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Neuro > Acquired and genetic myopathies > Flashcards

Acquired and genetic myopathies Flashcards

1
Q

What is the proper name for Azoturia/Tying up?

A

Equine Rhabdomyolysis Syndrome

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2
Q

What are the signs you might observe during an episode of rhabdomyolysis?

A

Stiff movements

Pain

Tachcardia

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3
Q

What are the clinpath changes in a horse that has recently had an episode of exertional rhabdomyolysis?

A

Myoglobinuria

Increased plasma CK and AST

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4
Q

Which stick around longer in the blood.. AST or CK?

A

AST sticks around much longer

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5
Q

What is the treatment for acute exertional rhabdomyolysis?

A

NSAIDs or opiates for pain

Fluids and diuretics to minimise nephrotoxic effects of myoglobin

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6
Q

How do you test for exertional rhabdomyolysis between episodes?

A

Exercise test: 20 mins trot and canter on the lunge, CK levels pre exercise and 6 hrs post

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7
Q

What level of increase in CK is needed in the exercise test for it to be considered significant?

A

>100%

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8
Q

What are the acquired causes of exertional rhabdiomyolysis?

A

Overexertion

Electrolyte imbalance

Hormonal influence?

Infectious causes

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9
Q

What are the inherited causes of exertional rhabdomyolysis?

A

Repeated exertional due to calcium regulation defect, or polysaccharide storage myopathy

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10
Q

What is RER?

A

Recurrent exertional rhabdomyolysis

Recognised in thoroughbreds

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11
Q

What percentage of TBs are affected with RER and which group are most at risk?

A

About 5%

Young nervous fillies most likely to be affected

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12
Q

How do you treat RER?

A

Dantrolene - Calcium release channel blocker

High fat low carb diet

regular exercise/turnout

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13
Q

Which breeds are especially affected by PSSM-1

A

Cobs, quarter horses, warmbloods, drafts & others

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14
Q

Which gene is mutated in PSSM-1?

A

Mutation in glycogen synthase gene in skeletal muscle so can’t make glycogen

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15
Q

How do you diagnose PSSM-1?

A

DNA test available - Submit blood in EDTA or hair pluck

Muscle biopsy-polysaccharide inclusions

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16
Q

How do you treat PSSM?

A

High fat low carb diet

DAILY exercise

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17
Q

What are the changes in the body in an exhausted horse (e.g. relatively unfit horse after a long day hunting)

A

Glycogen depletion from the muscles

Electrolyte loss from sweat

Hypovolaemia

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18
Q

What are the clinical signs in the exhausted horse?

A

Depression

Dehydration, anorexia, decreased thirst,

Increased RR and HR

Poor sweating response

Laminitis

Pyrexia

Poor jugular distenstion, increased CRT, decreased pulse pressure

Synchronous Diaphragmatic flutter (thumps)

Muscle pain and stiffness

19
Q

What is thumps?

A

Synchronous diaphragmatic flutter

When the diaphragm twitches in time with the heart beat

20
Q

How do you treat exhausted horse?

A

Fluids (oral or IV) with or without electrolytes

Rapid cooling

NSAIDs

Check for evidence of rhabdomyolysis (CK, AST)

21
Q

Which other species can rhabdomyolysis occur in?

A

Dogs eg sled dogs

22
Q

What is coccygeal muscle injury?

A

Pain at the tail base with mild elevations in CK

23
Q

What breeds often get coccygeal muscle injury?

A

Working breeds eg labrador, pointer

24
Q

What kinds of activities predispose to Coccygeal muscle injury?

A

Cold exercise, swimming, long cage transportation

25
Q

How long does it take to recover from coccygeal muscle injury and what is the treatment?

A

Recovery over several days

Treatment: rest and NSAIDs

26
Q

What is the name of the condition which causes hyperkalaemic periodic paralysis in quarter horses?

A

Sarcolemmal sodium pump channelopathy

(can’t swap sodium for potassium)

27
Q

What is the cause of malignant hyperthermia and which species/breeds does it affect?

A

ryanodine receptor channelopathy

Landrace pigs

mixed breed dogs

quarter horses

28
Q

Which breed is affected by calcium ATPase channelopathy?

A

Chianina cattle

causes congenital pseudomyetonia

29
Q

What is the cause of ‘double muscle syndrome’ as seen in belgian blues and bully whippets?

A

Myostatin mutation

30
Q

How do you get muscle strain injury?

A

Overstretching of muscles –> disruption of fibres

leads to inflammation and fibrosis

31
Q

Which breed is fibrotic myopathy common in?

A

Quarter horse

32
Q

Which muscleis most often affected by fibrotic myopathy?

Which other 2 muscles are often implicated?

A

Semitendinosus

Semimembranosus & Gracilis

33
Q

3 common causes of fibrotic myopathy

A

IM injection

Muscle tear

Neuropathy

34
Q

What is the treatment for fibrotic myopathy?

A

Rest NSAIDs, surgical resection of fibrous tissue or tenotomy

35
Q

What clinpath findings do you expect to see in a horse with atypical myopathy?

A

Huge increase in CK and AST

Blood can look red with myoglobin

Due to fat build up in the skeletal and cardiac muscle

Histo slide = fat in muscle

36
Q

What is the proposed pathogenesis of atypical myopathy?

A

Eating of plants which have MCPA as a metabolite. Hypoglycin A common precursor.

MCPA inhibits acetyl-CoA dehydrogenase, interferes with b oxidation

37
Q

What are the suggested treatments for atypical myopathy? NB all speculative

A

Riboflavin (vitamin B2)

Carnitine supplementation

Support carbohydrate metabolism (glucose, insulin?)

38
Q

How do you diagnose AM?

A

Muscle biopsy

urine/plasma acyl carnitine

hypoglycin measurement?

39
Q

What does this histo section show?

A

Muscular dystrophy

40
Q
A
41
Q

Why do AM horses die?

A

Normally cardiac arrhythmias or diaphragm weakness

very high mortality rate about 80%

42
Q

Duchen MD = **** frame deletions

A

Out of

43
Q

Becker MD = ***** deletions

A

in frame

Neuro (13 decks)

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