Clinath curly case

1. Curly Case
Presentation
2YO F HIGHLAND PONY

2. Presented
Recumbent in field

3. Haematology Abnormalities
Leukocytosis 18.67
(5.4 – 14.3 x10E9/l)
Neutrophilia 16.243 (2.7
– 6.8 x10E9/l)

4. Biochem Abnormalities
Hypochloraemia 91.5 (94-113mmol/l)
Hypocalcaemia 2.48 (2.78-3.30 mmol/l)
↑ Urea 8.6 (-6.84 mmol/l)
↑ Triglyceride 5.29 (-0.8 mmol/l)
↑ Total Bilirubin 63 (-25 mmol/l)

5. ALK Phos 1584 (-280 U/l)
AST 15368 (-240 U/l)
Creatinine Kinase 320 000 (-150 U/L)
CK levels achieved using a 1 in 20
dilution of the sample in the analyser
then corrected for reporting

6. Differentials
 Myopathy
Atypical myoglobinuria
Exertional myopathy/rhabdomyolysis
Polysaccharide storage myopathy
Equine Motor Neuron .
Fibrotic and ossifying myopathy
Nutritional myopathy
Post anaesthestic myopathy
 Decreased renal
function
 Acute liver
disease

7. Atypical Myopathy
(Atypical Myoglobinuria)
Acute rhabdomyolysis
Weakness, stiffness, recumbency and high
mortality rate
Linked to Sycamore seeds? (pasture grazing)
< 3 years old
Higher prevalence in females
Intensive therapy is required
Mortality rate is very high

8. References
http://www.minstervets.co.uk/uploads/Files/Blood%20Tests.pdf
http://www.iceep.org/pdf/iceep1/_1201141856_001.pdf
https://www.vetstream.com/equis/Content/LabTest/lab00054
http://liphookequinehospital.co.uk/wp-content/uploads/Lab-Book-Weight-
Loss.pdf
http://www.vet.cornell.edu/consultant/
http://www.sciencedirect.com/science/article/pii/S1090023308000518
http://labtestsonline.org.uk/understanding/analytes/ck/tab/test/
http://onlinelibrary.wiley.com/doi/10.1111/j.2042-3306.2006.tb05565.x/pdf