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Hind Leg Paralysis (HLP)
(Nutritional Secondary Hyperparathyroidism)
Hind leg paralysis is most often a nutritionally based deficiency involving calcium, phosphorus and/or Vitamin D. Sometimes it is referred to as metabolic bone disease. Metabolic bone disease is not really a single disease but a term used to describe many types of medical disorders affecting bones in animals and humans.
The most common type of metabolic bone disease affecting sugar gliders is known as nutritional secondary hyperparathyroidism. Hind leg paralysis (HLP) only describes one of the signs noticed by keepers of sugar gliders, but is not really a disease in and of itself. It is important that one understands that this is a complicated disease with a variety of symptoms and possible root causes.
Nutritional secondary hyperparathyroidism (HLP) results from a deficiency in dietary calcium, an improper balance of calcium to phosphorus in the diet
, too much dietary phosphorus and/or a shortage of Vitamin D. If calcium concentrations in the blood are too low (hypocalcemia), the parathyroid gland produces excess parathyroid hormone. This causes calcium to be removed from the bones to correct the low calcium levels in the blood. When calcium is removed from the bones they become weak and are more likely to break.
Parathyroids are glands located near the thyroid glands. These glands produce parathyroid hormone. This hormone effects the metabolism of calcium, phosphorus and Vitamin D by the bones, kidneys and intestines.
Sugar gliders are prone to some conditions that cause paralysis of the hind end, causing them to drag their legs, and ultimately leading to death. Often it seems to be related to calcium deficiency, which causes loss of bone mass and broken bones (particularly the hips). It can also happen in times of stress, such as when a glider moves to a new home. This condition is very grave because with this softening of the skeleton, comes other very severe complications such as:
Paralysis of the hind legs Since the pelvis and femurs (upper portion of the hind legs) are two large bone masses, they are probably hit first and hardest.
Pneumonia As the ribs decalcify, the diaphragm and intercostals muscles loose their ability to open the rib cage for deeper breaths of air. Without these large inhalations, moisture begins to collect in the lungs thus leading to pneumonia.
Collapsing of the spinal column This is the biggest and scariest of problems. The decalcification of the vertebral bodies can lead to their collapsing in on each other. This can result in the spinal cord being severed, which results in true paralysis and the inability to eliminate waste. If this happens, the only humane thing to do is put the animal to sleep, as the pain of waste retention is excruciating and will surely end in death.
Cardiac problems Calcium is essential for the heart muscle to operate properly, so calcium deficiencies are especially dangerous for the heart.
Nutritional Osteodystrophy or a decalcification (softening) of the bones due to lack of nutrients. In this condition, the body does not have enough calcium and protein to perform its various functions, and begins to draw calcium from the only source it can: the bones. Bone material becomes fibrous and flexible as the calcium which keeps it hard is steadily removed. Once the bones reach a certain point, they no longer offer anything to resist the contraction of muscles, and the victim becomes effectively paralyzed.
Osteodystrophy is caused by deficiencies of these nutrients:
1. Vitamin-D1: This D vitamin is readily available in many foods, but it needs to be converted to D3 via sunlight to be used efficiently.
2. Vitamin-D3: D3 enables the body to convert calcium to bone material.
3. Calcium: Calcium is necessary to keep the skeleton hard, as well as ensuring proper cardiac functions and many other bodily functions.
4. Protein: Used in conjunction with calcium to build strong bones. Also used to develop and maintain muscles.
Signs and Symptoms:
4. Fractured bones
7. Loss of use of hind legs or favoring one leg
8. Poor gripping ability
Hypocalcemia can also cause the nervous system to become more excitable. This in turn causes muscle tremors, tetany, and sometimes convulsions. It can also cause a generalized weakness, lethargy and lack of appetite.
Animals (including humans) need calcium, phosphorus and Vitamin D in specific balances to remain healthy. These chemicals are important for many functions in the body, not just for bones and teeth.
Things become more complicated bio-chemically when we consider the roles played by Vitamin D and phosphorus. Vitamin D has a major effect on increasing calcium absorption from the intestinal tract. Vitamin D ultimately aids in the absorption of calcium through a series of reactions in both the liver and the kidneys. It is through transformation of Vitamin D that calcium is able to properly absorb. Without Vitamin D in the diet
, calcium is an element that is relatively insoluble and difficult for the body to use.
When choosing foods to feed your sugar glider you should note the nutritional analysis on the food label or research other sources of available information on fresh foods offered. In addition to ensuring that calcium levels are sufficient in your petís diet
, you should also note the phosphorus levels.
Phosphorus in an element that is easily absorbed by the intestines, but it can combine with calcium for form calcium phosphate compounds that are not absorbed, but excreted in the feces. This process is prevalent if excess calcium is present. Elevated levels of phosphorus can also negatively effect the proper transformation of Vitamin D into a usable form, due to the effects of excessive phosphorus on the production of parathyroid hormone. To much dietary phosphorus ultimately inhibits the effectiveness of the body to absorb and utilize calcium in a manner supportive to good animal health.
How to help your pet immediately:
Get your pet to a vet
as soon as possible. Hopefully you can find a vet
who is familiar with Sugar Gliders, but if not, or if the vet
is unsure of what to do, at the very least, have the vet
give your pet a calcium supplement injection Neoglucagon/Calglucagon. A Vitamin-D supplement is also needed for processing of the calcium.
Be sure your pet gets at least one-half to one hour of unfiltered sunlight a day. This is necessary if your pet is not getting sufficient quantities of Vitamin-D3 in their diet
or supplements. Sunlight converts Vitamin-D1 to D3 and the body then uses the D3 to process the calcium into bone material.
Be sure your pet is eliminating. Calcium has the side effect of being a gas producer. You may notice your pet is somewhat bloated. This is alright if your pet is eliminating. If he/she is not eliminating, it may indicate a spinal injury or, at the very least, it may mean that your pet is having trouble bearing down for bowel movements.
Keep your pet quiet and restrict movement as much as possible. Leave some room for movement (perhaps a 1 to 1.5 ft. square space). Your petís skeleton is probably pretty weak, and it runs the risk of injuring itself just by moving around. Be careful not to do anything that might frighten it and cause it to try and flee.
Avoid picking your pet up too much. Once again, those bones are pretty weak. Handling, only while necessary. By picking him/her up could easily cause more damage. Talking softly, and petting, offering treats etc. to let them know that you love them and that they are safe. If you do pick him/her up, be sure not to try to manipulate the appendages. This can also cause severe damage to the bones.
As a sugar glider owner, it is important that you understand that a well balanced diet
is critical to your pets long term health. One of the components of a good dietary plan will include provision for proper amounts and ratios of calcium, phosphorus, and Vitamin D in the foods that your glider eats. Your want to maintain positive calcium to phosphorus ratio.
In summary, metabolic bone disease develops over time from extended poor feeding habits. If you begin to see signs of tremors, weakness, paralysis or lethargy, see your veterinarian
immediately. Often when symptoms such as these present, the disease may be in a last stage and immediate treatment will be prescribed. Your sugar glider may require aggressive treatment to reverse the effects of nutritional secondary hyperparathyroidism. This may include diagnostics such as blood work and/or radiographs, hospitalization, calcium and/or vitamin injections, fluids, oral calcium and a diet
Remember, prevention is the best medicine and feeding your sugar glider a healthy diet
will ward off many unwelcome conditions. Daily exercise is vital. Exercise helps bones absorb calcium and stimulates bone thickening. Always try to aim for high Calcium to Phosphorus ratios. Last but not least....Give your Sugar Glider plenty of love, healthy treats, and maintain a low stress environment.