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Differential Diagnoses of Equine Myopathies

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Myopathy Type	Differential Diagnoses
*Non-exercise-associated Rhabdomyolysis*
Inflammatory	Clostridial myositis Influenza myositis Sarcocystis myositis Anaplasmosis Immune-mediated myositis
Toxic	Ionophore toxicity Senna occidentalis Rayless goldenrod/white snakeroot Hypoglycin A in box elder and European sycamore trees
Traumatic	Compressive anesthetic myopathy Trauma
Genetic	Glycogen branching enzyme deficiency in Quarter Horse foals Polysaccharide storage myopathy types 1 and 2 Malignant hyperthermia in Quarter Horses Myosin heavy chain myopathy (Quarter Horse-related breeds)
*Exertional Rhabdomyolysis*
Sporadic exertional rhabdomyolysis	Focal muscle strain Overexertion, dietary imbalances, vitamins, minerals, electrolytes
Chronic exertional rhabdomyolysis	Polysaccharide storage myopathy types 1 and 2 Malignant hyperthermia Recurrent exertional rhabdomyolysis Idiopathic chronic exertional rhabdomyolysis
*Exertional Myopathy with Normal CK activity*
Mitochondrial myopathy	Polysaccharide storage myopathy type 2 Myofibrillar myopathy
*Muscle Atrophy*
Myogenic atrophy	Severe rhabdomyolysis Disuse Cushing disease Immune-mediated myositis (rapid atrophy) Vitamin E–responsive myopathy Homozygous polysaccharide storage myopathy type 1 Myofibrillar myopathy
Neurogenic atrophy	Equine protozoal myelitis Local nerve trauma Equine motor neuron disease Idiopathic peripheral neuropathy Toxic peripheral neuropathies
*Muscle Fasciculations*
	Pain, fear Weakness (botulism, chronic debilitation) Electrolyte abnormalities Equine motor neuron disease Vitamin E–responsive myopathy Hyperkalemic periodic paralysis Hypokalemia Otobius megnini (ear tick) infestation Myotonic dystrophy Stiff horse syndrome Shivers