Sulfur-Associated Polioenephalomalacia Flashcards

1
Q

What is Polioencephalomalacia?

A
  • Term used in 2 ways:
    • Brain lesion lacking etiological specificity
    • Neurologic disease syndrome traditionally blamed on disturbed thiamine status
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2
Q

What are the etiologies for the characteristic brain lesion in PEM?

A
  • Salt poisoning / water deprivation
  • Lead poisoning
  • Sulfur intoxication/thiamine deficiency
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3
Q

How does Sulfur/Sulfate cause toxicity?

A
  • Sulfur/sulfate converted to sulfide by rumen and cecum microbes
  • Hypothesized that sulfide:
    • blocks neuronal energy metabolism
    • interferes with cerebrum blood flow
    • generates reactive oxygen species
  • Induces PEM
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4
Q

What are the signs of Sulfur poisoning?

A
  • Weight loss
  • rotten egg smell on breath
  • diarrhea
  • rumen stasis
  • dehydration
  • tachycardia
  • lethargy
  • apparent blindness
  • head pressing
  • ataxia
  • recumbency
  • convulsions
  • death
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5
Q

What clinical pathology can sulfur toxicity cause?

A
  • Metabolic acidosis
  • Hypokalemia
  • hypochloremia
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6
Q

What are the clinical signs of PEM

A
  • Mild blindness to grand mal seizures and death
  • Head pressing
  • muscle tremors
  • hypersalivation
  • convulsions may be sporadic
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7
Q

What is the treatment for PEM?

A
  • Thiamine injection - nonspecific for neuronal injury
  • No effective treatment for cerebral necrosis
  • Remove suspected sulfur sources
  • Corticosteroids, oral fluids, good nutrition may reduce incidence of further cases
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8
Q

What does the brain of sulfur-associated PEM look like postmortem?

A
  • Swelling, flattening, and shortening of cerebral gyri
  • focal malacia or cavitation in the midbrain/thalamus
    • may fluoresce under UV light - especially if fixed in formalin
  • Rarely: cerebral herniation into the foramen magnum
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9
Q

How is Sulfur-associate PEM diagnosed?

A
  • Response to treatment
  • Total dietary S consumption - >0.4%
  • Hydrogen sulfide in the rumen contents > 10,000 ppm
  • Histological confirmation of PEM changes in brain tissue
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