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Cordella A, Bertaccini J, Rondena M, Zoia A, Bertolini G. Multidetector-Row CT Findings in Dogs with Different Primary Parathyroid Gland Diseases. Vet Sci 2022; 9:vetsci9060273. [PMID: 35737325 PMCID: PMC9228294 DOI: 10.3390/vetsci9060273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/30/2022] [Accepted: 06/03/2022] [Indexed: 11/29/2022] Open
Abstract
Primary hyperparathyroidism in dogs is a possibly life-threatening condition, characterized by the excess of parathyroid hormone (PTH) secretion, which leads to an increase in serum ionized calcium level. The utility of computed tomography (CT) in the detection and characterization of parathyroid diseases in dogs has not been assessed to date. Therefore, the aim of this study was to describe the use of multidetector-row CT (MDCT) for the diagnosis of parathyroid disease in dogs. For this descriptive, single-center study, the database of the San Marco Veterinary Clinic was searched for dogs having a suspicion of parathyroid disease who underwent contrast-enhanced MDCT in the period from 2005 to 2021. Dogs with histopathology of the affected parathyroid gland were subsequently considered for inclusion. A total of 22 parathyroid glands were included: 12 adenomas, 8 adenocarcinomas, and two glands with hyperplasia. Several CT features were evaluated, including parathyroid gland affected, lateralization, shape, size, attenuation, and contrast-enhancement. Although the overlap between the appearance of different diseases exists, contrast-enhanced CT was a useful method for the diagnosis of parathyroid disease in dogs.
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Affiliation(s)
- Alessia Cordella
- Diagnostic and Interventional Radiology Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy; (A.C.); (J.B.)
| | - Jessica Bertaccini
- Diagnostic and Interventional Radiology Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy; (A.C.); (J.B.)
| | - Marco Rondena
- Pathology Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy;
| | - Andrea Zoia
- Internal Medicine Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy;
| | - Giovanna Bertolini
- Diagnostic and Interventional Radiology Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy; (A.C.); (J.B.)
- Correspondence:
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Townsend KL, Ham KM. Current Concepts in Parathyroid/Thyroid Surgery. Vet Clin North Am Small Anim Pract 2022; 52:455-471. [DOI: 10.1016/j.cvsm.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tremolada G, Schaffer P, Pitt K. Non‐secreting parathyroid carcinoma in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Giovanni Tremolada
- Department of Veterinary Clinical Sciences College of Veterinary Medicine Ohio State University Columbus Ohio USA
- Flint Animal Cancer Centre College of Veterinary Medicine and Biological Sciences Colorado State University Fort Collins Colorado USA
| | - Paula Schaffer
- Veterinary Diagnostic Laboratory Department of Microbiology, Immunology and Pathology College of Veterinary Medicine and Biological Sciences Colorado State University Fort Collins Colorado USA
| | - Kathryne Pitt
- Flint Animal Cancer Centre College of Veterinary Medicine and Biological Sciences Colorado State University Fort Collins Colorado USA
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Erickson AK, Regier PJ, Watt MM, Ham KM, Marvel SJ, Wallace ML, Colopy SA, Scharf VF, Zheng J, Dugat DR, Sumner JP, Howard J, Skinner OT, Mickelson MA, Thieman-Mankin KM, Colee JC. Incidence, survival time, and surgical treatment of parathyroid carcinomas in dogs: 100 cases (2010-2019). J Am Vet Med Assoc 2021; 259:1309-1317. [PMID: 34727057 DOI: 10.2460/javma.20.06.0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate outcomes of dogs with parathyroid carcinoma (PTC) treated by surgical excision and to describe the incidence of postoperative hypocalcemia, degree of hypocalcemia, duration of hospitalization, duration of calcium supplementation, and survival time. ANIMALS 100 client-owned dogs with PTC admitted to academic, referral veterinary institutions. PROCEDURES In a retrospective multi-institutional study, medical records of dogs undergoing surgical excision of PTC between 2010 to 2019 were reviewed. Signalment, relevant medical history, clinical signs, clinicopathologic testing, imaging, surgical findings, intraoperative complications, histologic examination, and survival time were recorded. RESULTS 100 dogs with PTC were included, and 96 dogs had clinical or incidental hypercalcemia. Common clinical signs included polyuria (44%), polydipsia (43%), hind limb paresis (22%), lethargy (21%), and hyporexia (20%). Cervical ultrasonography detected a parathyroid nodule in 91 of 91 dogs, with a single nodule in 70.3% (64/91), 2 nodules in 25.3% (23/91), and ≥ 3 nodules in 4 (4/91)% of dogs. Hypercalcemia resolved in 89 of 96 dogs within 7 days after surgery. Thirty-four percent of dogs developed hypocalcemia, on the basis of individual analyzer ranges, within 1 week after surgery. One dog had metastatic PTC to the prescapular lymph node, and 3 dogs were euthanized for refractory postoperative hypocalcemia. Estimated 1-, 2-, and 3-year survival rates were 84%, 65%, and 51% respectively, with a median survival time of 2 years. CONCLUSIONS AND CLINICAL RELEVANCE Excision of PTC results in resolution of hypercalcemia and excellent long-term tumor control. Surgical excision of PTC is recommended because of resolution of hypercalcemia and a good long-term prognosis. Future prospective studies and long-term follow-up are needed to further assess primary tumor recurrence, metastasis, and incidence of postoperative hypocalcemia.
