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Ehrlich MR, Rudinsky AJ, Chew DJ, Parker VJ. Ionized hypercalcemia can resolve with nutritional modification in cats with idiopathic hypercalcemia or chronic kidney disease. J Feline Med Surg 2024; 26:1098612X241229811. [PMID: 38415620 PMCID: PMC10911303 DOI: 10.1177/1098612x241229811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
CASE SERIES SUMMARY Cats with ionized hypercalcemia that were fed diets with either more than 200 mg calcium per 100 kilocalories (kcal), a calcium:phosphorus (Ca:P) ratio greater than 1.4:1 or both, based on diet history, were included in this case series. Ionized hypercalcemia was documented at least twice in all cats before enrollment. Cats were referred for evaluation of ionized hypercalcemia (n = 5) or were incidentally found to have ionized hypercalcemia (n = 5). After medical workups, cats were diagnosed with either idiopathic hypercalcemia (IHC; n = 7) or chronic kidney disease (n = 3). Cats receiving medications to treat IHC (eg, alendronate, corticosteroids) were excluded. Nutritional recommendations were made to transition the cats to diets with less thn 200 mg calcium per 100 kcal and a Ca:P ratio less than 1.4:1. Ionized calcium (iCa) concentrations were rechecked in all cats, with a median recheck time of 9 weeks (range 3-20). Of the 10 cats, nine (90%) had a decrease in iCa. Of the 10 cats, six (60%) became normocalcemic after the diet change, three (30%) had a partial response and one (10%) did not respond. Of the four cats that did not achieve normocalcemia with a change in diet, two (50%) received chia seeds (1-2 g per day), and at the next recheck, both cats' iCa concentrations had normalized. Three cats had a long-term follow-up. Ionized normocalcemia was maintained for at least two consecutive follow-up visits over a median follow-up period of 33 weeks (range 12-34). RELEVANCE AND NOVEL INFORMATION Dietary calcium concentrations and the dietary Ca:P ratio appear to be important variables in considering nutritional approaches for hypercalcemic cats.
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Affiliation(s)
- Margot R Ehrlich
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Adam J Rudinsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Dennis J Chew
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Valerie J Parker
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
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Kurtz M, Desquilbet L, Maire J, Da Riz F, Canonne-Guibert M, Benchekroun G, Maurey C. Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases. Vet Med (Auckl) 2022; 36:1921-1930. [PMID: 36181368 DOI: 10.1111/jvim.16508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Limited information is available concerning treatment of ionized hypercalcemia in cats. HYPOTHESIS/OBJECTIVES Describe clinical findings in a cohort of cats with persistent ionized hypercalcemia and evaluate long-term tolerance and efficacy of alendronate in these patients. ANIMALS Twenty cats with persistent ionized hypercalcemia of undetermined origin, presented for routine or referral consultation at the teaching hospital of Maisons-Alfort (France). METHODS Medical records were retrospectively reviewed. Cats were divided into Group 1 (cats that received alendronate as well as other treatments, n = 11) and Group 2 (cats that did not receive alendronate, n = 9). Survival analysis (Kaplan-Meier method, log-rank test, and Cox proportional hazard models) was conducted to compare time to selected outcomes. RESULTS Azotemia was present in 15 cats (75%). Alendronate treatment was administered and well tolerated during the entire follow-up period (median, 9.5 months; interquartile range [IQR], 6.3; 27) in all cats from Group 1, except in 1 cat that developed severe hypophosphatemia, prompting treatment discontinuation. Univariate analysis determined that alendronate treatment was significantly associated with shorter time to reach a 15% decrease in ionized calcium concentration (iCa) from baseline during follow-up (119 days vs median not reached, P = .02). This association was no longer significant after adjustment for age and initial iCa. CONCLUSIONS AND CLINICAL IMPORTANCE Alendronate overall was well tolerated with chronic use in this cohort, and can be considered a treatment option for persistent ionized hypercalcemia in cats.
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Affiliation(s)
- Maxime Kurtz
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Loïc Desquilbet
- Department of Clinical Epidemiology and Biostatistics, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est Créteil, INSERM, IMRB, Maisons-Alfort, France
| | - Justine Maire
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Fiona Da Riz
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Morgane Canonne-Guibert
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est Créteil, INSERM, IMRB, Maisons-Alfort, France
| | - Ghita Benchekroun
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,Ecole Nationale Vétérinaire d'Alfort, Université Paris Est Créteil, INSERM, IMRB, Maisons-Alfort, France
| | - Christelle Maurey
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
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Kennedy AJ, White JD. Feline ureteral obstruction: a case-control study of risk factors (2016-2019). J Feline Med Surg 2022; 24:298-303. [PMID: 34076537 PMCID: PMC10812244 DOI: 10.1177/1098612x211017461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Ureteral obstruction (UO) in cats causes acute kidney injury and typically requires surgical intervention. Information is required about potentially modifiable risk factors to inform prevention strategies. METHODS A case-control study was performed to assess risk factors associated with feline UO. Cases were defined as cats with either of the following: (1) ureteral obstruction (ureteroliths: 13/18; unknown: 5/18) confirmed with pyelography; or (2) a creatinine concentration >140 µmol/l with both UO (ureteroliths: 6/10; blood clots: 3/10; pyonephrosis: 1/10) and pyelectasia ⩾5 mm on abdominal ultra sonography. Controls were defined as cats without evidence of UO on history, physical examination and abdominal ultrasound. Age, sex, breed (domestic shorthair/longhair), diet (predominantly dry, mixed or predominantly moist food), housing (indoors or mixed) and plasma total calcium were evaluated for their association with UO using multivariable logistic regression. A receiver operator characteristic (ROC) curve was created to evaluate the predictive ability of the final model. RESULTS In total, 168 cats (28 cases, 140 controls) were included. Age, sex, breed, housing and total calcium were not significantly associated with UO; however, diet was. Compared with cats eating a predominantly moist food diet, cats fed a predominantly dry food diet were 15.9 times more likely to develop a UO (95% confidence interval 2.9-295; P = 0.009). There was no difference in the association between diet and UO in cats fed a mixed diet vs cats fed a predominantly moist food diet (P = 0.25). The area under the ROC curve was 72%. CONCLUSIONS AND RELEVANCE Changes in diet formulation could provide a simple and economical method to reduce the risk of UO.
