myopathy

Question 1

What is HYPP?

Answer 1

autocomal dominant defect in Na channels leading to persistent depolarization (IMPRESSIVE)

Question 2

What are the clinical signs of HYPP?

Answer 2

Asymptomatic
Brief myotonia
3rd eyelid prolapse

Weakness/ Staggering/ Dog sitting/ Recumbence

Dysphagia
Resp. distress

Question 3

What do you see on CBC indicating HYPP?

Answer 3

increase K, +/- mild Na
hemoconcentration

no change in CK!!

Question 4

How do you treat HYPP?

How do you prevent it from happening again?

Answer 4

acetazolamide (insulin stimulation), hydrochlorothiazide

decrease K intake (avoid Alfalfa, soybean, sugar, beet molasses) + increase K loss
high water content
regular exercise

Question 5

What CS do you see with C. myositis?

Answer 5

Fever (systemic toxemia), Dyspnea, Death/coma

(RAT) Recumbence, Ataxia, Tremors

RAPID clinical course

Question 6

How do you DX C. myositis?

Answer 6

Aspirates –

• direct smear
• fluro. Ab test
• anaerobic culture

Question 7

How do you TX C. myositis?

Answer 7

Penicillin
PO metro.
Analgesia
fasiculotomy

Question 8

What cs do you see with S. equi?

Answer 8

Submandibular lymphadenopathy; +/- guttural pouch emphyema (NASAL discharge)

Stiff gait

Firm, swollen, painful epaxial & gluteal muscles

Question 9

What is increased in chem profile with S. equi infections?

Answer 9

neut, fibrinogen-emia, CK, AST

Question 10

how do you tx S. equi infections?

Answer 10

“FANS”

Flush pouches
Analgesia (lidocaine, ket, detomidine CRI)
NAIDS
sling

Question 11

what are risk factors for post-anesthetic myopathy?

Answer 11

MH, PSSM, RER

Question 12

How do you prevent post-anesthetic myopathy?

Answer 12

AVOID with light plane of anesthesia, adequate BP, padding/limb placement

Question 13

How do you treat post-anesthetic myopathy?

Answer 13

“NEVER SAY (NSAIDS), water (fluids), prevents (prevent necrosis), Nurses (Nursing care) from dancing (Dantrolene)

NSAIDS
Fluids 
Prevent further necrosis
Nursing care (bandage)
dentrolene

Question 14

when do you see sporadic ER?

Answer 14

15-20 mins after LIGHT exercise

Question 15

What are the CS related to sporadic ER? What do you see in relation to enzyme changes?

Answer 15

MRSS (MYOGLOBINURIA, High RR after exercise, Stiff gait, sweating [excessive])

increased CK, +/- AST

serum cortisol LOWER than with RER

nonspecific histopath; can do bx if unmanageable

Question 16

how do you tx sporadic ER?

Answer 16

Anti-infl.
sedative/tranq.
fluids
muscle relax (methocarbamol)
nutrition ( low NSC, high forage, Adequate Se/vit E)
STALL rest!

Question 17

how do you tx RER?

Answer 17

decrease STRESS = tranq.
EXERCISE = Consecutive submax. exercise (ace before)
DIET = Low carb diet/starch, high fat diet; Vit/minerals KEY
DRUGS = Progesterone inj., Dantrolene, reserpine, fluphenizine, phenoitin

Question 18

What are the risk factors for RER?

Answer 18

YOUNG female thoroughbred

Question 19

Who is known to get PSSM? what do they look like?

Answer 19

“easy keepers”

THEY get FAT!!

Question 20

whats the deal with Polysaccharide myopathy?

Answer 20

can’t generate enough Acetyl co A :-(

have 2x muscle glycogen concentrations

Question 21

What are the CS related to PSSM?

Answer 21

Acute=
Tucking abdomen
Flank fasciculation’s
Stiff muscles
Painful (<2hrs)
Reluctant to move
~10% recumbent

chronic=
poor performance
reluctant to move
stop & stretch
chronic back/lumbar pain

Question 22

How do we DZX PSSM?

Answer 22

exercise test: >5x CK (norm>3)

ck > 35,000

Question 23

How do we tx PSSM?

Answer 23

Limit stall confinement to <24 hr after episode

Low starch, high fat (supplement)

Regular exercise

Sweet feed, furosemide, stress, gastric ulcers