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Burkhardt SJ, Sumner JP, Mann S. Ambidirectional cohort study on the agreement of ultrasonography and surgery in the identification of parathyroid pathology, and predictors of postoperative hypocalcemia in 47 dogs undergoing parathyroidectomy due to primary hyperparathyroidism. Vet Surg 2021; 50:1379-1388. [PMID: 34365655 PMCID: PMC9290980 DOI: 10.1111/vsu.13707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/17/2021] [Accepted: 07/25/2021] [Indexed: 02/01/2023]
Abstract
Objective To investigate (1a) agreement of ultrasonographic, surgical, and histopathologic findings in the diagnosis of a neoplastic etiology underlying primary hyperparathyroidism (PHPT), (1b) the ability of ultrasonographically determined parathyroid gland size to distinguish between malignant (carcinoma) and non‐malignant (hyperplasia, adenoma) pathology, and (2) variables associated with postoperative hypocalcemia in dogs undergoing surgical treatment of PHPT. Study Design Ambidirectional cohort study. Animals Forty‐seven client owned dogs with PHPT (34 retrospective; 13 prospective). Methods Data were extracted from medical records. Method agreements were explored using Cohen's Kappa statistic. A receiver operating characteristic curve (ROC) was used to determine a cut‐off separating parathyroid pathologies. Univariable and multivariable models assessed associations between postoperative hypocalcemia and potential risk factors. Results Agreement of ultrasound and surgery for number and side of affected glands was 31/47 (65.9%) and 34/47 (72.3%), respectively. In 37/47 (78.7%) cases, parathyroid tissue was correctly assessed as pathologic by the surgeon. An ultrasonographic cut‐off of ≥8.0 mm (ROC AUC = 0.82) best distinguished malignant from benign pathologies. Dogs with a preoperative serum ionized calcium (iCa) concentration ≥1.75 mEq/L had 7.5 times greater odds of becoming hypocalcemic postoperatively. Conclusion A fair agreement existed between ultrasonographic and surgical findings in dogs with PHPT. A parathyroid mass ≥8.0 mm on ultrasonographic examination was suggestive of malignancy, while dogs with a preoperative serum iCa concentration ≥1.75 mEq/L were at increased risk for postoperative hypocalcemia in this study. Clinical significance This study supports the use of bilateral cervical surgical exploration to identify abnormal parathyroid glands for the treatment of PHPT.
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Affiliation(s)
- Samuel J Burkhardt
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States
| | - Julia P Sumner
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States
| | - Sabine Mann
- Department of Population Medicine and Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States
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Secrest S, Grimes J. Ultrasonographic size of the canine parathyroid gland may not correlate with histopathology. Vet Radiol Ultrasound 2019; 60:729-733. [PMID: 31353771 DOI: 10.1111/vru.12789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/18/2019] [Accepted: 06/06/2019] [Indexed: 11/29/2022] Open
Abstract
Accurate ultrasonographic differentiation of normal versus abnormal parathyroid glands is important for clinical workup and presurgical screening in dogs with hypercalcemia. In previous published studies, size has been the only ultrasonographic criterion correlated with histologic diagnoses of abnormal parathyroid glands. In this retrospective, cross-sectional study, the medical records of dogs with ultrasonographic examinations of the parathyroid glands and histologic diagnoses of parathyroid gland hyperplasia, adenoma, and adenocarcinoma were evaluated. Ultrasonographic characteristics were recorded for each gland and compared among histologic diagnosis groups. A total of 49 dogs and 59 parathyroid glands were sampled and assigned to the following groups for analyses: adenoma (n = 24), hyperplastic (n = 20), and adenocarcinoma (n = 15). There were no associations with dog age, sex, weight, breed; or gland laterality, location, ultrasonographic shape, or echogenicity among histologic diagnosis groups (P > .05). Parathyroid gland adenocarcinomas were found to be less likely to have a homogeneous echotexture on ultrasonographic evaluation, with hyperplastic glands being smaller (P = .022) and adenocarcinomas being larger (P = .042). While 3 mm was the optimum cutoff for differentiating hyperplastic and neoplastic parathyroid glands in this sample of dogs, values varied widely within groups and there were overlapping values between groups. Therefore, authors caution against using ultrasonographic size as a sole criterion for differentiating hyperplasia from neoplasia and normal versus abnormal parathyroid glands.
