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Ruminant Medicine > Calcium, phosphorus, magnesium, sodium and potassium disorders > Flashcards

Calcium, phosphorus, magnesium, sodium and potassium disorders Flashcards

1
Q

What diseases are associated with calcium?

A
  1. Milk fever
  2. Downer cow syndrome
  3. Enzootic calcinosis
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2
Q

What are some other names for milk fever?

A
  1. Hypocalcaemia
  2. Parturient paresis
  3. Calving paralysis
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3
Q

When does milk fever occur?

A

75% occur within 24 hours after calving

5% occur post-48 hours

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4
Q

How many dairy cows are affected by milk fever in the UK (%)?

A

4-9%

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5
Q

How many grams of calcium is needed for 12l of colostrum?

A

30g

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6
Q

How many grams of calcium is needed for 40l of milk?

A

80g

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7
Q

Which cows are mostly affected by milk fever?

A

Older cows, after their 3rd lactation

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8
Q

How is calcium homeostasis maintained?

A
  1. Parathyroid hormone
  2. 1,25-dehydroxyvitamin D3
  3. Calcitonin
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9
Q

Why does milk fever occur?

A

Due to a rapid increase in the demands of calcium post-partum (colostrum). The body takes 2-3 days to compensate and for the hormonal mechanisms to take effect.

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10
Q

How many clinical stages are there to milk fever?

A

Three

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11
Q

Describe the clinical signs of stage 1 of milk fever

A
  • Standing but wobbly
  • Brief stage of excitement
  • Tetany with hypersensitivity
  • Muscle tremor of head and limbs
  • Disinclined to move
  • Inappetence
  • Protrusion of tongue
  • Bruxism
  • Hind limb stiffness, ataxia and falling
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12
Q

Describe the clinical signs of stage 2 of milk fever

A
  • Sternal recumbency
  • Lateral kink in neck (S-shape)
  • Inability to stand
  • Depressed, drowsy
  • Dry muzzle
  • Cool extremities
  • Marked decrease in heart sound intensity but tachycardia
  • Dry, staring eyes
  • Ruminal stasis and bloat
  • Relaxed anal reflexes
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13
Q

Describe the clinical signs of stage 3 of milk fever

A
  • Lateral recumbency
  • Unresponsive, almost comatose
  • Completely flaccid movement of legs
  • Marked depressed on rectal temperature
  • Almost inaudible heart sounds
  • Increased heart rate (>120bpm)
  • Bloat
  • Death due to shock and respiratory muscle paralysis
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14
Q

How can milk fever be further complicated?

A
  1. Aspiration pneumonia due to inhalation of rumen content

2. Pressure damage to nerves and muscles

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15
Q

What post-mortem signs will you see in milk fever?

A
  1. Fatty liver

2. Displaced abomasum

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16
Q

How do we diagnose milk fever?

A
  1. History and clinical signs

2. Calcium levels (serum) - <1.5mmol.l

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17
Q

What are the NORMAL levels of calcium?

A

2.2-2.8mmol.l

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18
Q

What is the MAIN differential for milk fever?

A

Ketosis - >24 hours post-partum

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19
Q

How do we treat milk fever?

A
  1. Calcium salts - IV - slow injection over 5-10 minutes
  2. 400ml of 40% (160ml) calcium borogluconate administration
  3. Magnesium and phosphorus
  4. SC calcium - to prevent relapse
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20
Q

How do we prevent milk fever?

A
  1. BCS of 2.5-3.5 at calving
  2. Low calcium levels in the dry period (<30g/d)
  3. Limit P levels to <45g/d
  4. Calcium drench (150g CaCl2 daily) in days before calving
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21
Q

What is downer cow syndrome and how is it linked to milk fever?

A

Ischaemic necrosis of muscles due to prolonged (>24 hours) recumbency in one position (e.g. during milk fever)

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22
Q

What is a massive negative prognostic indicator of downer cow syndrome?

A

Damage to the sciatic nerve

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23
Q

What would we see on a post-mortem of a downer cow?

A
  • Extensive necrosis of the caudal thigh muscles
  • Inflammation of the sciatic nerve
  • Necrosis of muscle fibres
  • Rupture of muscle fibres
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24
Q

What enzymes would be elevated in downer cow syndrome?

A

CK, AST and LDH

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25
Q

How do we prevent downer cow syndrome?

A

Manual movement of a cow that is in recumbency for prolonged periods

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26
Q

What is enzootic calcinosis?

A

Intoxication with calcinogenic plants, resulting in hypERcalcaemia

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27
Q

What plants are calcinogenic?

A
  1. Solanum malacoxylon

2. Trisetum flavescens

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28
Q

What causes calcinogenic plants to be toxic?

