Page 2727 - Cote clinical veterinary advisor dogs and cats 4th

1418 Fractures, Multiple Pathologic

Fractures, Multiple Pathologic
VetBooks.ir

Multiple fractures in a young animal
Radiographs: thin cortices with wide medullae

Normal width Increased width Increased or normal
growth plates growth plates width growth plates

Normal serum calcium (Ca) Low to normal Ca
Low serum phosphorus (P) Low to normal P Normal routine
Increased serum PTH Increased PTH blood values
Increased serum 1,25(OH) 2 Decreased 1,25(OH) vitamin D
vitamin D 2
Specific blood chemistry
(PTH, vitamin D, thyroxine,
Nutritional secondary Rickets alkaline phosphatase,
hyperparathyroidism
osteocalcin)
Switch to
Switch to balanced diet Rare bone diseases
balanced diet (osteogenesis imperfecta,
/ Yes hypothyroidism)

Add Ca carbonate or Normalization of No improvement with
Ca lactate to diet skeletal mineralization balanced diet
in 3 weeks

Long-term vitamin D therapy
No improvement Regression/improvement not sustained
(From Ettinger SJ, Feldman EC: Textbook of veterinary internal medicine, ed 7, St. Louis, 2010, Elsevier.)

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