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Affiliation(s)
- Scott Secrest
- Department of Veterinary Biosciences and Diagnostic Imaging, University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Janet Grimes
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
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Riehl V, Hartmann A, Rohrberg A, Neiger R. Percutaneous ultrasound-guided ethanol ablation for treatment of primary hyperparathyroidism in a cat. JFMS Open Rep 2019; 5:2055116919860276. [PMID: 31308957 PMCID: PMC6607573 DOI: 10.1177/2055116919860276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Case summary A 9-year-old male neutered European Shorthair cat was presented owing to vomiting and mild weight loss. Clinical examination was normal, but biochemistry results showed increased concentrations of total calcium (4.05 mmol/l; reference interval [RI] 2.20-2.90 mmol/l) and ionised calcium (iCa) (2.19 mmol/l; RI 1.12-1.40 mmol/l), as well as hypophosphataemia (2.5 mg/dl; RI 3.1-7.5 mg/dl). Parathyroid hormone (PTH) concentration (>1000 pg/ml) was markedly increased, while parathyroid hormone-related protein concentration (<0.8 pmol/l) was normal. Neck ultrasound showed a large left parathyroid mass (13 × 7 × 6 mm). Under general anaesthesia and with ultrasonographic guidance, a fine-needle aspiration of the mass followed by chemical ablation with 2 ml 96% ethanol was performed. The cat was re-evaluated and iCa concentration measured 24 h, 72 h, 5 days, 4 weeks and 4 months post-ablation. Normocalcaemia was reached within 24 h, remained stable throughout the whole evaluation period and the concentration of PTH normalised 4 months later. Vomiting stopped promptly after chemical ablation and a slight change in voice, as well as a mild prolapse of the nictitating membrane, were the only side effects after the treatment but resolved some weeks later. Relevance and novel information To our knowledge, this is the first report of successful chemical ablation of a parathyroid mass in a cat with primary hyperparathyroidism. Chemical ablation might therefore be a possible alternative to parathyroidectomy in cats.
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Affiliation(s)
| | | | | | - Reto Neiger
- Veterinary Clinic Hofheim, Hofheim am Taunus, Germany
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Singh A, Giuffrida MA, Thomson CB, Baum J, Kramek B, Liptak JM, Hyndman P, Ringwood B, Smeak D, Ham K, Berg J, Thieman-Mankin K, Blois SL, Boston SE. Perioperative characteristics, histological diagnosis, and outcome in cats undergoing surgical treatment of primary hyperparathyroidism. Vet Surg 2019; 48:367-374. [PMID: 30666680 DOI: 10.1111/vsu.13165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 11/08/2018] [Accepted: 12/24/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To report perioperative characteristics, complications, histopathologic diagnosis and outcome in cats undergoing surgical treatment for primary hyperparathyroidism (PHPT). STUDY DESIGN Multi-institutional, retrospective case series. ANIMALS Thirty-two client-owned cats. METHODS Medical records of cats treated with surgical removal of 1 or more parathyroid gland(s) with confirmed histopathologic evaluation were reviewed. Cats were divided into preoperative ionized calcium (iCa) groups corresponding to the 33rd, 67th, and 100th percentiles of the preoperative iCa results of the study population. Follow-up consisted of phone conversation with owners or primary veterinarian. RESULTS Ionized calcium was above reference range in all cats (median 1.8 mmol/L [interquartile range, 1.5-1.9]). Abnormal tissue was excised after cervical exploration in all cats. The most common histopathologic diagnoses were parathyroid adenoma in 20 of 32 (62.5%) cats and parathyroid carcinoma in 7 of 32 (21.9%) cats. At discharge, 6 of 32 (18.8%) cats had hypercalcemia, 5 of 32 (15.6%) had hypocalcemia, and 21 of 32 (65.6%) were normocalcemic. Preoperative iCa did not correlate with postoperative iCa. The median follow-up time was 332 days (range, 7-3156). Overall median survival time was 1109 days (95% CI, 856-1332). Survival time was not associated with preoperative iCa group, hypocalcemia at discharge, hypercalcemia at discharge, or diagnosis of carcinoma. CONCLUSION In this cohort of cats, parathyroid adenoma was the most common cause of PHPT, and surgical treatment resulted in very good median survival time. Preoperative iCa was not predictive of postoperative hypocalcemia. CLINICAL SIGNIFICANCE Surgical parathyroidectomy for treatment of PHPT in cats provides a favorable prognosis.
