atyp myopathy Flashcards
mortality atyp myopathy
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%)
temperature as prognostic factor in AM
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
sedation as prognostic indicator AM
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
Evidence-based therapy for atypical myopathy in horses L. S. Fabius and C. M. Westermann 2017
- 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
AM: which plants are responsible?
seeds, leaves or sprouts of trees of Acer family, such as Acer negundo, Acer pseudoplatanus
pathogenesis of AM
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
What happens to HGA in the body
Hypoglycin is metabolised by transamination and oxidative decarboxylation to the toxic compound MCPA by the liver
How is MCPA excreted?
MCPA is subsequently conjugated and excreted in urine
which muscles are mostly affected in AM
affecting mostly respiratory and postural muscles