Hyperkalemic periodic paralysis, plasma lactate and exercise tolerance

The purpose of this, trial was to determine the effect of hyperkalemic periodic paralysis (HYPP) on exercise tolerance in Quarter Horses. Five HYPP affected and five nonaffected horses were matched for age, size, gender and reproductive status. HYPP status was diagnosed by DNA analysis and potassium chloride challenge testing. Plasma lactate concentration and heart rate were used as indicators of work intensity. Serum potassium concentrations were also monitored. Two exercise experiments were conducted, the first being forty-five minutes of slow, aerobic exercise (hacking) and the other being moderate, partially anaerobic exercise (galloping). Post-exercise the horses were cooled out by randomly assigning them to either forty minutes, of standing still or forty minutes of walking. Heart rates of HYPP affected and unaffected horses were not significantly different during exercise or recovery. Plasma lactate concentrations changed slightly following slow exercise and were significantly higher for HYPP affected horses (P=0.01).At the end of exercise, values were 1.4±0.2 mmol/L and 1.0±0.1 mmol/L for HYPP affected and unaffected horses, respectively. Following moderate exercise, plasma lactate concentrations were much greater, and the difference (P<0.001) between affected and unaffected horses was more marked: immediately following exercise concentrations were 10.6±1.8 and 6.2±1.0 mmol/L in affected and unaffected horses, respectively. The higher post-exercise plasma lactate concentrations in affected horses indicates increased anaerobic muscle metabolism. Serum potassium concentrations rose following exercise and significantly higher values were seen in horses that were walked rather than stood still post-exercise.Hyperkalemic periodic paralysis (HYPP) is a dominant autosomal genetic defect occurring in American Quarter Horses and related breeds. ^1–5 The condition is widely geographically distributed and has been estimated to affect 0.4% of all Quarter Horses.⁶ Signs include sporadic attacks of muscle fasciculation, muscle spasm, sweating and weakness. Oral administration of potassium chloride produces a more severe hyperkalemia in HYPP affected horses and induces clinical attacks.¹ Electromyography reveals widespread continuous, spontaneous, muscle contraction.² Some people believe that HYPP affected horses are suitable for riding⁷; others have expressed doubts about the safety of this practice and the exercise tolerance of affected horses. HYPP affected horses have an unstable muscle membrane potential causing random muscle fiber contractions,^2,8 which could antagonize purposeful movement. This, in combination with increases in extracellular potassium concentration occurring during exercise,^9–11 may cause affected horses to stumble or collapse while being ridden, posing a danger to both horse and rider. In HYPP affected people, potassium concentration rises approximately one to two hours after exercise during which time HYPP attacks can occur.^9,10 For these reasons, the exercise tolerance of HYPP affected horses and the effects of exercise on spontaneous HYPP attacks deserves investigation.We standardized the exercise test and chose heart rate and plasma lactate concentrations as indicatoors, of exercise tolerance and energy metabolism.¹² Heart rate is the major determinant of oxygen delivery to muscle and the rate rises with exercise intensity until it reaches a plateau at high velocities.^13,14 Several lines of investigation indicate that plasma lactate concentrations reflect muscle work. Lactate release from resting muscle is minimal but large amounts are released during strenuous exercise.^15–17 Lactate release increases with increasing muscle work.^16,18 During exercise, muscle oxygen consumption increases until eventually a plateau is reached after which no further increase in oxygen consumption in response to increased work loads is possible.¹⁸ At this point the mitochondrial electron chain transport system is operating at its maximal possible rate, energy production can only be supplemented by the use of inefficient anerobic glycolytic metabolism and the muscle starts to release lactate. If the concentrations of plasma lactate are high, the muscles are depending on anaerobic metabolism and are working closer to exhaustion^16,18–21The objectives of this experiment were twofold. One was to determine if HYPP adversely affects exercise performance. The second was to study the effects of cooling out, by either standing still or walking, on serum potassium and plasma lactate concentrations.     

