1 / 32

Meghan Ellis

Meghan Ellis. Calcium and Phosphorus Metabolism in Reptiles. Clinical Importance. More than 3.9 million US households with 1+ reptile pets Ca and P derangements are common in pet reptiles Preventable with proper husbandry Treatable with early intervention. Calcium Importance.

morwen
Download Presentation

Meghan Ellis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Meghan Ellis Calcium and Phosphorus Metabolism in Reptiles

  2. Clinical Importance • More than 3.9 million US households with 1+ reptile pets • Ca and P derangements are common in pet reptiles • Preventable with proper husbandry • Treatable with early intervention

  3. Calcium Importance • Cell signaling • Neural transmission • Muscle function • Blood coagulation • Enzymatic co-factor • Membrane and cytoskeletal functions • Bone mineralization

  4. Calcium Regulation

  5. Parathyroid Gland

  6. PTH Regulation • Decreased serum ionized calcium increased synthesis and secretion of PTH from chief cells • Increased serum ionized calcium negative feedback loop • Increased phosphorus decreased serum Ca stimulation of PTH increased renal excretion of phosphorus

  7. Metabolic Functions of PTH • Activate osteoclasts mobilizes calcium from bone • Increase renal tubular reabsorption of calcium • Increases conversion of vitamin D to active dihydroxy form in kidneys • Augments GI calcium absorption

  8. Metabolic Functions of Calcitonin • Promotes absorption of calcium by skeletal system • Inhibits resorption of bone by osteoclasts

  9. Calcitonin Regulation • Increased serum ionized calcium increased synthesis and secretion of calcitonin by C cells of thyroid gland • Decreased serum ionized calcium negative feedback loop

  10. Thyroid Gland

  11. Phosphorus Importance • Bone mineralization • Phospholipid in cellular membranes • Cellular respiration • Component of DNA and RNA • Post-transcriptional modification of proteins

  12. Phosphorus Regulation

  13. Vitamin D3 • Stimulates calcium and phosphorus absorption by intestinal mucosa • Maintains calcium and phosphorus balance for optimal bone mineralization

  14. Calcium Clinical Pathology • Normal total serum calcium: 8-11mg/dL in most reptiles • Normal ionized calcium in Green Iguana: 1.47 +/- 0.104 mmol/L

  15. Hypocalcemia (<8.0 mg/dL) • Dietary deficiency • Excessive dietary phosphorus • Secondary nutritional hyperparathyroidism • Vitamin D3 deficiency (dietary or lack of UV light) • Hypoablbuminemia • Hypoparathyroidism

  16. Hypercalcemia (>20mg/dL) • Excessive dietary calcium and vitamin D3 • Primary hyperparathyroidism • Pseudohyperparathyroidism • Osteolytic bone disease • Vitellogenesis (physiologic)

  17. Phosphorus Clinical Pathology • Normal serum phosphorus: 1-5mg/dL

  18. Hypophosphatemia • Starvation • Nutritional deficiency

  19. Hyperphosphatemia (>5mg/dL) • Excessive dietary phosphorus • Hypervitamintosis D3 • Renal disease • Severe tissue trauma • Osteolytic bone disease • Sample handling error

  20. Nutritional Secondary Hyperparathyroidism • Cause: diet low in calcium or vitamin D3, diet high in phosphorus, lack of exposure to UV-B light • Pathogenesis: Low serum Ca PTH secretion increased bone resorption, increased renal absorption of Ca and increased excretion of PO4, stimulation of 1,25-dihydroxycholecalciferol which increases GI absorption of Ca increase serum calcium and decrease serum PO4

  21. NSHP Effects • Hypocalcemia neural hyperexcitability twitching digits, hyperreflexia, ataxia, disorientation, cloacal prolapse • Increased osteoclastic osteolysis demineralization of bone fractures of long bones and spine, thickening and swelling of long bones and mandibles, “rubber jaw”

  22. NSHP Effects continued • Effects on reproduction: decreased calcification of egg shells weak rubbery eggs • Clinical Pathology: low normal serum calcium; increased PTH

  23. NSHP

  24. NSHP Treatment • Correct hypocalcemia • Rehydrate • Correct Husbandry

  25. Renal Secondary Hyperparathyroidism • Cause: chronic renal disease- degenerative nephroses due to inadequate husbandry, poor nutrition, NSHP • Pathogenesis:failure of kidneys to excrete excess phosphorus decreased serum Ca due to Ca X P rule PTH secretion • Hyperphosphatemia renal tubular cells cannot hydroxylate 25-hydroxycholecalciferol to active vitamin D3 increased PTH secretion • Decreased vitamin D3 no GI absorption of Ca

  26. RSHP Effects • Crispy critters: Ca x P >9  mineralization of kidneys; >12 mineralization of other soft tissues especially GI and cardiorespiratory systems • Ischemic necrosis of tail, vomiting, passing poorly digested food, congestion of peripheral blood vessels especially obvious in sclera • All the signs of hypocalcemia

  27. RSHP

  28. RSHP Clinical Pathology • Hyperphosphatemia • Low or low normal serum calcium • Dehydration • Nonregenerative anemia • Inverted Ca:P ratio (should be 1.2-2:1) • Increased PTH • Iohexol clearance study for GFR estimate

  29. Other Methods • Renal biopsy • Ultrasound • Radiograph

  30. RSHP Treatment • Usually present in end-stage renal failure • Reduce dietary protein • Correct hyperphosphatemia • Correct hypocalcemia • Correct and prevent dehydration • Supplement vitamin B complex • Omega-6: Omega-3 = 3:1 • Correct husbandry

  31. The End

  32. References • Robbins and Cotran Pathologic Basis of Disease 7th ed • Nelson and Couto Small Animal Internal Medicine 3rd ed • Mader Reptile Medicine and Surgery • Hernandez-Divers, Stephen et al “Renal evaluation in healthy green iguanas (Iguana iguana): assessment of plasma biochemistry, glomerular filtration rate, and endoscopic biopsy.” Journal of Zoo and Wildlife Medicine June 2005; 36(2):155-168

More Related