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Affiliation(s)
- Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Michelle A Giuffrida
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Christopher B Thomson
- Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, Minnesota
| | - Jared Baum
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Betty Kramek
- Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, Minnesota
| | - Julius M Liptak
- Department of Surgery, VCA Canada-Alta Vista Animal Hospital, Ottawa, Ontario, Canada
| | - Philip Hyndman
- Department of Surgery, Veterinary Emergency Clinic, Toronto, Ontario, Canada
| | - Brendon Ringwood
- Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, Minnesota
| | - Daniel Smeak
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Kathleen Ham
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - John Berg
- Department of Clinical Sciences, Tufts University, North Grafton, Massachusetts
| | - Kelley Thieman-Mankin
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Sarah E Boston
- VCA Canada-404 Veterinary Emergency and Referral, Newmarket, Ontario, Canada
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Leal RO, Frau Pascual L, Hernandez J. The Use of Percutaneous Ultrasound-Guided Radiofrequency Heat Ablation for Treatment of Primary Hyperparathyroidism in Eight Dogs: Outcome and Complications. Vet Sci 2018; 5:vetsci5040091. [PMID: 30340351 PMCID: PMC6313915 DOI: 10.3390/vetsci5040091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 09/26/2018] [Accepted: 10/16/2018] [Indexed: 11/17/2022] Open
Abstract
Percutaneous ultrasound-guided radiofrequency heat-ablation (UG-RHA) is a therapeutic option for dogs with primary hyperparathyroidism (PHPTH) but information about its outcome is still controversial. This retrospective study aimed to evaluate the outcome and complications of UG-RHA in dogs with PHPTH. The medical records of dogs with PHPTH submitted to UG-RHA between June 2012 and September 2015 in a French referral center were retrospectively reviewed. Eight cases were included. No sex predisposition was found. The median age at diagnosis was 12 years. The most common clinical sign was polyuria/polydipsia. All of the dogs were hypercalcaemic prior to UG-RHA, and all showed a parathyroid nodule identified upon cervical ultrasound. UG-RHA was uneventful, allowing a successful resolution of hypercalcemia in all dogs (8/8). Six out of eight dogs did not receive vitamin D supplementation either pre- or post-procedure. From these, three dogs developed biochemical hypocalcemia, but only one required therapy. Other short-term complications included Horner's syndrome (1/8) and aspiration bronchopneumonia, which led to cardio-respiratory arrest in one large-breed dog (1/8). Long-term complications were scarce, with no recurrence reported in all of the cases that were assessed in follow-up (4/7). This study demonstrates that UG-RHA has few short or long-term complications, and it is a good therapeutic alternative for dogs with PHPTH.
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Affiliation(s)
- Rodolfo Oliveira Leal
- Centre Hospitalier Vétérinaire Fregis, 43 Av. Aristide Briand, 94110 Arcueil, France.
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal.
- Hospital Escolar Veterinário-Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal.
| | - Laura Frau Pascual
- Centre Hospitalier Vétérinaire Fregis, 43 Av. Aristide Briand, 94110 Arcueil, France.
- Ciutat d'Inca Veterinary Hospital. Av. General Luque, 372, 07300 Inca, Spain.
| | - Juan Hernandez
- Centre Hospitalier Vétérinaire Fregis, 43 Av. Aristide Briand, 94110 Arcueil, France.
- Internal Medecine Unit of Oniris, Nantes-Atlantic College of Veterinary Medicine and Food Sciences, Atlanpole La Chantrerie, CS 40706, 44307 Nantes CEDEX 3, France.
