Nutritional Secondary Hyperparathyroidism in the Horse

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36 Nutritional Secondary Hyperparathyroidism in the Horse the disease”. Young growing animals develop the lesions faster and more severely than older ones. Increasing age does not, however, produce resistance. 4. Symptoms The first symptom is usually an insidious, shifting lameness [VARNELL (1 860), and most subsequent investigators]. A general tenderness of the joints and a stiff, stilted gait then occur. Muscular weakness, trembling, and a tottering motion when in motion have been described. Some animals prefer to canter rather than to trot; others refuse to move and if forced to do so inch along in a most crippled fashion. Spontaneous fractures and spontaneous avulsion of ligaments have been noted in all extensive outbreaks. Although lameness is the first sign, the most severe changes occur in the skull bones, notably the jaws. The maxilla and, usually to a lesser degree, the mandible and nasal bone may later exhibit a hyperostotic osteitis fibrosa. This swelling hasgiven the disease the expressive name “bighead” [LANE (1906); STURGESS and CRAWFORD (1927) ; KINTNER andHoLT (1932); OLIVER (1933); THEILER (1934); GREENLEE (1939); and others]. The appetite is normal; pica may occur [HAUBNER (1854)l. Due to extensive resorption of bone around the teeth mastication problems usually occur late in the course of the disease. This may, however, be the first sign [RYCHNER (185l)l. The duration varies and is apparently related to the degree of calcium to phosphorus imbalance in the feed. HAUBNER (1 854) observed a case for over 2 years; VARNELL (1860) gave a time of 6 months. The disease is not fatal in itself, but animals may die form starvation due to impaired mastication. More commonly, however, the horses are destroyed because of locomotor disturbances, especially when fractures occur. 5. Clinical Pathology NIIMI and AOKI (1927) reported decreased blood serum calcium levels in their two experimental cases of nutritional secondary hyperparathyroidism in mature horses. The average level was 13% lower than in two controls. Blood serum phosphorus was elevated 23% at the same time. Blood determinations were made only once. Downloaded from vet.sagepub.com by guest on April 14, 2010
Clinical Pathology 37 Table X. Serum calcium and phosphorus in spontaneous nutritional secondary hyperparathyroidism in the horse (KINTNER and HOLT) Calcium Phosphorus mg./100 ml. mg./100ml. Normal horses, n = 96 Maximum 14.3 5.00 Minimum 10.2 2.63 Average 11.2 3.55 Horses with nutritional secondary hyperparathyroidism, n = 36 Maximum 12.7 5.87 Minimum 8.1 3.20 Average 10.2 4.26 Samples were taken only once. KINTNER and HOLT (1932) studied a wide range of blood constituents in affected and normal horses. Differences existed only with regard to calcium and phosphorus (Table X). GROENEWALD (1937) reported that blood serum calcium, phosphorus, and alkaline phosphatase were normal inhis three experimental cases compared to two controls. No reports of a series of determinations of serum calcium, phosphorus, and alkaline phosphatase made during the experimentally induced course of nutritional secondary hyperparathyroidism in the horse have been found in available literature. 6. Roentgenologic Changes KINTNER and HOLT (1932) used radiographs as an aid to diagnosis. Anteroposterior views of the metacarpi were taken. The progress was followed radiographically with follow-up plates taken 3 months after the initial ones. Correlation with clinical symptoms was good. Cortical and medullary portions blended together to give a hazy, irregular appearance to the line of separation. The medulla was widened at the expense of the cortex. Longitudinal striations of decreased density were apparent in the cortex in varying degrees. GROENEWALD (1937) also radiographed the metacarpi of his experimental horses. He did this once, 2 months prior to the time severe clinical symptoms were noted. His findings were similar to those of KINTNER and HOLT. Downloaded from vet.sagepub.com by guest on April 14, 2010
Page 1 and 2: Pathologia Veterinaria Online http:
Page 3 and 4: Supplementum ad Vol. 1 (1964) Patho
Page 5 and 6: V . Experimental Nritritional Secon
Page 7 and 8: Introduction and Object of Investig
Page 9 and 10: I. The Anatomy of the Parathyroid G
Page 11 and 12: Comparative Aspects of the Embryolo
Page 13 and 14: The Aracroscopic Anatomy of the Equ
Page 15 and 16: The Microscopic Anatomy of the Equi
Page 17 and 18: 'I'hc hlicroscopic Anatomy of the E
Page 19 and 20: ’The I\licroscopic Anatomy of the
Page 21 and 22: 10 . 9 . a . 7 0 + 6 . 5 . 0 ’I
Page 23 and 24: ‘The hl icroscopic Anatomy of the
Page 25 and 26: ’I’hc hlicroscopic Anatomy of t
Page 27 and 28: ‘I’lic ihlrcroscopic Anatomy of
Page 29 and 30: ‘I’hc Alicroscopic Anatomy of t
Page 31 and 32: Discussion 25 7bbic 1 .. Avcragc si
Page 33 and 34: Discussion 27 Table VZZ. Nuclear si
Page 35 and 36: 11. Nutritional Secondary Hyperpara
Page 37 and 38: The Nature of the Osteopathy 31 Fig
Page 39 and 40: ’The Nature of the Osteopathy 33
Page 41: Etiology 35 Experiments and clinica
Page 45 and 46: 111. Experimental Nutritional Secon
Page 47 and 48: Ration 41 Table XI/. Calcium and ph
Page 49 and 50: Necrops y 43 6. Necropsy The animal
Page 51 and 52: Clinical Observations 45 During wee
Page 53 and 54: Clinico-pathologic Determinations 4
Page 55 and 56: 90. *. 90. 90. 70. / . Clinico-path
Page 57 and 58: (:linico-pathologic Determinations
Page 59 and 60: Rocntgencilogic Observations 53 Fie
Page 61 and 62: lioentgcnologic Ohscrvntions 55 I,'
Page 63 and 64: Pathologic Anatomy 57 7bb/e XIS. Si
Page 65 and 66: Pathologic Anatomy 59 fhb/c. A’X.
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Page 71 and 72: Pathologic Anatoiny Downloaded from
Page 73 and 74: Pathologic Anatomy 67 Downloaded fr
Page 75 and 76: Pathologic Anatomy 69 Fiq. 37. Cont
Page 77 and 78: V. Experimental Nutritional Seconda
Page 79 and 80: Scruin Phosphorus, Calciiiiii, and
Page 81 and 82: Serum Phosphorus, Calcium, and Alka
Page 83 and 84: Serum Phosphorus, Calcium, and Alka
Page 85 and 86: The Parathyroid Glands 79 should be
Page 87 and 88: The Skeleton 81 5. The Skeleton The
Page 89 and 90: The Skeleton 83 ary hyperparathyroi
Page 91 and 92: Summary and Conclusions The thesis
Page 93 and 94:
Siimmary and Conclusions 87 Rocntgc
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References 89 COILIP, J. B.: 'I'hc
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Refereiices 91 ~~CILAN, F. C. and U
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Appendix Tables and Statistical Ana
Page 101 and 102:
Tables and Statistical Analyses 95
Page 103 and 104:
’Tablcs and Statistical Analyscs
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Nutritional Secondary Hyperparathyroidism in the Horse

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