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VMS3011 Veterinary Medicine 2 > Endo Treatment > Flashcards

Endo Treatment Flashcards

1
Q

Ketosis (cattle)

A
  • Oral glucose precursors: propylene glycol; glycerol
  • Glucocorticoids - stimulate appetite + promote gluconeogenesis
  • B vitamins - appetite stimulation
  • Nutrition + nursing
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2
Q

Pregnancy toxaemia (sheep)

A
  • Oral glucose precursors
  • IV dextrose
  • NSAIDs
  • Hypocalcium Tx - prolonged IV calcium
  • Induction of parturition: glucocorticoids + PGF / caesarean section
  • Euthanasia
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3
Q

Hypocalcaemia (cattle + sheep)

A
  • IV calcium borogluconate (40%) (Don’t give sub-cut, not as effective, IV = better perfusion) bolus
  • Oral calcium (e.g. calcium chloride / propionate)
  • Nursing + nutrition - e.g. manipulate PTH system w/ low Ca^2+ diet prior to parturition, dilute grass w/ straw; Mg^2+ supplementation - MgCl2 in TMR/drinking water
  • Management of 2^y conditions
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4
Q

Hypomagnesaemia (ruminants)

A
  • Slow IV: 100 mL MgSO4 in 300 mL CaBG 20%
  • SC: 400 mL MgSO4
  • Warm infusions first, IV important for perfusion (sub-cut = poorer Px, only perfusion of peripheral tissues)
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5
Q

Primary hyperparathyroidism - hypercalcaemia (companion animal, equine)

A
  • IVFT - NaCl - extra Na+ competes w/ Ca2+ to reduce tubular uptake in kidney
  • Loop diuretic when adequately hydrated e.g. furosemide to reduce serum Ca2+ w/o causing hypokalemia
  • Glucocorticoids - only when clear Dx (may hide malignancy/paraneoplastic syndrome)
  • Bisphosphonates - inhibit osteoclastic action
  • Surgical parathyroidectomy - glands v hard to find, scintigraphy to localise tissue
  • Percutaneous ultrasound-guided ethanol/heat ablation (leave unaffected gland in-situ if want maintain own ability to control calcium homeostasis, often only one affected) - ethanol - induces coagulation, necrosis + thrombosis in parathyroid gland, can stop production of PTH
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6
Q

Hypoparathyroidism (companion animal)

A
  • Acute: intravenous calcium gluconate
  • Chronic: oral elemental calcium supplementation; vitamin D supplementation; calcitriol
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7
Q

Feline hyperaldosteronism (Conn syndrome)

A
  • Sx - only if unilateral tumour, removal of adrenal gland
  • Potassium supplementation - kaminox
  • Spironolactone - aldosterone blocker
  • Amlodipine - Ca2+ channel blocker -> smooth muscle relaxant for hypertension
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8
Q

Diabetes insipidus (companion animal)

A
  • Desmopressin
  • Intranasal spray/conjunctival drop
  • Provide water
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9
Q

Hypothyroidism (dog)

A
  • Sodium levothyroxine (0.02mg/kg q12 h) - T4 tablet supplement
  • Repeat T4, TSH 6-8 weeks following treatment - Test 4-6 hours post tablet administration (peak of total T4)
  • Want to be within normal range or T4 just above normal
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10
Q

Thyroid carcinoma (dog)

A
  • Surgical excision - palliative - mets
  • Radiotherapy - remove hyperactive tissue
  • Radioiodine^131 - high dose compared to cats
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11
Q

Feline hyperthyroidism (cat)

A

(Non-curative)
- 1). MEDICAL - anti-thyroid hormone drugs: carbimazole, methimazole, thiamazole; monitor T4 levels, haematological side effects, renal disease, blood pressure
- 2). DIET - ultra-low iodine diet

(Curative)
- 3). Sx - unilateral/bilateral thyroidectomy
- 4). Radioiodine (I^131) - locally destructive, but preserves thyroid tissue + parathyroid glands

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12
Q

Feline hyperthyroidism renal disease - hyperthyroidism

A
  • Diet: Hyperthyroid diets often high in protein
  • Balance T4 levels with azotaemia
  • Avoid iatrogenic hypothyroidism
  • Consider medical trial before definitive treatment if worried about renal function
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13
Q

Feline hypothyroidism

A
  • Levothyroxine supplementation
  • Monitor TSH + renal parameters
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14
Q

Canine hyperadrenocorticism (Cushing’s disease) (+ feline)

A

Sx:
- Transphenoidal hypophysectomy - surgical removal of pit gland + long-term management: glucocorticoids, thyroxine, desmopressin
- Unilateral adrenalectomy - curative, glucocorticoids 6 w post-op

