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Flashcards in Nutritional bone disease Deck (22)
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1

Presentation - bone disease

- young (can be adult)
- deviation of limbs, poor posture, weakness
- axial skeleton as well as appendicular
- dietary problems
- comparison with littermates
- pathological fractures
- generalised disease

2

Actions - PTH

- increase Ca absorption
- decrease Ca excretion
- both increase plasma calcium

3

Outline secondary nutritional hyperparathyroidsim

- low dietary Ca drives:
- high PTH levels
- serum Ca often protected
- bones are malformed or poorly formed
- usually young growing animal (v. unusual for dietary Ca to be low in adults)

4

Define pathological fracture

when an underlying problem in bone precipitates a fracture which wouldn't otherwise occur

5

Outline vitamin D deficiency

- v rare in animals
- juvenile --> rickets
- adults --> osteopaenia

6

Outline secondary renal hyperparathyroidism

- Chronic renal failure (adult normally)
- decreased vitamin D activation (kidney)
- lowered phosphate excretion (phosphate binds to Ca, serum Ca is lowered)
- increased PTH drive and effects on bones
- mandible is classic place to see this

7

What animals does secondary nutritional hyperparathyroidism affect?

most domestic dogs/cats are fed well balanced commercial food, usually a problem for inexperienced exotics owners

8

What is metabolic bone disease (MBD) of reptiles and chelonians?

- called 'metabolic' but aetiology unknwon
- green iguanas
- low dietary availability of Ca
- decreased activation or availability of vitamin D3

9

MBD - hx

* lethargy
- inability to lift trunk/tail
- pliant mandible
- abnormal posture
- wt loss/ decreased appetite
- check diet
- male/female going to lay eggs

10

Clinical exam - MBD

- activity
- movement/ lamaness
- joint/limb swelling
- mm tone and atrophy

11

Radiography - MBD

- joints, limbs and spine
- egg binding
- spontaneous fractures

12

Where to take a blood sample -reptiles

tail vein (look for low Ca in MBD)

13

Ddx - MBD

- gout
- septic arthritis
- spinal spondylosis

14

Confirmation of MBD

- swollen bones
- poor density
- misshapen
- pliant mandibles
- lethargy
- unable to lift body off ground
- path. fractures
- low serum Ca

15

Tx - MBD

- Ca gluconate, dietary adjustment (2% Ca diet)
- UV light, and/or direct sunlight (not through glass)
- monitor blood Ca

16

Phosphates and Ca level in meat

- high phosphates
- low calcium

17

What other diseases are also called 'metabolic' bone disease

- calcinosis circumscripta
- craniomandibular osteopathy
- (metaphyseal osteopathy)/ hypertrophic osteodystrophy (HOD)
- panosteitis
- hypertrophy pulmonary osteoarthropathy (Maries' disease)

18

What is calcinosis circumscripta?

extra Ca deposti around joint possibly d/t trauma?

19

What is craniomandibular osteopathy?

possibly immune-mediated

20

What is Metaphyseal osteopathy?

= better called hypertrophic osteodystrophy (HOD)
- provoked by distemper
- note the 'extra' physeal line which is in fact bone necrosis
- animal is often very febrile with this condition

21

What is panosteitis?

- young growing dog
- unknown aetiology
- self-resolving condition
- endosteitis seen

22

What is hypertrophic pulmonary oseoarthropathy?

= Maries' disease in humans
- perisoteal activation in distal limbs
- usually related to thoracic/ abdominal tumour
- tumour produces growth factors leads to this condition