accumulation of muscle glycogen, which is the storage form of glucose in muscles . (see box).


Horses with either form of PSSM have signs typically associated with what's commonly called "tying-up": muscle stiffness, sweating, and reluctance to move. These signs most often appear when horses go into initial training or return to work after a lay-up. Episodes usually begin after light exercise, such as 10 to 20 minutes of walking and trotting. Symptoms may also occur without exercise. Most horses with the condition have a history of repeated episodes of muscle stiffness at the commencement of training; however, mildly affected horses may have only one or two episodes per year.


Carbohydrates high in starch—such as sweet feed, corn, wheat, oats, barley, and molasses—appear to worsen both types of PSSM and should be avoided. Provide extra calories in the form of fat, instead. Gradual introduction of exercise is essential, and a daily exercise program enhances glucose use and improves energy metabolism in skeletal muscle. Research shows that when only the diet is changed, only about 50 percent of horses improve. But if both diet and exercise are altered, 90 percent of horses experience no or few subsequent tying-up episodes. Horses with PSSM can't be cured,


THE  BOX  - The Science of PSSM 

Originally, we diagnosed PSSM by the excessive accumulation of the normal form of sugar stored in muscle (glycogen) and an abnormal form of sugar (polysaccharide) evident in muscle biopsy tissues. Thousands of horses have been identified with the tying-up associated with this abnormal accumulation of polysaccharide in muscle. Then different forms of PSSM were identified based on pinpointing a mutation in a gene (GYSI) that codes for the enzyme responsible for making glycogen (glycogen synthase). This genetic form of PSSM, Type 1, is inherited as a dominant trait. We don't know the cause of other forms of PSSM, and they're grouped under the term Type 2 to distinguish them from the known gene mutation in glycogen synthase. Pedigree analysis of Type 2 suggests a familial basis, even though the genetic mutation for this disease has not yet been identified. We have a DNA test for the genetic mutation that causes Type 1, but until we know more about the basic cellular mechanism involved in Type 2, we'll have difficulty identifying the gene with its mutation. Research is ongoing.



but they can be managed through diet and exercise. Severity of symptoms vary widely. Some affected horses are readily managed, but a few persist with repeated episodes of muscle pain. Also, because Type 1 PSSM is inherited as a dominant trait, horses with it have at least a 50-percent chance of passing it on to offspring.

STEPHANIE VALBERG, DVM, PhD, DACVIM

Professor, Large Animal Medicine

University of Minnesota Equine Center

HorseandRider.com

For more, review "Muscle Maladies" at the Web site; see the PSSM Forum on Facebook.

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