Idiopathic peripheral neuropathy in a horse with knuckling

We report the pathological findings of the skeletal muscle and peripheral nerves from a male 14-months-old thoroughbred horse showing idiopathic knuckling. The affected animal, when in staining position, presented knuckling at the fetlock joint of both forelegs, and dragged both fore- and hindlegs when attempting forward movement. The skeletal muscles demonstrated neurogenic atrophy characterized by the scattering of single angular fibers, groups consisting of five to ten angular fibers, and multiple fascicles of atrophic and hypertrophic fibers. The severity of changes tended to be a distal gradient. While there was no evidence of fiber loss on light microscopy, a diffuse scattering of myelin ovoid, Wallerian-like degeneration and onion-bulb formations were observed in almost all peripheral nerves collected. The characteristic features in electron microscope were swollen axons, which contained accumulations of organelles, especially degenerative mitochondria and neurofilamanets. Onion-bulb formations were frequently found and were associated with Schwann cell processes and occasional collagen pockets. Other prominent feature were Büngner bands which contained myelin debris and regenerating axons or sprouts. These findings suggested that the nature of this disease was a disturbance in axonal transport and were indicative of a distal axonopathy.