Jamshidi needle biopsy for diagnosis of bone lesions in small animals

Sixty-two bone lesions in 59 small animals were biopsied using a Jamshidi-type biopsy needle. In all instances, the Jamshidi needle biopsy diagnosis was confirmed or disputed by results of histologic examination of specimens obtained by surgical resection or by amputation or at necropsy. In 57 of 62 bone lesions, biopsy resulted in an accurate diagnosis of tumor vs nontumor, yielding an accuracy rate of 91.9%. The specific tumor type or lesion type was identified accurately by Jamshidi needle biopsy in 51 of 62 lesions, yielding an accuracy of 82.3%. Of the 62 bone lesions, 48 were intramedullary osteosarcoma and 62.5% of these were subclassified correctly by Jamshidi needle biopsy results as osteoblastic, chondroblastic, fibroblastic, osteoclastic, or poorly differentiated osteosarcoma. Jamshidi needle biopsy was easy, quick, and safe, and its high accuracy rate of diagnosis indicated that it should be a valuable aid for diagnosis of bone lesions in small animals.     

Vascular Injury Associated with Naturally Occurring Strangulating Obstructions of the Equine Large Colon

Ten horses were euthanatized before, during, or after surgery to correct severe volvulus of the large colon. At surgery, the colonic serosa changed from blue-gray, blue or purple toward a more normal pink in seven horses after the volvulus was corrected. The mucosa consistently remained black or dark red. Results of postmortem colonic microangiography revealed perfusion of the serosa and the circular and longitudinal muscle layers, but mucosal perfusion was limited by thrombosis in the muscularis mucosae and submucosa. There was evidence of thrombosis of the mesenteric colic vessels in six horses. Damage to the colonic vascular system, especially thromboembolism in the submucosa, may be an important limitation to colonic viability after surgical correction of volvulus of the large colon.     

COMPARISON OF THREE METHODS FOR CALCULATING PORTAL BLOOD FLOW VELOCITY IN DOGS USING DUPLEX-DOPPLER ULTRASONOGRAPHY

Measurement of portal blood flow in dogs using duplex-Doppler ultrasonography has potential clinical utility for diagnosis of cirrhosis and portosystemic shunts. Three methods for calculating portal blood flow were compared to identify a consistent method with minimal potential for intraoperator variation. Sixteen unsedated, normal beagles had their mean portal blood flow velocity determined using three methods: method 1 used a small Doppler sample volume positioned over the center of the portal vein and manual selection of data points on the resulting velocity spectra, followed by arithmetic correction of the calculated maximum velocity to mean velocity using the factor 0.57; method 2 used a small centrally-located Doppler sample volume and computed maximum flow determination, again corrected using the factor 0.57; method 3 used a large Doppler sample volume that overlapped the walls of the portal vein followed by computed mean blood flow velocity determination. The calculated mean (SD) portal blood flow velocity was 15.8 (1.8), 15.1 (1.4), and 14.7 (2.5) cm/s using methods 1–3, respectively. There was no significant difference between the results of the three methods; however, method 3 (uniform insonation) was easier to use and produced a higher amplitude Doppler signal and therefore represents a useful alternative to the peak flow methods.     

COMPUTED TOMOGRAPHY OF AN ACUTE HEMORRHAGIC CEREBRAL INFARCT IN A DOG

Computed tomography (CT) was performed on an eleven-year-old dog four days after an acute onset of seizures and neurologic deficits. A ring-enhancing, intra-axial lesion associated with edema, falcial deviation and non-uniform ventricular compression was identified in the left frontal lobe. An area of ill-defined hyperdensity, compatible with hemorrhage, was noted on corresponding CT images prior to contrast enhancement. At post-mortem examination, a focal, hemorrhagic infarct, characterized by liquif ication necrosis, marked gliosis and neovascularization, was found. The etiology of the infarction could not be identified. The CT findings, however, were similar to those seen in humans with cerebral infarction due to embolic occlusion and subsequent hemorrhage. These findings and the pathophysi-ologic mechanisms behind them are discussed.     

