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Y4 exotics > Endocrine disease > Flashcards

Endocrine disease Flashcards

1
Q

Calcium metabolism in birds & reptiles

A
  • if you increase calcium in the diet it might not increase blood calcium levels
  • vitamin D is needed to absorb dietary calcium from the intestines
  • vitamin D2 is found in plants, unlike mammals, birds and reptiles can’t easily use vitamin D2 – they need to use active vitamin D3
  • UVB and head are needed for some spp to convert D2->D3
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2
Q

3 things needed for calcium metabolism in the bearded dragon

A
  • UVB light (UV doesn’t penetrate glass so needs to be direct)
  • heat
  • correct diet & supplements
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3
Q

What should the Ca:P ratio in the diet be?

A

between 1:1 and 2:1

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4
Q

When do herbivorous reptiles need a calcium supplement?

A
  • always
  • diet in captivity often has an inverse Ca:P ratio and/or contains phytates and oxalates which may further reduce calcium availability in the diet
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5
Q

When do insectivorous reptiles need a calcium supplement?

A
  • always
  • captive-raised insects often have an inverse Ca:P ratio
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6
Q

When do carnivorous reptiles need a calcium supplement?

A
  • not if they’re fed whole prey
  • if fed all-meat diet or neonatal prey it can result in inverse Ca:P ratio
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7
Q

Calcium metabolism in birds

A
  • similar to reptiles
  • hypocalcaemia is often due to inappropriate diet and husbandry
  • UVB is essential for some birds (e.g. African Grey Parrot) but not all
  • egg laying like most reptiles, but multiple clutching in birds can cause hypocalcaemia e.g. laying hens
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8
Q

When do insectivorous birds need a calcium supplement?

A
  • always
  • captive-farmed insects have an inverse Ca:P ratio
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9
Q

When do parrots need a calcium supplement?

A
  • not needed if diet is correct
  • seed-based diets are deficient in calcium and vitamin D
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10
Q

When do carnivorous birds need a calcium supplement?

A
  • not if fed whole prey
  • all-meat diet, or over enthusiastic eviscerating will result in inverse Ca:P
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11
Q

Calcium metabolism in rabbits

A
  • same hormones involved (PTH, calcitonin, vitamin D3)
  • rabbit calcium metabolism differs to most other mammals as they can absorb dietary calcium from the gut using both an active and passive absorption methods
  • active absorption (same as mammals): vit D2->D3 in kidney by PTH if have low serum calcium, this stimulates intestinal absorption
  • passive absorption: absorbed across gut wall, vit D to required (unlike other mammals), no feedback mechanism
  • so if they have high calcium levels in their diet, they will absorb too much calcium
  • calcium excretion in rabbits is mostly via kidneys (44.9% fractional excretion vs 2% most other mammals) – they can excrete up to 60% ingested calcium in their urine
  • they have a good tolerance of high levels of dietary Ca2+ (
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12
Q

Calcium metabolism in guinea pigs

A
  • like rabbits, they don’t regulate calcium absorption from the gut
  • they absorb ~50% of the calcium they ingest
  • if fed excess calcium, the excess absorbed calcium is excreted through the urinary tract
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13
Q

Clinical signs of endocrine dz in small mammals

A
  • non-specific: PUPD, anorexia, lethargy/weakness, weight loss
  • more specific signs depend on systems affected
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14
Q

Clinical signs of pancreatic adenomas in small mammals

A
  • hindlimb weakness
  • nausea
  • gazed expression
  • ataxia
  • collapse
  • coma
    (- basically hypoglycaemia)
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15
Q

Clinical signs of hypercalcaemia in small mammals

A
  • dysuria
  • pollakiuria
  • haematuria
  • thick, beige-brown urine
  • urine staining
  • abdo pain
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16
Q

Clinical signs of reproductive disorders in small mammals

A
  • swollen vulva
  • symmetrical hair loss
  • palpable cystic ovaries
  • anaemia
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17
Q

Clinical signs of MBD in reptiles

A
  • anorexia
  • lethargy/weakness
  • abnormal gait
  • bone deformities and swellings e.g. mandible, long bones
  • pathologic fractures
  • constipation, egg binding, cloacal prolapse
  • dysecdysis
  • muscle tremors/fasciculations and tetany
  • weak eggs without a thick shell (can cause issues if they rupture)
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18
Q

