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Flashcards in Nutritional bone disease Deck (22)
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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


Actions - PTH

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


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)


Define pathological fracture

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


Outline vitamin D deficiency

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


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


What animals does secondary nutritional hyperparathyroidism affect?

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


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


MBD - hx

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


Clinical exam - MBD

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


Radiography - MBD

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


Where to take a blood sample -reptiles

tail vein (look for low Ca in MBD)


Ddx - MBD

- gout
- septic arthritis
- spinal spondylosis


Confirmation of MBD

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


Tx - MBD

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


Phosphates and Ca level in meat

- high phosphates
- low calcium


What other diseases are also called 'metabolic' bone disease

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


What is calcinosis circumscripta?

extra Ca deposti around joint possibly d/t trauma?


What is craniomandibular osteopathy?

possibly immune-mediated


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


What is panosteitis?

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


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