Effects of dietary pH and phosphorus source on performance, gastrointestinal tract digesta, and bone measurements of weanling pigs.

Crossbred pigs (n = 144, average age and weight = 28 +/- 3 d, 7.5 kg) were used in two 6-wk trials to assess the effects of dietary pH and P source on growth performance, gastrointestinal digesta pH and chloride ion concentration (Cl-), and bone characteristics. Treatments were randomly allotted within blocks (based on weight within gender) to a 3 x 2 factorial arrangement with three dietary pH levels (5.4, 6.0, and 6.7) and two P sources: dicalcium phosphate (DCP) and defluorinated phosphate (DFP). Pigs fed the pH 6.7 diet had reduced ADG (P less than .01) and average daily feed intakes (ADFI; P less than .001) during wk 1 to 3 and overall compared with pigs fed the pH 6.0 diet, but ADG and ADFI were not affected when the pH 5.4 diet was fed. There was a dietary pH x P source interaction (P less than .05) for ADFI. Pigs had decreased ADFI as dietary pH was increased from 6.0 to 6.7 for both DCP and DFP, but ADFI was similar for the pH 6.0 and 5.4 diets with DFP, whereas ADFI was greater for the pH 5.4 diet with DCP. Dietary pH did not influence ADFI:ADG ratio (F:G; P greater than .05), and P source had no effect (P greater than .05) on either ADG, ADFI, or F:G.(ABSTRACT TRUNCATED AT 250 WORDS)     

OSTEOSARCOMA IN THE MIDDIAPHYSIS OF THE RADIUS IN THE DOG

This case report describes the radiographic/clinical progression of a lesion in the middiaphysis of the radius in a dog. The lesion initially looked benign but progressed and eventually was diagnosed as an anaplastic osteosarcoma.     

Unusual Patterns of Serum Antibodies to Streptococcus Equi in Two Horses with Purpura Hemorrhagica

An enzyme-linked immunosorbent assay (ELISA) was developed for use in horses to determine serum titers of antibodies of the immunoglobulin classes IgA, IgG, and IgM to Streptococcus equi M-like protein and culture supernatant protein antigens. Serum antibodies were determined in 28 adult horses, including 9 horses with recent S. equi infections, 17 horses without known exposure to S. equi, but without a history of respiratory disease in the preceding 4 months, and 2 horses with clinical purpura hemorrhagica. Serum IgA titers to culture supernatant protein antigen were highest in recently infected horses (P less than 0.001). Serial determinations of antibody titers in the horses with purpura showed that IgG antibodies to both S. equi M-like protein and culture supernatant protein antigens were undetectable initially, but later rose coincidental with clinical recovery from the disease. Possible mechanisms for these findings are discussed.     

MAGNETIC RESONANCE IMAGING AND COMPUTED TOMOGRAPHY CHARACTERISTICS OF INTRACRANIAL INTRA-ARACHNOID CYSTS IN 6 DOGS

Magnetic resonance imaging (MRI) and computed tomographic imaging (CT) characteristics of intracranial intra-arachnoid cysts in six dogs are described.Of the six dogs, three were less than one year of age and 4 were males. Five of the six dogs weighed less than 11 kg. Five cysts were located in the quadrigeminal cistern.On CT images, the intracranial intra-arachnoid cysts had sharply defined margins, contained fluid isodense to CSf and did not enhance following IV administration of contrast. On MRI images, the intracranial intra-arachnoid cysts were extra-axial, contained fluid isointense with CSF and did not enhance following IV contrast. While spinal arachnoid cysts of dogs have been reported in the literature, other than the six dogs contained in this report, intracranial intra-arachnoid cysts have not to our knowledge been described in animals. These six dogs have a similar age, sex, arachnoid cysts.