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Secondary hypoparathyroidism in horses is secondary to... (2)
sepsis (critically ill patients), hypomagnesemia
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Secondary hyperparathyroidism in horses is secondary to... (2)
renal failure, nutritional
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What are the hallmarks of hypoparathyroidism in horses? (3)
low calcium, low PTH, increased phosphorous
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Clinical signs of hypoparthyroidism in horses. (6)
muscle fasciculations, seizures, ataxia, arrhythmias, ileus, colic [ALL SIGNS OF HYPOCALCEMIA IN GENERAL]
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In horses, primary hypoparathyroidism is __________.
idiopathic
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Ca2+ blocks _______ from getting into the cells; therefore, blocking __________.
Na+; depolarization
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Clinical signs of hypocalcemia are related to _______________, thus increased ___________.
increased Na+ entering cells; depolarization
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Striated muscle contraction depends on...
how much Ca2+ is inside the cells.
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Smooth muscle contraction depends on...
how much Ca2+ is outside the cells (extracellular).
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Synchronous diaphragmatic flutter in horses is caused by...
hypocalcemia (hypoparathyroidism) and often with concurrent low Mg2+
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Synchronous diaphragmatic flutter occurs because the ________ nerve is in a low ______ environment and is easier to _________.
phrenic; Ca2+; depolarize (every time the heart contracts, the depolarization spreads from the SA node to the phrenic nerve)
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RFM occurs with _________ because the uterus is a _________, which requires _______ to contract.
hypocalcemia; smooth muscle; Ca2+
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Why do sick horses develop hypocalcemia?
inflammatory cytokines impair the function of the parathyroid gland--> low PTH
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Binding of Ca2+ to albumin is ____-dependent.
pH
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With acidosis, Ca2+ is not _________ in as high proportions as normal; therefore, metabolic acidosis may lead to __________ on bloodwork.
bound to albumin; hyperCa2+
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Metabolic aklalosis is associated with _________ because...
hypocalcemia; increased binding of Ca2+ and Mg2+ to albumin, decreasing their free plasma concs.
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Prolonged exercises causes _________ [acid-bse status].
alkalosis
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Why do horses under severe exercise develop alkalosis?
hyperventilation--> respiratory alkalosis; chloride loss in sweat--> replace with bicarb
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In acute renal injury/tubular necrosis, there is decreased renal __________; thus, increasing urinary __________ and contributing to the development of _________.
Ca2+ reabsorption; excretion; hypocalcemia
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In duodenitis-proximal jejunitis (DPJ), horses develop _________ because...
hypocalcemia; horse is refluxing stomach contents, losing Cl---> replaced with bicarb--> alkalosis--> hypocalcemia
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Thyroid gland pathologies in horses are usually __________.
aesthetic (don't cause clinical disease)
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Clinical signs of hyperCa2+ in horses. (6)
depend on primary problem: neurologic, muscular, GI, depression, decreased GI motility, PU/PD [NON-SPECIFIC]
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How does hyperCa2+ causes PU/PD?
Ca2+ decreases affect of ADH, decreases H2O reabsorption--> diuresis
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Common cause of secondary hypercalcemia in horses.
CKD
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Cause of primary hyperparathyroidism in horses.
function chief cell adenoma--> autonomous secretion of PTH
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Lab findings associated with primary hyperparathyroidism in horses. (3)
hyperCa2+, hypophosphatemia, high PTH
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Secondary hyperparathyroidism in horses due to renal disease is accompanied by... (2)
hyperphosphatemia, hypovitaminosis D.
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Secondary hyperparathyroidism in horses due to nutrition is caused by... (2)
excess phosphate/oxalates in diet, low Ca2+ diet
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Clinically, what do you see with nutritional secondary hyperparathyroidism in horses? (3)
osteodystrophia fibrosa, osteitis fibrosa, equine osteoporosis
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Hypocalcemia and/or hyperphosphatemia induce parathyroid _________ and ____________.
hyperplasia; increased PTH secretion
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Excess of phosphates/oxalates in the diet bind ________, causing an increase in __(3)__.
Ca2+; PTH, bone resorption, and bone loss
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Vit D increased ____________ and __________ of __(2)__.
intestinal absorption; renal reabsorption; Ca2+ and Ph
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Vit D increases _______ formation.
new bone
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Vit D inhibits _________; therefore, low vit D leads to ___________.
PTH secretion; hyperparathyroidism
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Hypervitaminosis D in horses is usually caused by... (2)
iatrogenic, toxic plants
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Clinical signs of hypervitaminosis D in horses. (3)
weight loss, soft tissue mineralization, organ failure
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Lab findings in horses with hypervitaminosis D. (4)
increased Ca2+, increased Ph, low PTH,+/- evidence of organ failure
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Treatment and prognosis for horses with hypervitaminosis D. (2)
palliative, cortisol [POOR PROGNOSIS]
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Hypercalcemia of malignancy in horses is seen with... (4)
lymphosarcoma, SCC, ameloblastoma, multiple myeloma
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Lab findings in horses with hypercalcemia of malignancy. (4)
hypercalcemia, hypoposphatemia, high PTHrP, low PTH
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Hypercalcemia of malignancy is often accompanied by _________ on radiograph.
bone loss
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Treatment and prognosis for hypercalcemia of malignancy in horses. (3)
palliative, chemotherapy, sx [PROGNOSIS IS GRAVE]
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Why do horses with CKD, unlike other species, develop hypercalcemia?
calcium retention due to high GI absorption and renal excretion of Ca2+ (renal excretion reduced in CKD, obvi)
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