Signs usually appear in adult horses. Two kinds of attack are on record.
Attacks under anaesthesia:
- Body temperature climbing fast, recorded between 40 and 45 degrees Celsius. In one monitored case it rose about 0.12 degrees every minute.
- A racing heart that loses its rhythm, and high blood pressure
- Heavy sweating. The anaesthetic tubing becomes hot to the touch.
- Muscles locking up: first in one place, such as the ears drawn in or the jaw clamped shut, then all over, with the third eyelid showing and the eye pulled back into the socket
- The blood turning acid, with carbon dioxide building up even though the horse is on a ventilator with pure oxygen
- Blood salts out of balance, thickened blood, high blood sugar, struggling kidneys and muscle breakdown products rising fast
- Death, with the body stiffening unusually quickly afterwards
Attacks with no anaesthetic involved:
- Severe, sudden muscle breakdown with a body temperature recorded between 40.2 and 43.3 degrees Celsius
- Episodes that look like colic, locked muscles, a stiff way of going, tiring quickly, sweating on and off, a fast heart and fast breathing
- Extremely high muscle enzymes on a blood test, and acid blood
- Muscle enzymes that stay raised between attacks, in horses that otherwise look well
- Sudden death, including death out in the field on an unusually hot day
What sets off an attack: every gas anaesthetic of the halogenated family (halothane, isoflurane, desflurane, sevoflurane) and muscle relaxants such as succinylcholine. Also exercise, the stress of transport or a new place, the start of training, the excitement of breeding, extreme heat, and another illness or muscle disease at the same time.
An attack is a veterinary emergency. What is reported to save horses: spotting it early, stopping the anaesthetic gas or muscle relaxant at once, cooling the body actively, and giving dantrolene.
None of these signs is unique to MH. They also happen under anaesthesia and after hard work for other reasons. Your veterinarian makes the diagnosis from the history, the examination, blood results and this genetic result.