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968 Thiamine Deficiency

• Plain skull or spinal radiographs ○ Hygiene: regular cleaning of perineum; • Nursing care is often intensive, extensive,
• Cerebral spinal fluid (CSF) analysis (pp. 1080 ensure animals are kept on clean, dry and expensive.
VetBooks.ir • Myelography Chronic Treatment Technician Tips
and 1323)
bedding.
Technicians caring for these patients should be
• MRI (p. 1132) or CT
• Electrodiagnostic and histopathologic evalu-
ation of affected muscle and nerves Long-term supportive therapy may be necessary. able to turn the patients regularly to minimize
the risk for pressure sores, be familiar with
• Detection of antibodies to acetylcholine recep- Possible Complications precautions to be taken when moving patients
tors in cases of fulminant myasthenia gravis Complications associated with tetraplegia or that have spinal cord disease, be familiar with
severe tetraparesis: urinary catheter management, and be able to
TREATMENT • Decubital ulcers/pressure sores perform range-of-motion exercises.
• Urinary tract infections (with chronic urinary
Treatment Overview bladder catheterization) Client Education
Treatment goals are to eliminate the inciting • Fecal impaction • Diseases resulting in tetraplegia or tetraparesis
cause and provide adequate supportive nursing • Pneumonia can be costly to diagnose and treat.
care. • When applicable, provide a Client Education
Recommended Monitoring Sheet: How to Perform Range-of-Motion
Acute General Treatment • Complete physical exams two times per day Exercises.
• Treat underlying condition if possible. to identify complications from recumbency
• Intensity of nursing care depends on the • Regularly scheduled and frequent neurologic SUGGESTED READING
individual needs of the animal. assessments to monitor disease progression Comparative Neuromuscular Laboratory, University
• Some supportive therapies to be considered • Severe or progressive CNS or neuromuscular of California, San Diego, Department of Pathology,
○ Assisted pulmonary ventilation (p. 1185): disease: regular assessment of respiratory School of Medicine (website). http://vetneuromus-
if inadequate spontaneous ventilation function cular.ucsd.edu.
○ Caloric intake: hand-feeding (p. 1199), AUTHOR: Aubrey A. Webb, DVM, PhD
feeding by esophagostomy/gastrostomy PROGNOSIS & OUTCOME EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
tube (p. 1106)
○ Hydration: appropriate fluid therapy Varies, depending on underlying cause
○ Muscle contracture: passive range-of-
motion exercises PEARLS & CONSIDERATIONS
○ Pressure sores: turn animals frequently,
and treat the lesions early and intensively Comments
if they occur. • Referral to an appropriate treatment center
○ Urinary bladder (e.g., catheterization) and is often necessary.
bowel management (e.g., stool softener)

Thiamine Deficiency

BASIC INFORMATION ○ Excessive losses during conventional pet ○ May occur despite adequate intake due
food production; processing conditions to chronic gastrointestinal (GI) diseases
Definition are destructive to thiamine, especially and subsequent malabsorption or
Deficiency of thiamine (i.e., vitamin B 1), canning. Typically, manufacturers over- maldigestion.
a water-soluble vitamin, may result from come predicted losses by adding synthetic ○ Feline leukemia virus (FeLV) subgroup
inadequate intake or alterations of thiamine thiamine before processing. A attaches to the thiamine transporter 1
absorption, retention, and metabolism. ○ Consumption of antagonists that inacti- (THTR1), which subsequently prevents
vate thiamine; thiaminases that degrade thiamine uptake. Because THTR2 is not
Epidemiology thiamine are found in raw seafood, affected, the risk of thiamine deficiency
SPECIES, AGE, SEX certain ferns, and some bacterial species. as a result of FeLV may be low.
• All dogs and cats, irrespective of signalment Cooking destroys these enzymes. Natural ○ Alaskan Husky encephalopathy, a fatal
• Cats are more susceptible due to higher polyhydroxyphenols (caffeic acid, phenols, juvenile neurologic disease, is thought to
dietary thiamine requirement and frequent flavonoids, and tannins), which are heat- be caused by a mutation of the SLC19A3
consumption of fish-based diets. stable compounds found in plants, can gene encoding THTR2 in nervous
• Growth and reproduction also increase transform thiamine to nonabsorbable tissue.
thiamine requirement. thiamine disulfide. Sulfur dioxide and • Excessive renal excretion of thiamine
sodium disulfide are antithiamine factors ○ Increased urinary thiamine excretion
RISK FACTORS used to preserve meats and have been occurs with polyuria/polydipsia or
• Low dietary thiamine intake implicated in cases of thiamine deficiency administration of diuretics (furosemide,
○ Consumption of unbalanced homemade in dogs and cats; these are prohibited by chlorothiazide). Surprisingly, dogs with
diets; can occur when the diet is not the U.S. Department of Agriculture. chronic kidney disease (CKD) have
formulated by a specialist in nutrition or ○ Hyporexia or anorexia higher blood thiamine diphosphate
when pet owner deviates from a balanced • Alterations of thiamine absorption and concentrations compared with healthy
recipe metabolism controls.

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