Review of exertional rhabdomyolysis and a case in a rhesus monkey (Macaca mulatta)

This is the first confirmed report of exertional rhabdomyolysis in a non-hu man primate. The monkey was singly housed and presented with anorexia and r eluctance to move. There was no external evidence of trauma. Clinicopatholo gic findings included mild azotemia, marked elevation in serum creatine pho sphokinase (CPK), alanine aminotransferase, aspartate aminotransferase, and myoglobinuria. Two days post-incident, the peripheral skeletal muscle had marked multifocal myonecrosis and fibrillar disruption without an inflammat ory reaction. Treatment included diuresis and pain relief, and urinary outp ut was monitored. The monkey recovered over the next two weeks. The major s ignificance of skeletal muscle damage is the potential of released myoglobi n to cause acute renal failure in the presence of other co-factors such as hypovolemia, acidosis, or ischemia. CPK levels can be highly variable and a re inconsistent with the degree of muscle damage; however, CPK is thought t o be the most sensitive enzyme marker for muscle necrosis. Because of the p otential life-threatening sequelae, exertional rhabdomyolysis should be inc luded as a differential diagnosis when similar clinical and pathological si gns are observed.