Term
|
Definition
| -Hyperkalemic Periodic Paralysis |
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Term
| What is the most common presentation of HYPP? |
|
Definition
-2-5 year old QH
-can present in foals with airway obstruction or primary muscle signs
-heavy muscled
-descendants of Impressive |
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Term
| What are the clinical signs seen during episodes of HYPP? |
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Definition
-brief myotonic period
-sweating
-third eyelid prolapse
-muscle fasciculations
-airway collapse
-recumbency 15 mins to hours to death |
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Term
| How do we treat hyperkalemic periodic paralysis? |
|
Definition
-document with serum electrolyte panel
-Dextrose, Calcium, or bicarbonate infusion
-management with diet and acetazolamide |
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Term
| What is the physiology of muscle sodium channel? How do you genetically test for it? |
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Definition
-leads to outflow of potassium and hyperkalemia during episodes
-mane hair collected for testing (AQHA) |
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Term
| Are Clostridium spp gram pos or neg? Shape? |
|
Definition
-gram po
-spore-forming rod |
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Term
| Describe the environment of Clostridium spp. |
|
Definition
-anaerobic
-soil
-GI tract |
|
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Term
| What is the most common Clostridial species? |
|
Definition
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Term
| What are the clinical signs of Clostridial myonecrosis? |
|
Definition
rapidly progressive necrosis of muscle
-muscle pain
-swelling
-fever
-lethargy
-systemic inflammatory response |
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Term
| What are the other names for Clostridial myonecrosis? |
|
Definition
-Clostridial myositis
-Clostridial Cellulitis
-Malignant edema |
|
|
Term
| Describe the enteric mode of Clostridial infection. |
|
Definition
-absorption of spores from GI tract
-muscle latency
-anaerobic environment
-spre vegetation
-toxin production |
|
|
Term
| What is the most common IM injection that leads to Clostridial infections? |
|
Definition
| -Flunixin meglumine = Banamine |
|
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Term
| What is the prognosis for Clostridial myositis in the horse? |
|
Definition
| -guarded unless aggressive treatment is instituted early |
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Term
| How do we treat Clostridial myositis in the horse? |
|
Definition
-muscle fasciotomy
-systemic antimicrobials
-NSAIDs
-supportive care
-wound care |
|
|
Term
| What are the two types of Strep equi myopathies in the horse? |
|
Definition
-Infarctive (IgA): acute rhabdomyolysis
-IgG immune-mediated: progressive muscle atrophy |
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|
Term
| What clinical situation lead to Strep equi myopathy? |
|
Definition
-after exposure or vaccination
-may be history of overt resp disease
-QH and Paints |
|
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Term
| Describe Strep equi myopathy in QH and Paints. |
|
Definition
-M protein in Streptococcal cell wall has amino acid sequences similar to myosin
-can result in acute death
-muscle atrophy may be slow or rapid
-inc muscle enzymes: CK and AST |
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|
Term
| When does infarctive Strep equi myopathy develop? |
|
Definition
| -during the acute phase of respiratory infection (within 1 week of overt clinical signs) |
|
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Term
| What are the clinical signs of infarctive Strep equi myopathy? |
|
Definition
-extremely painful
-may be recumbent
-stiff gait |
|
|
Term
| What is the mortality rate of infarctive Strep equi in the horse? |
|
Definition
|
|
Term
| What will we see on Chem/CBC with severe acute rhabdomyolysis due to Strep equi? |
|
Definition
| -elevated WBC, fibrinogen, marked inc in CK, AST |
|
|
Term
| What are the electrolyte derangements do we see with severe acute rhabdomyolisys due to Strep equi? |
|
Definition
| -sodium, chloride, potassium |
|
|
Term
| What do we see on muscle histopath wiht severe actue rhabdomyolysis due to Strep equi? |
|
Definition
| -severe acute myonecrosis with macrophage infiltrate |
|
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Term
| What do we see on Chem/CBC of infartive myopathy due to Strep equi? |
|
Definition
| -leukocytosis, hyperfibrinogenemia, hypoproteinemia and extreme elevations of CK and AST |
|
|
Term
| What is the other name for infarctive myopathy due to Strep equi? |
|
Definition
-IgA myopathy
-rhabdomyolysis secondary to vascular infarction and immune mediated vasculitis |
|
|
Term
| What are the clinical signs of infarctive myopathy? |
|
Definition
-severe depression
-muscle pain
-stiff gait
-thrombosis
-hemorrhage
-colic |
|
|
Term
| What are some of the sequelae of infarctive myopathy? |
|
Definition
-flocculent serosanguinous fluid over major muscle groups
-signs are rapidly progressive over first 24 hours |
|
|
Term
| How do we treat infarctive myopathy? |
|
Definition
| -aggressive support and long term corticosteroids |
|
|
Term
| How do we definitively diagnose infarctive myopathy? |
|
Definition
| -acute coagulative necrosis with infarctions |
|
|
Term
| What are the signs of chronic stress in the horse on CC? |
