User:ANUSHA JOY PAYYAPPILLY/sandbox

Synchronous Diaphragmatic Flutter
'GENERAL INFORMATION'''

Synchronous diaphragmatic flutter (SDF) is a contraction of the diaphragm that is synchronous with the contraction of the heart or the spontaneous contractions of the abdominal wall and across the coastal arches, The rate of contractions coincided with the heart rate and increased during exercise. Its is also known as "thumps".The phrenic nerve traverses the thoracic cavity ,nerve to the heart ,to inner active the diaphragm. The nerves becomes hyper excitable due to fluid and electrolyte imbalances ,mainly calcium ,causing it to fire when the atrium of the heart contracts. It may also, less commonly , be due too much potassium outside the cells.Any age , breed , or sex may be affected. Though it can be caused by an number of reasons in humans,the origin of thumps in horses can usually be traced due to the electrolyte imbalance

content
 * CAUSES
 * SYMPTOMS
 * DIAGNOSIS
 * TREATMENT
 * REFERENCE

CAUSES Endurance horses are commonly affected due to the loss of calcium in sweat, But it may also happen in horses ill from other causes.So any time there is a prolonged exercise associated with profuse sweating this may occur.It may also occur to gastrointestinal disease. It most commonly seen as sign of dehydration and electrolyte depletion among horses performing in endurances races.This can also result from a horse ingesting canthardin, a toxin found in blister beetles, insects that are sometimes harvested in alfalfa hay.

SYMPTOMS This may develop as soon as 20-30 minutes into the ride. observation of the horse reveals spasmodic contraction in the flank area either unilaterally or bilaterally. Ausculating the heart while lightly palpating the flank area shows the synchronicity of the two. The Diaphragmatic contractions may range from barely palpable to spasms that move the whole body. these contractions may be continuous or intermittent DIAGNOSIS

Rather than a disease,Synchronous diaphragmatic flutter is a clinical manifestation of deranged electrolyte levels and acid base status, therefore many disease may be associated with this condition like Hiccups and non synchronous diaphragmatic flutter have been observed.However ,in these cases diaphragmatic twitching is not synchronous with cardiac contractions.The Forceful contractions  of the abdominal muscles may accompany severe respiratory disease(examples:recurrent airway obstruction,pneumonia).Affected horses present with the obvious signs of respiratory disease, however and each abdominal contractions is associated with expiration ,not wit a heart beat.It can be also diagnosed by  CBC ,Biochemistry,urinalysis test which can detect hypocalcemia , hypokalemia , and alkalosis (metabolic or respiratory) are the most common metabolic abnormalities,Serum ionized calcium concentration is more accurate than total calcium concentration to diagnose hypocalcemia. the other laboratory diagnosis also includes blood gas analysis is useful to asses acid base status. The diagnostic procedures can be confirmed by simultaneously recording the electrocardiogram and the diaphragmatic contractions, either manually or with electromyography or phonocardiography TREATMENT

Treatment consists of treating the underlying cause and replacing lost electrolytes, includes calcium, magnesium and sodium bicarbonate in horses with acid base disturbances. Electrolytes may be given orally in situation. Dehydration horses will require intravenous fluid administration should be avoided as this will make it more difficult for the body to control calcium levels via parathyroid hormone. Although SDF is not life threatening in most cases, electrolyte abnormalities may cause weakness, intestinal stasis and and cardiac arrhythmias

REFRENCE
 * 1) https://www.merckvetmanual.com/endocrine-system/the-parathyroid-glands-and-disorders-of-calcium-metabolism/hypercalcemia-in-horses
 * 2) https://thehorse.com/122996/equine-thumps-are-more-than-mere-hiccups/
 * 3) http://lib.dr.iastate.edu/cgi/viewcontent.cgi?article=3144&context=iowastate_veterinarian