Medical:
- Trilostane (vetoryl) - dec cortisol production, risk of iatrogenic hypercortisolaemia (Addison’s)

  • Monitor pre-pill for dose; ACTH stim test - if over-suppressed/can up dose
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15
Q

Canine hypoadrenocorticism (Addison’s) - acute collapsed

A
  • IVFT - 0.9% NaCl, crystalloid (K+ in Hartmann’s negligible) dextrose/glucose if hypocalcaemia
  • ECG - to monitor for life-threatening bradycardia, insulin + glucose = co-transporter of K+
  • Hydrocortisone sodium succinate (Solu-Cortef) = balanced glucocorticoid + weak mineralocorticoid action, IVFT
  • Once stable - long-term Tx: zycortal + oral perdnisolone
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16
Q

Canine hypoadrenocorticism (Addison’s) - sub-acute

A
  • Oral prednisolone - 0.2 - 0.4 mg/kg cortisol required q24 h (normal adrenal production), so aim for 0.05 - 0.1 mg/kg prednisolone q24 h
  • Zycortal (desoxycortone pivalate (DOCP)) - for mineralocorticoid deficiency, sub-cut injection q4 w
17
Q

Canine diabetes

A
  • Insulin - Canisulin - starting dose 0.25 – 0.5 IU/kg /12 h, BID; hospitalise for 12 hours to do initial BG curve; discharge appointment (use of diary/home monitoring); initial BG curve: 1 week after starting insulin - glucose measurement q 2hr
  • Diet
  • Control co-morbidities
  • Discontinue glucocorticoids
  • Spay intact bitches
  • Regular moderate exercise
18
Q

Canine diabetes - hypoglycaemia, insulin resistance

A
  • Glucose admin
  • Reduce insulin dose
19
Q

Somogyi response to insulin therapy (hypoglycaemia-induced hyperglycaemia)

A
  • Reduce insulin dose
20
Q

Feline diabetes mellitus

A
  • 1). DIET
  • 2). WEIGHT CONTROL
  • 3). EXOGENOUS INSULIN THERAPY - ProZinc
  • 4). ORAL HYPOGLYCAEMIC AGENTS
21
Q

Acromegaly - due to diabetes (cats)

A
  • Glycaemic control
  • Radiotherapy
  • Hypophysectomy - Sx removal of pit gland, dec GH
22
Q

Insulinoma (companion animal)

A
  • Emergency: IV dextrose, glucose infusion
  • Surgical resection
  • Small freq meals, q4 - 6 per day to avoid spikes in insulin
  • Diazoxide - inhibits insulin secretion
  • Chemotherapy - streptozocin
23
Q

Insulinoma (ferret)

A
  • Constant access to food but avoidance of sugary snacks
  • Prednisolone - 2 mg/kg q12 h
  • Sx
24
Q

Calcium tetany (poultry, layers)

A
  • Soluble Ca (e.g. Ca pidolate) in water
  • 5 g oyster shell in feed per hen (>1 mm particle size, stays in intestinal tract longer for inc absorption - must be available in afternoon for when shell is laid down
  • Vit D3 (25(OH)D3) = HyD in water, 3d on, 3d off until resolution, up to 3w
  • Hospitalise individuals w/ ready access to feed + water supplements
25
Q

Hypocalcaemia prevention (layers)

A
  • Feed recommended levels of Ca, large particle size calcium, controlled light stimulation, adequate ventilation
  • Control bullying (BCS monitoring)
26
Q

Metabolic syndrome / spiking mortality syndrome (poultry)

A
  • Glucose supplement in drinking water
  • Resolve underlying issue
  • Inc day length so spend longer eating
27
Q

Pituitary pars intermedia dysfunction (PPID) (equine)

A
  • Dopamine agonists - pergolide mesylate (only licensed form), bromocriptine mesylate, cabergoline (Parkinson disease drug)
  • Cyproheptadine hydrochloride -> dec ACTH secretion from pars distalis, not fully established in equids
  • Monitor ACTH + CS + adjust dose (after 4 - 8 w)
28
Q

Diabetes mellitus (equine) (type II)

A
  • Diet - high energy, low NSC (good hay, beet pulp, copra, alfalfa)
  • Dopamine agonists (PPID cases only)
  • Exogenous insulin - too expensive + doesn’t stabilise cases
  • Insulin secretagogues (glibenclamide), less helpful if pancreas failing
29
Q

Diabetic ketoacidosis (companion animal)

A
  • Medical emergency
  • Short-acting (human insulin - Humulin), intermittent injections until BG 11 - 14mmol for 4-10 hours
  • Intravenous fluids (isotonic saline) /
    management of electrolytes (K +)
  • In-patient care
  • Transition to long-acting insulin once
    stable and eating

VMS3011 Veterinary Medicine 2 (20 decks)

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