1. Parathyroid gland ( Hyperparathyrodism) Dr/ Abd Elghany Hefnawy

2. PTH

3. Kidney -Decrease P reabsorption from PCT -Increase Ca reabsorption from DCT causing increase plasma Ca level Intestine Increase formation of 1,25 DHCC causing increase Ca absorption from intestine Bone Increase Ca resorption from bone causing increase plasma Ca level PTH

6. Hyperparathyrodism Autonomous Secondary Primary-HPT Pseudo-HPT Renal-HPT Nutritional- HPT

7. Autonomous HPT Secretion of PTH is autonomous i.e. not related to the existing Ca level Pseudo-HPTPrimary-HPT Excessive production of other bone resorbing substances (Non- parathyroid tissues) as mammary glands -Parathyroid neoplasm -Hyperplasia -Ectopic parathyroid neoplasm Hypercalcemia including Primary HPTPseudo HPT Hypervitaminosis-D

8. Autonomous HPT

9. Clinical Signs Anorexia and general depression Constipation and vomiting Muscular weakness Rubber jaw(softness of mandible bone) Easily fractured bone Polyueria and polydepsia Calcium urolithiasis Cardiac arrhythmia Loss teeth

10. Diagnosis History and clinical signs Lab diagnosis -High level of calcium and PTH -Low level of phosphorous Radiography -Decrease bone density and increase bone cysts -Ultrasonography of PTH glands -Surgical diagnosis

11. Steroid(Dexamethazon) suppression test To differentiate between PHPT and PsHPT By injection of Dexamethazon (0.5-1mg/kg IM) Calcium level decreased If PsHPT Calcium level remain high PHPT

12. Treatment Surgical interference

13. Renal Hyperparathyroidism

14. Renal failure Low production of vit-D (Active form 1.25DHCCF) Excessive Execretion of calcium Protein catabolism with excess release of phosphorous Hypocalcemia Hypertrophy of parathyroid gland Renal hyperparathyrodism

15. Diagnosis Low calcium High PTH Abnormal kidney function tests Treatment Calcium borogluconate Vitamin-D IM Treatment of renal failure

16. Nutritional Hyperparathyroidism Diet Calcium Phosphorou s Young animal with signs of rickets

17. Diagnosis Low calcium High PTH High phosphorous (In rickets the P is low) Treatment Calcium borogluconate Reduction using of corticosteroid because it reduces serum calcium Correction of the dietary supplementation Almunium hydroxide gel To inhibit P++ absorption

18. Hypoparathyroidism Congenital Autoimmune reaction in lymphatic parathyroditis Destruction of parathyroid gland by neoplasm Atrophy of parathyroid gland High number of puppies Usually in lactating bitch or queen

19. Clinical Signs Increase the neuromuscular excitability Hyperesthesia (Hypersensitivity against external stimuli) Ataxia and weakness -Tetany -Convulsion -Muscular spasm

20. Treatment Calcium borogluconat 10% (0.5-1 ml/kg) Admisteration of vitamin-D 50,000-100,000 IU /Day

21. QUESTIONS

22. وسائل التواصل Email: abdelghani72@yahoo.comabdelghani72@yahoo.com Abdelghany.hefnawy@bu.edu.eg Facebook abdelghany hefnawy د. عبد الغني حفناوي Web site to download lectures www.bu.edu.eg/staff/abdelghanyhefnawy www.bu.edu.eg/staff/abdelghanyhefnawy (Courses) Tel 01011676482