Monensin, lasalocid, salinomycin, maduramicin, and narasin may cause myopathy. Horses are highly susceptible, and toxicity has also been reported in cattle, sheep, pigs, dogs, chickens, turkeys, and guinea fowl. Toxicity generally results from exposure to undiluted premixes or from mixing errors. Toxicosis may be potentiated by various antibiotics and sulfonamides incorporated into feeds in combination with ionophores. Affected horses and cattle may develop anorexia, cardiac failure with tachycardia, dyspnea, diarrhea, stiffness, muscular weakness, recumbency, and myoglobinuria. At necropsy, pale areas of myocardial necrosis and pulmonary congestion are usually prominent in horses and cattle. Pigs and sheep tend to have mainly skeletal muscle lesions that appear quite similar grossly and histologically to those of nutritional myopathy. Diagnosis requires history of exposure with development of characteristic clinical and pathologic alterations.