Pedigree studies from Thoroughbreds with RER suggest this may be inherited as a dominant trait. Prevention of further episodes of RER in susceptible horses should include standardized daily routines and an environment that minimizes stress. The diet should be adjusted to include a balanced vitamin and mineral supplement, high quality hay and a minimum of carbohydrates such as grain and sweet feed. Dietary fat supplements may help to maintain weight in nervous fillies without providing excessive carbohydrates. The use of low doses of acepromazine before exercise in excitable horses is believed to help some horses.
Daily exercise is essential, whether in the form of turn-out, longing or riding.
It is the authors opinion that this is counterproductive and increases the likelihood that the horses will develop RER when put back into training. The initial muscle pain usually subsides within 24 hours of acute RER and daily turn-out in a small paddock can be provided at this time. Subsequently, a gradual return to performance is recommended once serum CK is within normal range. Dantrolene is used to prevent malignant hyperthermia in humans and swine by decreasing the release of calcium from the calcium release channel. Phenytoin acts on a number of ion channels within muscle and nerves including sodium and calcium channels.