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EqMed Q2, Endocrine
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What is big head disease or bran disease?
Cause?
Nutritional 2' Hyperparathyroidism
High Phospherous diet
How does Phosphorous affect vitamin D?
Excess P=
Stimulates parathyroid gland=
Inhibits vit D Synthesis=
Low vit D=
Stimulates parathyroid gland
Expected serum Ca with hyperparathyroidism?
Normal
Dz is slowly progressive
C/S associated with nutritional hyperparathyroidism? 6
Facial bone enlargement
Difficulty chewing dt bone loss
Molar fractures
Spontaneous long bone fractures
Unthrifty
Lameness
Tx for nutritional hyperparathyroidism? 4
Prognosis?
Eliminate grain and oxalates from diet
Supplement Ca (want ratio 3 or 4:1)
NSAIDs +/-
Confinement +/-
Complete recovery may not be possible
Hypothyroidism is a rare condition in horses. What are lab findings that support this diagnosis?
Decreased T4
Increased TRH and TSH
C/S associated with hypothyroidism? 5
Obesity
Anhidrosis (inability to sweat)
Laminitis
Rhabdomyolysis
Infertility
Common thyroid neoplasia?
Benign or malignant?
Adenoma
Benign/nonfunctional
(enlarged and palpable)
Expected T4 with thyroid adenoma?
WNL
Recommended Yx for thyroid adenoma?
Tx unnecessary
Unless compresses trachea/esophagus - then thyroid supplement is warranted
Equine cushings syndrome is AKA?
Pars Pituitary Intermedia Dysfunction
(minimal adrenal involvement in equine cushings)
what is common age and most common sign associated with PPI/Cushings?
Middle aged to older (>15yr)
Hirsutism
Role of dopamine in equine cushings?
Inhibits melanotrope hormone
No Dopamine
⇩
Inc. Melanotrope Horm.
⇩
Hypertrophy/hyperplasia of PPI
Hypertrophy of pars intermedia causes excess release of ____, and therefore...
*increased POMC*
⇩
α-MSH
(melanocyte stim hormone)
β-endorphin
CLIP
(corticotropin like intermediate lobe peptide)
What leads to C/S's associated with cushings?
Enlarged/highly active pars intermedia
*
POMC
*
Compression of adjacent hypothalmic tissues
How does cushings affect immune system?
α-MSH
⇩
Decreases immune response
⇩
Chronic infections & poor wound healing
how does cushings affect physical appearance? how does it affect behavior?
Hirsutism
Coat color change
Guard hairs on chin
Abnormal fat deposition
Docile
Seizures
Blindness
How does cushings affect limbs?
Laxity in suspensory ligament
Chronic laminitis
What is another endocrine disorder 2' to cushings?
Type 2 DM
Dx tests for cushings? 4
Endogenous ACTH
ACTH Stim
Measure for Hyperinsulinemia
TRH stim (directly stimulates melanotropes)
How is dexamethasone suppression test done in the horse?
What is indication of +?
T0 (Baseline cortisol)
T15 Hrs
T20 Hrs (overnight)
+Cushings if fail to suppress cortisol
What is MOA of pergolide as treatment for cushings?
Dopamine antagonist
(side effects include V/D, anorexia)
MOA of Cyproheptadine as Tx for cushings?
Blocks Serotonin
= Interferes with POMC
(expensive and not readily available)
Prognosis for horse with cushings?
Can be managed for years with pergolide and good husbandry/foot care
(most common reason for euthanasia is laminitis complications)
what is cause of laminitis related to endocrinopathy?
Insulin resistance/Hyperinsulinemia
What characterizes equine metabolic syndrome?
Regional adiposity (fat deposition)
Insuline resistance
"easy keepers"
What is signalment of affected horses?
Adult (>5yr)
No sex predilection
Ponies>Morgans>Arabs>Fjords
Dx for metabolic syndrome?
Resting hyperinsulinemia >30 uu/ml defines
Combined Glucose-Insulin test to ck for insulin resistance
How is glucose-insulin test done?
+ Test?
Baseline glucose
IV dextrose + insulin
Elevated BG >45min = insulin resistance
how is metabolic syndrome treated/managed? 6
Wt loss is critical (remove CHO, feed grass hay)
Soak hay to decr. CHO
Grazing muzzle
Exercise/swimming
Manage laminitis
Levothyroxine
what are goals of using levothyroxine to manage metabolic syndrome?
Lower body weight
Improves insulin sensitivity
(Short term only, stop when ideal body weight or <6 mo)
Author
HLW
ID
212926
Card Set
EqMed Q2, Endocrine
Description
EqMed Q2, Endocrine
Updated
2013-04-11T22:48:05Z
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