Systemic calcinosis in a Quarter Horse gelding homozygous for a myosin heavy chain 1 mutation

J Vet Intern Med. 2022 Jul;36(4):1543-1549. doi: 10.1111/jvim.16481. Epub 2022 Jul 8.

Abstract

Case description: A 9-year-old Quarter Horse gelding was presented for lethargy, decreased appetite, polyuria and polydipsia (PU/PD), and severe muscle wasting suggestive of immune-mediated myositis.

Clinical findings: The horse displayed lethargy, fever, tachyarrhythmia, inappetence, PU/PD, and severe epaxial and gluteal muscle wasting. Clinicopathologic findings were consistent with previously reported cases of systemic calcinosis in horses, including increased muscle enzyme activity, hyperphosphatemia, increased calcium-phosphorus product, hypoproteinemia, and an inflammatory leukogram. A diagnosis of systemic calcinosis was established by histopathologic evaluation of biopsy specimens from skeletal muscle, lung, and kidney.

Treatment and outcome: Symptomatic treatment was complemented by IV treatment with sodium thiosulfate to reverse calcium-phosphate precipitation in soft tissue and PO aluminum hydroxide to decrease intestinal phosphorus absorption and serum phosphorus concentration.

Clinical relevance: This is the first report in the veterinary literature of an antemortem diagnosis of systemic calcinosis in the horse that was successfully treated and had favorable long-term outcome.

Keywords: calcium-phosphorus product; immune mediated myositis; polydipsia; polyuria; sodium thiosulfate.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Calcinosis* / drug therapy
  • Calcinosis* / veterinary
  • Calcium
  • Horse Diseases* / diagnosis
  • Horse Diseases* / drug therapy
  • Horse Diseases* / pathology
  • Horses
  • Lethargy / veterinary
  • Male
  • Muscular Diseases* / veterinary
  • Mutation
  • Myosin Heavy Chains
  • Phosphorus

Substances

  • Phosphorus
  • Myosin Heavy Chains
  • Calcium