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Pathological bradyarrhythmia is rare in horses but should be especially considered when presented with a horse that has signs consistent with episodic weakness or collapse. This paper reviews the literature describing our current knowledge of, and possible mechanisms causing, clinically significant bradyarrhythmia in horses.

Background: Hypokalaemic periodic paralysis (HPP) is a rare muscular disorder characterised by episodic weakness associated with hypokalaemia. The disease can either be inherited or acquired and misdiagnosis of the disease is quite common. Most of the data available on the disease is from the western world. Studies reporting aetiological, clinical and metabolic profiles of Indian population are sparse. Hence we tried to provide insights of the disease among the Indian population. Aim: To study the aetiological, clinical and metabolic profile of patients diagnosed with Hypokalaemic Periodic Paralysis (HPP). Materials and Methods: This is an observational and analytical study on HPP diagnosed patients, during September 2011 to September 2014 in Kasturba Hospital, Manipal. A total of 23 patients were studied. Detailed history, clinical evaluation and metabolic workup for secondary causes of HPP were analysed. Results: Of the 23 patients, 57% had primary HPP while 43% had secondary HPP. The group of patients with primary HPP comprised of 92% males and 8% females with mean age of 28 years and the mean duration of symptoms of 18 hours. The group with secondary HPP comprised of 70% males and 30% females with mean age of 38.7 years and the mean duration of symptoms of 60 hours. The secondary causes of HPP were thyrotoxicosis (50%), infective diarrhea (20%), Crohn’s disease (10%), renal tubular acidosis (RTA) Type I (10%) and Conn’s syndrome (10%). Conclusion: In our study primary HPP was found to be more common than secondary HPP. Males were predominantly affected in both groups. HPP should be ruled out before starting therapy for Guillain-Barre Syndrome (GBS).

Kolevska J., R. Husnik, V. Brunclik, V. Mandys, Z. Vernerova, P. Schanilec, L. Barto‰ova, M. Svoboda:A Case of Canine Insulinoma . Acta Vet. Brno 2004, 73: 353-358. The paper reports on a ten-year-old German Shepherd presented with a history of episodic weakness and convulsions after exercise. The patient showed status epilepticus upon presentation. Glucose concentrations repeatedly determined by glucometer were below detection threshold. After intravenous administration of glucose the condition always temporarily improved, however after 1‐2 hours the situation reverted. Insulinoma was diagnosed on the basis of parallel determination of hypoglycaemia (glucose 3.3 mmol⋅l -1 ) and hyperinsulinaemia (2.398 pmol⋅l -1 ). A poor prognosis was stated and the owner decided for euthanasia. Necropsy revealed a tumour of pancreas. Subsequent pathological, immunohistochemical and electron microscopic examinations confirmed the diagnosis of insulinoma.

To evaluate the usefulness of the Doppler-derived effective orifice area (EOA) in assessing the hemodynamic severity of subaortic stenosis (SAS) in dogs, 2-dimensional and Doppler echocardiographic examinations were performed in 16 dogs with SAS, 22 normal adult dogs, and 22 normal puppies. The EOA was calculated by the continuity equation using the stroke volume determined in the right ventricular outflow tract. The EOA was significantly lower (P or =1.25 cm2/m2. Among the demographic and echocardiographic parameters measured in this study, only the indexed EOA was significantly associated (P = .03) with the occurrence of adverse events (eg, syncope, episodic weakness, ventricular arrhythmias). This study demonstrates the usefulness and feasibility of the indexed EOA as measured by Doppler echocardiography for noninvasive assessment of SAS severity in dogs.

Answers on p 421. A 62 year old retired woman was admitted to hospital with a 10 month history of pain and weakness in the muscles of both arms and legs. Her problems began with episodic weakness in both legs such that on occasions her legs gave way and she fell to the ground. She had a gradual deterioration in her muscle strength and after a fall five months before admission she …

Answers on p 795. A 37 year old women presented with a 10 year history of episodes of weakness and palpitations. On one or two occasions each year she was admitted to her local hospital where her serum potassium concentration was always below the reference range with the lowest concentration reported at 2.2 mmol/l (3.5–5.0 mmol/l). The episodes …