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Kaiser AM, Kempker L, Neiger R. Parathyroid immunohistochemistry in a 12-year-old mixed-breed dog with parathyroid adenocarcinoma. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
SummaryA 12-year-old, female, spayed, mixed-breed dog with acute lethargy, anorexia and weakness and markedly elevated total and ionised calcium concentration showed an enlarged left cranial parathyroid gland on ultrasonography of the ventral neck. Despite preoperative therapy with furosemide and calcitonin, there was no decline of plasma ionised calcium concentration. The dog deteriorated rapidly and was euthanased two days after initial presentation. Postmortem histopathology revealed parathyroid tissue with characteristics of malignancy as local and vascular invasion. Immunohistochemistry showed parathyroid hormone positive staining of these cells. Unusual clinical presentation and histopathological characteristics are discussed.
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Armstrong AJ, Hauptman JG, Stanley BJ, Klocke E, Burneko M, Holt DE, Runge JJ, Rubin JA. Effect of Prophylactic Calcitriol Administration on Serum Ionized Calcium Concentrations after Parathyroidectomy: 78 Cases (2005-2015). J Vet Intern Med 2017; 32:99-106. [PMID: 29280194 PMCID: PMC5787196 DOI: 10.1111/jvim.15028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 11/07/2017] [Accepted: 11/28/2017] [Indexed: 01/24/2023] Open
Abstract
Background Prophylactic administration of calcitriol has been suggested to mitigate the risk of hypocalcemia after parathyroidectomy. The effect of calcitriol on postoperative serum ionized calcium concentrations has not been evaluated in dogs after parathyroidectomy. Hypothesis/Objectives To determine the effect of prophylactic calcitriol administration on postoperative serum ionized calcium (iCa) concentrations in dogs with primary hyperthyroidism (PHPTH) treated by parathyroidectomy. Animals Seventy‐eight dogs with primary hyperparathyroidism treated surgically. Methods Multi‐institutional retrospective case study. Medical records from 2005 to 2015 were evaluated. Dogs were included if they had a diagnosis of PHPTH and had surgery to remove parathyroid tissue. Serum iCa concentrations were monitored for a minimum of 2 days postoperatively. Two study groups were evaluated: calcitriol administration and no calcitriol administration. Results Serial postoperative iCa concentrations measured at 12‐hour time intervals for 2 days postoperatively were positively associated with preoperative iCa concentrations. This association was evident at each time interval, and the effect of preoperative iCa concentrations on postoperative iCa concentrations decreased as time elapsed (12 hours, P < 0.0001; 24 hours, P < 0.0001; 36 hours, P < 0.04; and 48 hours, P = 0.01). Prophylactic calcitriol administration was not found to be significantly associated with postoperative iCa concentrations or its rate of decrease after parathyroidectomy. Conclusion and Clinical Importance We found no protective value in administering calcitriol prophylactically to prevent hypocalcemia in the immediate postoperative period (48 hours) after parathyroidectomy. Preoperative iCa concentrations had a significant positive association with postoperative iCa concentrations throughout the monitoring period.
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Affiliation(s)
- A J Armstrong
- Department of Small Animal Clinical Studies, Michigan State University, East Lansing, MI
| | - J G Hauptman
- Department of Small Animal Clinical Studies, Michigan State University, East Lansing, MI
| | - B J Stanley
- Department of Small Animal Clinical Studies, Michigan State University, East Lansing, MI
| | - E Klocke
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | - M Burneko
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - D E Holt
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - J J Runge
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - J A Rubin
- Department of Small Animal Clinical Studies, Michigan State University, East Lansing, MI
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Guttin T, Knox VW, Diroff JS. Outcomes for dogs with primary hyperparathyroidism following treatment with percutaneous ultrasound-guided ethanol ablation of presumed functional parathyroid nodules: 27 cases (2008–2011). J Am Vet Med Assoc 2015; 247:771-7. [DOI: 10.2460/javma.247.7.771] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Hypocalcemia occurs in critically ill dogs and cats and is associated with medications, treatments, and underlying diseases such as acute kidney disease, pancreatitis, parathyroid disease, sepsis, and trauma. Possible underlying mechanisms include hypovitaminosis D, acquired or relative hypoparathyroidism, hypomagnesemia, and alterations in the ionized fraction of calcium caused by changes in chelated or protein-bound calcium. If severe or acute, hypocalcemia can cause obvious clinical signs related to muscle or neurologic hyperexcitability or more subtle signs of cardiovascular dysfunction. Emergency treatment with calcium gluconate administration is recommended when clinical signs are present or if there is moderate to severe ionized hypocalcemia.
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Milovancev M, Schmiedt CW. Preoperative factors associated with postoperative hypocalcemia in dogs with primary hyperparathyroidism that underwent parathyroidectomy: 62 cases (2004–2009). J Am Vet Med Assoc 2013; 242:507-15. [DOI: 10.2460/javma.242.4.507] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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