L37 &38_Endocrine disorders

Question 1

What is Equine Metabolic Syndrome?

Answer 1

A set of clinical signs and clinicopathological conditions that increase the likelihood of an equid developing laminitis.

Question 2

What is the key feature of EMS?

Answer 2

Insulin Dysregulation.

Question 3

Explain the 3 main factors Insulin Dysregulation.

Answer 3

1. Excessive release of insulin from Non-Structural Carbs.
2. Fasting hyperinsulinaemia
3. Insulin resistance (a reduced response of cells to normal levels of insulin).

Question 4

What is the signalment of horses with PPID (Pituitary Pars Intermidia Dysfunction)?

Answer 4

Geriatric horses. > 15 years old

Question 6

Define hypertriglyceride and its significance.

Answer 6

Increase in circulating triglycerides.

Question 7

Define hyperlipidaemia and its signficance.

Answer 7

Increase in triglycerides circulating for a pony 0.82 to 5.85 mmol/L.

No clinical signs apparent yet.

Question 8

Define hyperlipaemia and its signifcance.

Answer 8

Triglycerides in the blood > 5.65 mmol/L.

Fat deposits in plasma or serum, ie opalescent colour.

Sick patient.

Question 9

What is the signalment for hypertriglycdaemia?

Answer 9

Can occur in any equid breed.

Most common in: ponies, donkeys and mules.

Mares > 18 months in last trimester of gestation or lactating.

Question 10

Name 7 predisposing factors.

Answer 10

Breed

Obesity

Lactation

Little exercise

Pregnant

Old age

Female > Male

Question 11

Anything that can cause negative energy balance.

Hypophagia

Diet

Illness

Stress

Pain

Anxiety

Management changes

Question 12

What are the initial clinical signs? And what to do first?

Answer 12

Initital:

None

Dull / quiet

Lethargic

Failure to drink

Decreased GIT motility and faecal output.

Measure triglycerdies in the blood.

Question 13

How to diagnosis hypertriglyceridaemia and what results for each hyperlipidaemia and hyperlipaemia?

Answer 13

Blood test.

Results:

​Hypertriglyceridaemia

• Hyperlipidaemia in ponies 0.82 mmol/L < TG < 5.65 mmol/L
• Hyperlipaemia
  
  • > 5.65 mmol/L
  • grossly cloudy serum
  • patient overtly sick
• Metabolic acidaemia
• Glucose
• Azataemia
• Liver enzymes elevated

Question 14

Name 3 clinical signs of late lipaemia.

Answer 14

Recumbancy

Convulsions

Death

Whole clinical course: from days to 3 weeks

Question 15

What are the clinical signs of mid- hyperlipaemia?

Answer 15

• Colic - mild, mod or severe
  
  • liver capsule is stretching
• D+
  
  • disturbance of feed intake
• Icterus
  
  • liver disease
• Subcutaneous oedema
• CNS - poor prognosis for this sign.
  
  • hepatic encephalopathy

Question 16

What determines prognosis in hyperlipaemia?

Answer 16

How quickly they respond to treatment, not their TG levels at time of diagnosis.

Question 17

What are the clinical signs associated with in hypocalcaemia and give some examples.

Answer 17

Increased smooth muscle contractility and excitability.

• anxiety
• excitement
• ataxia
• cardiac arrythmias
• Hypersalivation
• Tachycardia
• Dysphagia - difficulty swallowing
• Colic
• Convulsions
• Hyperthermia
• Tetany
• Hyperhidrosis - increased sweating not necessarily associated with exercise.