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Exam 2
Equine Muscle Disorder
62
Veterinary Medicine
Professional
10/18/2016

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Cards

Term
What is HYPP?
Definition
-Hyperkalemic Periodic Paralysis
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
Term
What are the clinical signs seen during episodes of HYPP?
Definition
-brief myotonic period
-sweating
-third eyelid prolapse
-muscle fasciculations
-airway collapse
-recumbency 15 mins to hours to death
Term
How do we treat hyperkalemic periodic paralysis?
Definition
-document with serum electrolyte panel
-Dextrose, Calcium, or bicarbonate infusion
-management with diet and acetazolamide
Term
What is the physiology of muscle sodium channel? How do you genetically test for it?
Definition
-leads to outflow of potassium and hyperkalemia during episodes
-mane hair collected for testing (AQHA)
Term
Are Clostridium spp gram pos or neg? Shape?
Definition
-gram po
-spore-forming rod
Term
Describe the environment of Clostridium spp.
Definition
-anaerobic
-soil
-GI tract
Term
What is the most common Clostridial species?
Definition
-C. perfringens
Term
What are the clinical signs of Clostridial myonecrosis?
Definition
rapidly progressive necrosis of muscle
-muscle pain
-swelling
-fever
-lethargy
-systemic inflammatory response
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
Term
What is the prognosis for Clostridial myositis in the horse?
Definition
-guarded unless aggressive treatment is instituted early
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
Term
What clinical situation lead to Strep equi myopathy?
Definition
-after exposure or vaccination
-may be history of overt resp disease
-QH and Paints
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
Term
When does infarctive Strep equi myopathy develop?
Definition
-during the acute phase of respiratory infection (within 1 week of overt clinical signs)
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
-high mortality rate
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
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
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
-QH, dragts
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
-2-5 year olds
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
-CK and ASt elevated
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
-2 weeks
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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