A

Produce a substance that mimics calcitriol, and so bypasses the conversion of 25-hydroxycholcalciferol to calcitriol in the kidneys, resulting in greater calcium absorption that required

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29
Q

What are the clinical signs of enzootic calcinosis?

A
  • Stiffness and shifting limb lameness
  • Distal limbs become straight, slow, stiff and awkward
  • Abnormal gait - short strides
  • Shallow, diaphragmatic breathing
  • Extended head and neck
  • Tachycardia and heart murmurs
  • Weakness, weight loss, listlessness
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30
Q

What post-mortem lesions are associated with enzootic calcinosis?

A
  • Degeneration and calcification of soft tissues
  • Emaciation
  • Excess fluid in thoracic and abdominal cavities and pericardium
  • Calcification of bicuspid valves
  • Mineral deposits on pleura, lungs, kidneys, ligaments and tendons
  • Capsular thickening of articular cartilages
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31
Q

How do we diagnosis enzootic calcinosis?

A
  1. History and clinical signs
  2. Post mortem lesions
  3. High plasma calcium and phosphorus
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32
Q

How do we treat enzootic calcinosis?

A

No treatment

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33
Q

What conditions are associated with low phosphate levels?

A
  1. Hypophosphataemia
  2. Rickets
  3. Osteomalacia
  4. Post-parturient haemoglobinuria
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34
Q

What causes hypophosphataemia?

A

Low dietary levels of phosphate

35
Q

What is the function of phosphate?

A

Component of phospholipids, phosphoproteins, nucleic acids and ATP

36
Q

What is the normal plasma concentration of phosphorus?

A

1.3-2.6mmol.l

37
Q

Where is the majority of phosphorus found in the body?

A

Bones and teeth

38
Q

How is phosphorus metabolism regulated?

A

PTH - secreted during calcium stress

39
Q

What are the two types of hypophosphataemia and their blood levels?

A

Acute - 0.3-0.6mmol.l

Chronic - 0.6-1.3mmol.l

40
Q

When is acute hypophosphataemia seen?

A

Late gestation due to accelerated growth of foetus (or twin pregnancy) or at the onset of lactation

41
Q

What are the clinical signs of acute hypophosphataemia?

A

Recumbency, but cow seems fine and is able to eat

42
Q

What are the clinical signs of chronic hypophosphataemia?

A
  • Failure to grow
  • Inappetence
  • Pica
  • Lethargy
  • Decreased milk yield
  • Decreased fertility
43
Q

How do we treat hypophosphataemia?

A

Increase phosphate levels in feed and IV phosphorus

44
Q

What is the aetiology of post-parturient haemoglobinuria?

A
  1. Low phosphate levels in ration
  2. Ingestion of haemolytic agents - rape seed
  3. Phosphorus deficient soils
45
Q

When does post-parturient haemoglobinuria most commonly occur?

A

2-4 weeks following parturition in dairy cows
Usually in 3-6th lactation in high producers
Most common with selenium deficiency

46
Q

What is the pathogenesis of post-parturient haemoglobinuria?

A

It is characterised by development of peracute intravascular haemolysis and anaemia with potentially fatal outcome

47
Q

What are the clinical signs of post-parturient haemoglobinuria?

A
  • Haemoglobinuria - dark red urine
  • Inappetence
  • Sudden weakness and staggering
  • Decreased milk yield
  • Pale mucous membranes
  • Anaemia and jaundice
  • Dehydration
48
Q

What are the post-mortem lesions seen in post-parturient haemoglobinuria?

A
  • Thin blood
  • Icterus
  • Swollen liver
  • Bladder filled with red urine
49
Q

How do we diagnose post-parturient haemoglobinuria?

A
  • CBC - anaemia
  • Heinz body formation
  • Low P in blood
50
Q

How do we treat post-parturient haemoglobinuria?

A
  1. Blood transfusion
  2. Fluid therapy - supportive
  3. 60g sodium acid phosphate in 300ml of distilled water IV then SC
51
Q

What are other names for hypomagnesaemia?

A
  1. Hypomagnesaemic tetany
  2. Grass tetany
  3. Grass staggers
52
Q

What is the maintenance dose of magnesium?

A

3mg/kg BWT

53
Q

What is the lactational requirements of magnesium?

54
Q

What is the cause of grass staggers?

A
  • Reduced food intake during lactation
  • Pasture low in magnesium (e.g. grass)
  • High pasture nitrogen - reduces magnesium absorption
  • Stress
  • High moisture content - decreases absorption
55
Q

What are the plasma magnesium levels found in grass staggers?

A
  • Cattle - <0.5mmol.l
  • Sheep - <0.2mmol.l
  • CSF - <0.4mmol.l
56
Q

When do clinical signs develop during grass staggers?

