atyp myopathy Flashcards

1
Q

mortality atyp myopathy

A

Dunkel: The 56% mortality rate of horses suffering from AM in this study (england) was numerically lower than that documented in previous studies in Europe (74–97%)

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2
Q

temperature as prognostic factor in AM

A

Admission temperature was lower in nonsurvivors compared to survivors which is a fact that correlates with findings of previous studies.

This might represent reduced peripheral perfusion due to cardiovascular compromise or reduced rectal tone

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3
Q

sedation as prognostic indicator AM

A

dunkel:

. Use of sedation was significantly associated with outcome with 62.1% of nonsurvivors receiving sedation compared to 18.2% survivors.

given to relieve oesophageal obstruction

treatment of pain or distress

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4
Q

Evidence-based therapy for atypical myopathy in horses L. S. Fabius and C. M. Westermann 2017

A
  • IV fluids to increase myoglob clearance
  • glucose but beware of hyperglycemia
  • Insulin sc: 0.4 iu/kg/day
    • CRI: 0.07 iu/kg/h
  • carnitine (100 mg/kg po or 20mg/kg + saline slow IV):
    • increases leptin levels
    • detoxification - elimination of acyl remainders
  • Vitamin E and selenium (antioxidant)
  • riboflavin = Vit B1 = part of FAD, which is involved in the pathway inhibited in MADD
    • 44 ug/kg/day IV
  • administration of riboflavin, vitamin C and E, selenium and carnitine has proven beneficial in horses (Van Galen et al. 2012b).
  • NSAIDs: Meloxicam (0.6 mg/kg) or ketoprofen (2.2 mg/kg)
  • acepromazine 0.02–0.06 mg/kg i.v
  • paraffine and activated charcoal
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5
Q

AM: which plants are responsible?

A

seeds, leaves or sprouts of trees of Acer family, such as Acer negundo, Acer pseudoplatanus

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6
Q

pathogenesis of AM

A

hypoglycin A ->> methylenecyclopropyl acetic acid (MCPA),

>>induces the acquired multiple acyl-CoA dehydrogenase deficiency syndrome (MADD)

by binding to flavin-adenine dinucleotide (FAD) and subsequently

irreversibly inhibiting several different acyl-CoA dehydrogenases

>>> impaired fatty acid metaboslim

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7
Q

What happens to HGA in the body

A

Hypoglycin is metabolised by transamination and oxidative decarboxylation to the toxic compound MCPA by the liver

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8
Q

How is MCPA excreted?

A

MCPA is subsequently conjugated and excreted in urine

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9
Q

which muscles are mostly affected in AM

A

affecting mostly respiratory and postural muscles

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