Clinical signs of endocrine dz in birds

A
  • non-specific: PUPD, anorexia, lethargy/weakness
  • more specific signs depend on the systems affected
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19
Q

Clinical signs of hyperthyroidism in birds

A
  • dyspnoea
  • regurgitation and dysphagia seen with thyroid goitres
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20
Q

Clinical signs of parathyroid dz (MBD) in birds

A
  • weakness
  • ataxia
  • bone deformity/fractures
  • tetany
  • seizures
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21
Q

Common endocrine disorders in ferrets

A
  • hyperadrenocorticism*
  • insulinoma*
  • persistent oestrus*
  • diabetes mellitus
  • hypothyroidism
  • phaeochromocytoma
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22
Q

Common endocrine disorders in guinea pigs

A
  • cystic ovaries*
  • urolithiasis (hypercalcaemia)*
  • alopecia (during pregnancy/lactation)
  • diabetes mellitus
  • hyperthyroidism
  • hyperadrenocorticism
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23
Q

Common endocrine disorders in rabbits

A
  • bladder sludge (hypercalcaemia)*
  • urolithiasis (hypercalcaemia)
  • hypocalcaemia
  • diabetes mellitus
  • adrenal gland tumours
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24
Q

Common endocrine disorders in other rodents

A
  • diabetes mellitus (hamsters, degas, chinchillas, gerbils)
  • hyperadrenocorticism (hamsters, gerbils)
  • pituitary gland adenomas (rats)
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25
Q

Insulinoma

A
  • small pancreatic tumours of the beta cells
  • pancreatic adenomas in ferrets
  • hyperinsulinaemia -> hypoglycaemia
  • CS’s stop in response to food or glucose
  • av occurrence 2-8y
  • feeding processed dry foods hit in carbs might stimulate the development of tumours
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26
Q

Common causes of hypercalcaemia in rabbits

A
  • increased dietary intake e.g. alfalfa hay
  • renal dz (but renal dz can cause hypo and hypercalcaemia so its hard to tell what came 1st)
  • primary hyperparathyroidism
  • hypervitaminosis D
  • hypervitaminosis A (damages the kidneys and cause this as well)
  • osteomyelitis
  • paraneoplastic syndrome e.g. thymoma
27
Q

What are bladder sludge and uroliths caused by?

A
  • hypercalcaemia over a long period of time
  • dehydration
  • reduced movement e.g. arthritis, obesity and confinement
  • not fully voiding bladder when urinating e.g. partial obstruction, spondylosis, abdo pain
28
Q

Why can dehydration worsen/cause uroliths and bladder sludge?

A
  • the urine part of the bladder reduces and so calcium can gloop together and cause a urolith or become more of a presence in the bladder with less urine surrounding it
29
Q

Why does movement help bladder sludge / urolithiasis?

A
  • snow globe effect
  • urine and calcium will mix up so when they urinate calcium leaves with the urine and so it doesn’t build up as quickly
30
Q

Why can spinal pain cause bladder sludge / urolithiasis?

A
  • can’t stance to urinate properly -> not fully voiding the bladder
31
Q

What can persistent hypercalcaemia in rabbits result in?

A
  • dystrophic calcification, particularly in the aorta and kidneys e.g. kidney damage
  • hyper mineralisation of the skeleton
  • i.e. calcium deposits in soft tissues and bone
32
Q

Hypocalcaemia in rabbits

A
  • calcium deficient diet leads to reduced serum calcium and increased PTH secretion
  • leads to demineralisation of the skull, teeth and skeleton
  • spine fractures and dental dz are commonly found
  • PTH also increases RBC osmotic fragility causing anaemia
  • hypocalcaemia may be seen before parturition
33
Q

Common endocrine disorders in reptiles

A
  • hypocalcaemia / metabolic bone disease
  • hypercalcaemia
  • hypothyroidism and hyperthyroidism
34
Q

2 types of MBD

A
  • nutritional secondary hyperparathyroidism (NSHP)
  • renal secondary hyperparathyroidism (RSHP)
35
Q

How does NSHP work in reptiles?

A
  • causes: reduced calcium in diet, increased phosphorous in diet, lack of UVB light, poor environmental temp, reduced vit D in diet
  • increase in PTH to increase calcium in the blood
  • PTH-gland hyperplasia (exacerbates the problem as causes more and more calcium to be released from the bones)
  • calcium mobilised by bone
36
Q

Hypo & hyperthyroidism clinical signs in reptiles

A
  • similar clinical signs as other animals
  • e.g. under or overactive, shed more or less frequently
37
Q

How does RSHP work in reptiles?