A

When plasma Mg levesl drop to <0.35mmol.l

57
Q

How does a low magnesium level affect the body?

A

Interferes with neuromuscular transmission and neurone activation

58
Q

What are the forms of clinical grass staggers?

A
  1. Acute
  2. Chronic
  3. Calves - 2 weeks to 8 months
59
Q

What are the clinical signs of acute grass staggers?

A
  • Depression, dullness
  • Throw head up and bellow
  • Restlessness
  • Galloping in a blind frenzy
  • Fall and exhibit wild paddling convulsions
  • Tetanic spasms
  • Chewing
  • Coma and death
60
Q

What are the clinical signs of chronic grass staggers?

A
  • Nervous and irritable
  • Depressed appetite
  • Decreased production
  • Reduced gut motility
61
Q

What are the clinical signs of hypomagnesaemia in calves?

A
  • Hyperexcitability
  • Muscle fasciculations
  • Stiff gait
  • Constant movement
  • Ear flapping
  • Convulsions, spasms, tetany and death
62
Q

What are the differentials for grass staggers?

A
  1. Nitrate/nitrite intoxications
  2. Lead battery ingestion
  3. Infections - BSE, Aujeskys
63
Q

How do we treat grass staggers?

A
  1. Slow IV Ca and Mg (5%) salts and SC Mg
  2. Mg enema
  3. Oral Mg - use stomach tube
64
Q

How much Mg should go SC in grass staggers?

A

Cattle - 400ml 25%

Sheep - 40-50ml 25%

65
Q

What causes hyponatraemia?

A
  1. Low oral intake of sodium

2. Increased renal losses - diuretics, intestinal losses (diarrhoea)

66
Q

What is the function of sodium?

A
  • Maintains ECF osmolality and water distribution between ECF and ICF
  • Regulates acid-base balance
  • Maintains neuromuscular functions and cell permeability
67
Q

What are the clinical signs of low sodium?

A
  • Neurological signs
  • Hypovolaemia and hypotension
  • Shock
  • Anorexia
  • Apathy, weakness
  • Disturbances in rumen function - alkalosis
68
Q

How do we diagnose hyponatraemia?

A

Serum sodium <136mmol.l

69
Q

What causes sodium intoxication?

A
  • Increased sodium retention
  • Increased sodium intake
  • Increased water loss or decreased intake
  • Hypotonic water loss
70
Q

What are the clinical signs of sodium intoxication?

A
  • Increased thirst
  • Hypersalivation
  • Vomiting, abdominal pain and diarrhoea
  • Nervous signs
  • Coma
71
Q

What are the post-mortem signs of hypernatraemia?

A
  • Acute cerebral oedema
  • Inflamed meninges
  • Increased intra-cranial pressure
  • Gastric irritation and haemorrhages
72
Q

How do we diagnose hypernatraemia

A

Serum and CSF concentration of >160mmol.l

73
Q

How do we treat hypernatraemia?

A

Immediate removal of salt and water. Then trickle feed water

74
Q

What is the function of potassium in the body?

A

Determining resting membrane potential

75
Q

What can cause hyperkalaemia?

A
  • Increased dietary intake - mollasses
  • Decreased excretion - anuria, metabolic acidosis
  • Rapid IV administration of potassium
76
Q

How is potassium controlled in the body?

A

By aldosterone - enhancing renal and salivary excretion and promoting resorption of sodium ions

77
Q

What are the clinical signs of hyperkalaemia?

A
  • Cramping
  • Weakness
  • Diarrhoea
  • CNS signs - irritability and excitement
  • Paralysis
  • Cardiac failure - bradycardia - cardiac arrest
78
Q

How do we diagnose hyperkalaemia?

A

Serum levels >6.5mmol.l

Na:K ratio <25:1

79
Q

How do we treat hyperkalaemia?

A

0.9% NaCl IV to promote diuresis and NaHCO3 to correct acidosis

80
Q

What causes hypokalaemia?

A
  • Decreased intake
  • CCS use - enhances GIT and renal losses
  • Impaired absorption - abomasal displacement, ileus, diarrhoea, diuretics, etc
81
Q

What are the clinical signs of hypokalaemia?

A
  • Inappetence
  • Atony of GIT
  • Skeletal muscle weakness and muscle fasiculations
  • Arrhythmias
  • PU
  • Recumbency
  • Coma
82
Q

How do we diagnose hypoakalaemia?

A
  1. Moderate - 2.5-3.5mmol.l

2. Severe - <2.5mmol.l

83
Q

How do we treat hypokalaemia?

A
  1. Correct underlying imbalances

2. Potassium supplementation - SLOW

84
Q

How much potassium should we give?

A

30-60g KCl at 12 hour intervals (MAX 240g per day)

Ruminant Medicine (12 decks)

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