|
Definition
-neutrophilia
-hyperfibrinogenemia
-mild anemia of chronic dz
-hypergammaglobulinemia |
|
|
Term
| What are the clinical signs with IgG myopathy? |
|
Definition
-bright, laert, normal appetite
-muscle stiffness, lameness
-rapid onset and progression of muscle wasting and atrophy: epaxial and gluteal muscles |
|
|
Term
| What What do we see on CBC with IgG myopathy? |
|
Definition
| -moderately elevated CPK and AST |
|
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Term
| What is the pathology of IgG myopathy? |
|
Definition
| -cross reactivity b/n SeM and myosin |
|
|
Term
| How do we diagnose IgG myopathy? What do we see? |
|
Definition
-muscle biopsy
-chronic active rhabdomyolysis with regeneration, atrophy of fast twitch fibers, lymphocytic vasculitis |
|
|
Term
| How do we treat immune-mediated myopathy? |
|
Definition
-corticosteroids: induces laminitis
-antimicrobials
-supportive care |
|
|
Term
| What are the mechanisms of muscle injury in the horse? |
|
Definition
-trauma
-ischemia
-exercise
-metabolic
-overwork for level of fitness
-abrupt change in footing
-exhaustion |
|
|
Term
| What is the pathology behind rhabdomyolysis? |
|
Definition
-damage to sarcoplasmic membrane
-failure of energy metabolism
-rise in intracellular calcium = disruption of mitochondrial respiration |
|
|
Term
| What proteases are released during rhabdomyolysis? |
|
Definition
-myofibrillar
-cytoskeletal
-membrane |
|
|
Term
| What are released during rhabdomyolys that we will see on CBC/Chem? |
|
Definition
-myoglobin
-creatine kinase
-LDH
-AST
-potassium urea |
|
|
Term
| What factor is myocyte regeneration dependent after rhabdomyolysis? |
|
Definition
| -basement membrane viability |
|
|
Term
| What are the three common metabolic myopathies seen in horses? |
|
Definition
-plysaccharide storage myopathy
-glycogen branching enzyme deficiency
-recurrent exertional rhabdomyolysis |
|
|
Term
| Which horse breeds are predisposed to Polysaccharide Storage Myopathy? |
|
Definition
|
|
Term
| What is the pathology behind polysaccharide storage myopathy? |
|
Definition
| -glucose transport disorder suspected |
|
|
Term
| Which muscles are affected by polysaccharide storage myopathy? |
|
Definition
| -muscles of hindlimbs and lower back |
|
|
Term
| Which age of horse is affected by polysaccharide storage myopathy? |
|
Definition
|
|
Term
| What are the only 4 horse breeds that are not affected by PSSM? |
|
Definition
-Clydesdale
-Thoroughbred
-Connemara
-Hanoverian |
|
|
Term
| What are the clinical signs of PSSM in foals? |
|
Definition
-recumbent
-generalized muscle stiffness
-hyperextension
-gluteal, semimembranosus, semitendinosus, epaxial, quads, triceps
-mucus membrane hyperemia
-dehydration
-tachycardia
-tachypnea
-concurrent pneumonia
-concurent arrhythmias |
|
|
Term
| What do we see on Chem/UA of PSSM? |
|
Definition
-hyponatremia
-hyperkalemia
-hypochloremia
-hypocalcemia
-hyperphosphatemia
-proteinuria, hematuria, hyphosthenuria |
|
|
Term
| What changes if any occur with muscle enzymes in foals with PSSM? |
|
Definition
|
|
Term
| When do we see PSSM in adult horses? |
|
Definition
-intensity change
-after rest
-often short period of exercise causes episode
-multiple recurrent episodes
-once to twice a year |
|
|
Term
| What are the clinical signs of PSSM in adult horses? |
|
Definition
-less willing to work
-stiff gait (Easier to see at walk)
-pain/anxiety
-muscle trembling
-sweating
-reluctance to move
-lameness
-sweating
-tachycardia
-reluctance to move
-firm swollen muscles
-msucle atrophy
-inc CK
dark urine
-muscle atrophy
-inc muscle enzymes |
|
|
Term
| Describe glucose metabolism in adult horses with PSSM. |
|
Definition
-ehnanced tissue uptake
-inc insulin sensitivity
-lower fasting blood glucose
-inc muscle glucose
-inc glucose 6-P
-high glycogen synthase
-slows ATP generation
-abnormal polysaccharide
-higher muscle glycogen concentration
-GSY-1 activity increased |
|
|
Term
| What kind of genetic mutation is Recurrent Exertional Rhabdomyolysis (RER)? |
|
Definition
-autosomal dominant
-defect in calcium metabolism |
|
|
Term
| What breeds of horse are predisposed to RER? |
|
Definition
| -Arabians adn STandardbreds |
|
|
Term
| Which areas of the body are most often affected by RER? |
|
Definition
| -hindlimbs and lumbar region |
|
|
Term
| What causes over-exertion myopathy? |
|
Definition
| -RIDER ERROR: exercised beyond current level of fitness |
|
|
Term
| What are some complicating factors with over-exertion myopathy? |
|
Definition
-electrolyte imbalances: sweat loss, muscle damage, acid vase derangements
0heat exhaustion
-dehydration
-eletrolyte deplretion
-glycogen depletion
-acid base derangements |
|
|
Term
| What are some complications of rhabdomyolysis? |
|
Definition
-recumbency, death
-renal failure
-laminitis
-permanent muscle loss |
|
|
Term
| What are the three mechanism of myoglobinuric renal failure? |
|
Definition
-oxidant injury
-vasoconstriction
-tubular obstruction |
|
|
Term
| Describe the relative enzyme concentrations seen with rhabdomyolysis. |
|
Definition
-higher CK concentrations indicate more severe damage
-AST can remain inc for 2 weeks |
|
|
Term
| HOw long does AST remain increased in the face of rhabdomyolysis? |
|
Definition
|
|
Term
| When do we take pre and post exercise muscle enzymes for muscle rhabdomyolysis? |
|
Definition
-pull serum
-exercise on lung line or round pen for 15 mins
-pull second serum sample 4-6 hours later |
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