A
  • kidney dz ->
  • decreased phosphorous excretion so increased phosphorous in the blood ->
  • reversed Ca:P ratio ->
  • increased PTH to increase calcium in the blood ->
  • parathyroid gland hyperplasia ->
  • calcium mobilised from bone
38
Q

Common causes of kidney dz in reptiles

A
  • over supplementation of vit D3
  • malnutrition (e.g. hypovitaminosis A)
  • high protein diet (e.g. herbivores fed carnivore diet)
  • kidney infections
  • chronic dehydration
39
Q

Hypercalcaemia in reptiles and birds

A
  • most commonly physiological in reproducing females
  • para-neoplastic hypercalcaemia not reported
  • can be caused by hypervitaminosis D and excessive dietary calcium intake in both reptiles and birds
  • in reptiles esp, it can also be caused by primary hyperparathyroidism and osteolytic bone lesions
40
Q

Consequences of prolonged hypercalcaemia in reptiles and birds

A
  • soft tissue mineralisation
  • nephrocalcinosis -> visceral and articular gout
41
Q

Uroliths in reptiles

A
  • many reptiles don’t have bladders, but tortoises do and they commonly get uroliths
  • not like to calcium metabolism (cf. rabbits and GPs)
  • uroliths in tortoises consist of uric acid rather than calcium
42
Q

Common endocrine disorders in birds

A
  • medullary hyperostosis
  • hypocalcaemia (NSHP & RSHP)
  • hypercalcaemia
  • thyroid hyperplasia (goiter) due to dietary iodine deficiency
43
Q

What spp of birds commonly get goitres?

A
  • budgies
44
Q

Medullary hyperostosis (definition, etc)

A
  • hyperostosis = calcium storage in medullary bone changes the pneumatic appearance to solid and dense material
  • egg laying places huge demands on calcium supply
  • begins at 6w prior to egg laying
  • hyperostosis is reported in both normal and abnormal psittacine birds
  • under the influence of oestrogen and vitamin D
  • where calcium/vit D3 is insufficient, a moth-eaten appearance of the bone often occurs
45
Q

Calcium metabolism in birds cf reptiles

A
  • in birds, calcium metabolism during egg production appears to be similar to reptiles, only they produce eggs more frequently
  • hypocalcaemia in birds has the same CS as reptiles, + feather plucking due to bone and joint pain, breeding females also show egg-binding, soft-shelled eggs and infertility
  • BUT medullary hyperostosis doesn’t occur in reptiles: thought to be because when they lay eggs it doesn’t have the same dramatic effect on the calcium demand, so it doesn’t need to be stored up in preparation for laying eggs
46
Q

Diagnostic tests: blood tests

A
  • biochem: indicates body system involved, e.g. kidney dz
  • sex hormones, e.g. hyperadrenocorticism in ferrets
  • other hormones e.g. thyroid in any spp
  • vitamin and minerals often hard to test – often only history and husbandry can indicate deficiencies
  • calcium
47
Q

3 types of calcium in the blood

A
  • ionised (active)
  • protein-bound (esp albumin)
  • complexed to anions (citrate, bicarbonate, phosphorous)
48
Q

Calcium testing

A
  • total calcium measures all 3 types of calcium in the blood – if albumin levels change, total calcium will change, pH can also change total calcium as it affects protein binding, therefore total calcium is not reflective of true calcium status
  • ionised calcium, also called free calcium, is the most active form
  • measure ionised calcium in birds and reptiles (measure ionised and total calcium in conjunction with albumin)
49
Q

Urinalysis in birds and reptiles

A
  • not very useful to assess kidney function
50
Q

Urinalysis in rabbits and guinea pigs

A
  • manual USG can help assess kidney function (wide normal range of 1.003-1.036)
  • can perform a dipstick to look for blood, e.g. urolith or cystitis
  • hard to obtain a sterile sample for culture, cystocentesis has a high risk for peritonitis in hind gut fermenters
51
Q

Diagnostic tests: radiography

A
  • can assess bone density, bone deformities, fractures, tissue mineralisation etc
  • can identify eggs in birds and reptiles, cystic ovaries in GPs and bladder sludge and/or urolithiasis in GPs and rabbits
52
Q

