Why should Ca be given IV to a cow with milk fever rather than subcut?
much faster
Poor peripheral supply in milk fever so subcut would take a long time to take effect
Why is it important to auscultate heart of cow while administering Ca for milk fever?
if given too quickly can cause atrial fibrillation and general cardiac arythmias
What are the signs of successful milk fever treatment in cows?
Should be fast
Stand up
Burp/eructation
Feel for rumen turnover
Defecation
Heart slowing, no dysrhythmia
What are the early warning signs of milk fever?
teeth grinding
loss of appetite
stiff legs
constipation
increased resp rate
muscle tremors
hyperactivity
What is the source of growth hormone?
somatotropes in anterior pituitary
What are the short & long term effects of GH (growth hormone) & IGF-1 (insulin-like growth factor-1)
Why can GH not be given orally?
Would be digested
Describe the promotion of protein synthesis by GH and IGF-1 (growth response)
increased nuclear transcription
Increased translation
Increased AA transport
through cell membrane
Decreased catabolism of proteins and AAs
What is the stimulus for GH release? (starvation response)
Decreased blood glucose
Decreased blood free FAs
Decreased protein
Trauma, stress, excitement
Exercise
Describe the physiological effects of GH in the starvation response?
Rapid catabolic actions => hyperglycaemia
Increased rate of protein synthesis
Increased lipolysis
Promotes hyperglycaemia:
- decreased glucose transport across cell membranes
- increased insulin antagonism
- increased gluconeogenesis
Describe the features of IGF-1
Mimics effects of insulin on growth
Stimulated by GH
Produced mainly by liver
Bound to carrier proteins - increases half life
Describe the effect of IGF-1 on bone
increases chondrocytes and osteogenic cell replication
increase chondrocytes and osteogenic cell protein deposition to promote bone growth
converts chondrocytes to osteoblasts to form new bone
Describe bone growth
Open growth plates or epiphyseal cartilage
GH => increased cartilage deposition
GH => stimulates osteoblasts
Cartilage mineralises => increased bone length
Growth plates close
Epiphyseal cartilage fused to bone shaft (diaphysis)
What is the mechanism of pituitary dwarfism
Mutation of a gene coding for a transcription factor that regulates pituitary stem cell differentiation
Defect occurs after corticotrope differentiation (ACTH not affected)
Decreases GH, TSH, prolactin and gonadotropins
Can be accompanied by a cyst
What are the clinical features of pituitary dwarfism
proportionate growth retardation
Soft woolly hair coat:
- lack of primary hairs
Truncal alopecia
Lethargic
Decreased appetite
appear systemically ill
What can occur secondary to pituitary dwarfism
secondary hypothyroidism - thyroid hormones have a large impact on brain development
What is the effect of pituitary dwarfism on reproductive function
Decreased gonadotropins
Males:
- uni/bilateral cryptorchidism
Females:
- persistent oestrus
- failure to ovulate (low P4)
How is pituitary dwarfism diagnosed
Decreased IGF-1
Decreased GH (pulsatile so difficult to diagnose with this)
Dynamic pituitary stim test
- baseline blood sample
- inject GH stimulant
- healthy dogs: GH increase 2-4x
- pituitary dwarfism: no GH increase
What are the effects of GH excess
Giantism - develops in young patients before closure of epiphyses
Acromegaly - develops in adult patients after closure of epiphyses
What is the cause of pituitary dwarfism
congenital (spontaneous mutation)
hereditary in german shepherds
What is the effect of giantism
All tissue grow excessively
Hyperglycaemia (GH antagonises insulin)
Pancreatic failure due to overworking
Diabetes mellitus
Panhypopituitarism
Describe the effects of acromegaly
Long bones can no longer grow
Membranous bones continue to grow:
- broad coarsened facial feature
- prognathism (protrusion of mandible)
- nose
- feet (paw enlargement)
Increased facial soft tissues:
- increased soft tissue over eyes
- macroglossia (large tongue)
- increased interdental spaces
Internal organomegaly:
- heart
- liver
- kidneys
What is the most common cause of feline acromegaly
pituitary tumour secreting excess GH
why are cats with acromegaly usually diabetic
Acromegaly most common cause of insulin resistance in diabetic cats
Higher insulin doses required to treat diabetes due to GH causing insulin resistance