The disease might lie dormant unless specific factors trigger the calcium regulatory system to malfunction. Triggering events include stress, excitement, lameness, high grain diets, and exercise at submaximal speeds. Young fillies are most commonly affected and usually are the most nervous and high strung. Prevention of further episodes of tying-up in susceptible horses should include standardized daily routines and an environment that minimizes stress and excitement. Feeding less than five pounds of sweet feed and adding additional calories in the form of fat decrease muscle damage with exercise.
Daily exercise is essential, either in the form of turnout, longing, or riding.
This imbalance in sugar storage and accumulated precursors apparently disturb energy metabolism, and affected horses develop muscle cramping with light exercise. Treatment of polysaccharide storage myopathy involves supplying them with an alternative source of energy rather than sugar. Eliminating grain and sweet feed completely and feeding fats such as rice bran stabilizes blood sugar and decreases sugar storage in muscle. It is essential that horses with PSSM be turned out as much as possible and exercised often, even if only for 10 minutes every day. Horses with mild to moderate clinical signs might be able to return to full athletic performance with careful dietary and management changes, which include regular daily exercise without extended periods of inactivity.