Diagnostic tests: US

A
  • can identify reproductive follicles in reptiles
  • assess adrenal glands (always enlarged in ferret HAC) and tissue mineralisation e.g. kidneys
  • not useful in hind gut fermenters due to gas in intestines, can often visualise the bladder e.g. urolithiasis
53
Q

Ferret insulinoma: diagnosis

A
  • blood glucose <3.4mmol/L after 4h fast
  • CS disappear after eating food (or being given glucose)
  • may want to follow up with US of the pancreas
54
Q

Diagnosis of MBD in reptiles and birds

A
  • total and ionised calcium may be low or normal
  • blood work is not enough as the body works hard to keep the blood calcium normal
  • history (diet, UVB provision, egg-laying, temperatures)
  • total and ionised calcium, albumin, ALKP
  • whole body radiography (2 views)
55
Q

Ferret insulinoma: tx

A
  • medical: prednisolone +/- drugs that inhibit insulin secretion e.g. diazoxide or a somatostatin analogue (usually a palliative approach and will usually end up getting worse and more tumours)
  • surgery: partial pancreatectomy (but may not be curative as many of these tumours can be microscopic and so can be missed, but removing the whole pancreas would make the animal diabetic, also possible for them to spontaneously reoccur later on i.e. new tumour growth 1y post surgery
  • diet changes: feed a high protein and fat, low in carb diet, feed small but frequent meals
56
Q

MBD: medical tx (reptiles & birds)

A
  • give calcium, route depends on severity: oral if mild (calcium blubionate) or injectable (e.g. calcium gluconate IM or slow IV (if pt critical, having seizures) [caution- slow to not cause cardiac issues])
  • cage rest & analgesia
  • apply splits to any recent / unstable fractures, but care as don’t want to add extra weight to the bottom of an already fragile limb
  • diazepam +/- anaesthesia if seizure (birds)
  • deslorelin implant in birds if a prolific egg layer, to give them a chance to recover
  • euthanasia if severe
57
Q

MBD: surgical tx (reptiles & birds)

A
  • treating fractures surgically is usually contraindicated – plates, screws etc are too heavy and can cause further damage, placement alone can cause them to shatter
  • for a straight forward fracture from trauma with no MBD can use surgical tx
  • if a reptile, consider an ovariectomy once stable
58
Q

MBD: husbandry changes (reptiles & birds)

A
  • provide warmth and the appropriate UVB light
  • reduce reproductive drive (shorten day length, remove nest sites and/or mate (owner?)
59
Q

MBD: diet changes (including examples of supplements)

A
  • convert to an appropriate diet for the spp – do this very slowly in parrots (over 6m)
  • use Ca/vit D supplement (appropriately)
  • Zolcal: prescription supplement, oral drug, tx option for poorly animal due to low calcium, contains Ca and vit D
  • Nutroba & calci-dust: supplements that should be included in normal day-day husbandry
  • Reptoboost - doesn’t have any vitamins or minerals in it, basically an electrolyte solution, so good to give esp if dehydrated
60
Q

Bladder sludge (rabbits): medical tx

A
  • identify and tx any conditions that will predispose to urinary disease (e.g. joint or abdominal pain)
  • fluid therapy to increase the need for urination
  • gentle bladder expressions to full void bladder
  • place a urinary catheter and flush the bladder if unable to remove sludge through manual bladder expressions
  • if blood in urine -> possible secondary infection that needs treating (i.e. sludge alone won’t cause blood in the urine)
61
Q

Uroliths (rabbits & GPs): surgical tx

A
  • cystotomy: same surgery as cats/dogs, extra precautions for the anaesthesia and minimise gut handling
  • sample urine directly from the bladder for C&ST
  • catheterise and flush so calculi in the urethra are flushed back into the bladder
62
Q

Bladder sludge & uroliths (small mammals): husbandry changes

A
  • change diet (e.g. VetCare Plus ruinary diet, reduce veg that are high in Ca [spinach & kale], no alfalfa hay (normal adults shouldn’t have this but if they have an increased Ca requirement e.g. pregnant or young it could be appropriate)
  • weight loss if overweight
  • increase water intake
  • encourage exercise
  • reduce stress (can cause cystitis)
63
Q

What can neutering guinea pigs prevent?

A
  • cystic ovaries

Y4 exotics (9 decks)

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