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| |a1= Bone resorption is shown, caused by excessive secretion of parathyroid hormone due to secondary nutritional hyperparathyroidism, which is often seen in this species. | | |a1= Bone resorption is shown, caused by excessive secretion of parathyroid hormone due to secondary nutritional hyperparathyroidism, which is often seen in this species. |
| In this case, there was insufficient dietary intake of vitamin D3 (New World primates require vitamin D3, not D2) which produced insufficient intestinal absorption of calcium. As blood calcium concentration falls, parathyroid hormone concentration rises to mobilize calcium from the bones into the circulation. Although low calcium intake and kidney disease can also cause this type of bone resorption, the principal cause in captive common marmosets is lack of dietary vitamin D3. | | In this case, there was insufficient dietary intake of vitamin D3 (New World primates require vitamin D3, not D2) which produced insufficient intestinal absorption of calcium. As blood calcium concentration falls, parathyroid hormone concentration rises to mobilize calcium from the bones into the circulation. Although low calcium intake and kidney disease can also cause this type of bone resorption, the principal cause in captive common marmosets is lack of dietary vitamin D3. |
− | |l1= Hyperparathyroidism#Nutritional Hyperparathyroidism | + | |l1= Hyperparathyroidism#Introduction |
| |q2= What clinical signs might you see when this condition is present? | | |q2= What clinical signs might you see when this condition is present? |
| |a2= When bone resorption becomes severe, captive primates become inactive and move slowly about their cages due to pain, muscle weakness and pathologic fractures. The teeth become loose resulting in eating difficulties. | | |a2= When bone resorption becomes severe, captive primates become inactive and move slowly about their cages due to pain, muscle weakness and pathologic fractures. The teeth become loose resulting in eating difficulties. |
− | |l2= Hyperparathyroidism#Nutritional Hyperparathyroidism | + | |l2= Hyperparathyroidism#Clinical Signs |
| |q3= How would you confirm the diagnosis? | | |q3= How would you confirm the diagnosis? |
| |a3= Radiograph the caudal skull and long bones. | | |a3= Radiograph the caudal skull and long bones. |
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| Obtain a blood sample to detect low serum calcium concentration. An ionized calcium concentration is a more sensitive test than total serum calcium. | | Obtain a blood sample to detect low serum calcium concentration. An ionized calcium concentration is a more sensitive test than total serum calcium. |
| Absolute confirmation of the diagnosis is possible by measuring blood parathyroid concentration. Some test kits used in humans are suitable. Parathyroid hormone concentration up to 10 times normal can be seen. | | Absolute confirmation of the diagnosis is possible by measuring blood parathyroid concentration. Some test kits used in humans are suitable. Parathyroid hormone concentration up to 10 times normal can be seen. |
− | |l3= Hyperparathyroidism#Nutritional Hyperparathyroidism | + | |l3= Hyperparathyroidism#Diagnosis |
| |q4= How would you treat the condition? | | |q4= How would you treat the condition? |
| |a4= Although the need for vitamin D3 rather than vitamin D2 is commonly understood, the high dietary requirement in this species is less recognized. Marmosets and some other New World primates have a 1,25 (OH)2 vitamin D3 receptor that is either blocked by a protein or is much less sensitive to vitamin D3. The blood concentration of vitamin D3 needs to be high to compensate for the presence of this blocking protein. | | |a4= Although the need for vitamin D3 rather than vitamin D2 is commonly understood, the high dietary requirement in this species is less recognized. Marmosets and some other New World primates have a 1,25 (OH)2 vitamin D3 receptor that is either blocked by a protein or is much less sensitive to vitamin D3. The blood concentration of vitamin D3 needs to be high to compensate for the presence of this blocking protein. |
| Maintain a high blood concentration of vitamin D3 in the marmoset by administering approximately 1,100 iu/kg/day (compared to 11 iu/kg/day in dogs) of vitamin D3. In addition, expose New World primates to unfiltered sunlight to encourage production of vitamin D3 in the skin. It is may be possible to provide some UV light using daylight spectrum light bulbs. | | Maintain a high blood concentration of vitamin D3 in the marmoset by administering approximately 1,100 iu/kg/day (compared to 11 iu/kg/day in dogs) of vitamin D3. In addition, expose New World primates to unfiltered sunlight to encourage production of vitamin D3 in the skin. It is may be possible to provide some UV light using daylight spectrum light bulbs. |
− | |l4= Hyperparathyroidism#Nutritional Hyperparathyroidism | + | |l4= HyperparathyroidismTreatment |
| </FlashCard> | | </FlashCard> |
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