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Stockman J, Villaverde C, Corbee RJ. Calcium, Phosphorus, and Vitamin D in Dogs and Cats: Beyond the Bones. Vet Clin North Am Small Anim Pract 2021; 51:623-634. [PMID: 33653533 DOI: 10.1016/j.cvsm.2021.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Calcium, phosphorus, and vitamin D are nutrients that play a key role in maintaining normal organ, cell, and tissue function. Much is known about their role in bone metabolism, but these nutrients are also important in renal health, urinary tract disease, and multiple other organ systems. It is nutritionally important to meet the physiologic requirements for each of these nutrients, but the interplay between them should also be considered.
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Affiliation(s)
- Jonathan Stockman
- Department of Clinical Veterinary Sciences, LIU College of Veterinary Medicine, Long Island University, 720 Northern Boulevard, Brookville, NY 11548, USA
| | | | - Ronald Jan Corbee
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht 3584 CM, The Netherlands.
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Geddes RF, van den Broek DHN, Chang YM, Biourge V, Elliott J, Jepson RE. The effect of attenuating dietary phosphate restriction on blood ionized calcium concentrations in cats with chronic kidney disease and ionized hypercalcemia. J Vet Intern Med 2021; 35:997-1007. [PMID: 33527601 PMCID: PMC7995425 DOI: 10.1111/jvim.16050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 12/30/2022] Open
Abstract
Background Hypercalcemia is commonly observed in cats with azotemic chronic kidney disease (CKD). Dietary phosphate restriction is considered standard of care but may contribute to the development of hypercalcemia. The optimal dietary management strategy for these cats is unclear. Objectives To describe the effect of feeding a moderately phosphate‐restricted diet (MP; 1.5 g/Mcal phosphorus; Ca : P ratio, 1.3) to cats with concurrent azotemic CKD and ionized hypercalcemia. Animals Client‐owned cats with ionized hypercalcemia (ionized calcium [iCa] concentration >1.4 mmol/L) at diagnosis of CKD (n = 11; baseline hypercalcemics) or after CKD diagnosis while eating a phosphate‐restricted clinical renal diet (0.8 g/Mcal phosphorus; Ca : P ratio, 1.9; n = 10; RD hypercalcemics). Methods Changes in variables over time, after starting MP at visit 1, were assessed using linear mixed model analysis within each group of cats. Data are reporte as median [25th, 75th percentiles]. Results At visit 1, iCa was 1.47 [1.42, 1.55] mmol/L for baseline hypercalcemics and 1.53 [1.5, 1.67] mmol/L for RD hypercalcemics. Blood iCa decreased (P < .001) when RD hypercalcemics were fed MP, with iCa <1.4 mmol/L in 8/10 cats after 2.2 [1.8, 3.7] months. Plasma phosphate concentrations did not change. In contrast, the baseline hypercalcemic group overall showed no change in iCa but a decrease in plasma phosphate concentration during 8.8 [5.5, 10.6] months on the MP diet, although 4/11 individual cats achieved iCa <1.4 mmol/L by 3.4 [1.0, 6.2] months. Conclusions and Clinical Importance Attenuation of dietary phosphate restriction could result in normalization of iCa in cats that develop hypercalcemia while eating a clinical renal diet.
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Affiliation(s)
- Rebecca F Geddes
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - D Hendrik N van den Broek
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
| | - Yu-Mei Chang
- Research Support Office, Royal Veterinary College, University of London, London, UK
| | | | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - Rosanne E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK
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Fantinati M, Priymenko N. Managing Feline Idiopathic Hypercalcemia With Chia Seeds ( Salvia hispanica L.): A Case Series. Front Vet Sci 2020; 7:421. [PMID: 32793647 PMCID: PMC7387619 DOI: 10.3389/fvets.2020.00421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/12/2020] [Indexed: 12/11/2022] Open
Abstract
Background: We describe for the first time the use of chia seeds (Salvia hispanica L.) as a non-pharmacological solution in managing feline idiopathic hypercalcemia when dietary change alone fails. Case Summary: Over a 2-year period of time, three female spayed, middle-aged, Domestic Shorthair cats were diagnosed with idiopathic hypercalcemia. Reason for consultation were lethargy and dysorexia, with a single episode of vomiting described in one cat and dysuria in another. Thorough diagnostic work-up included complete blood count, serum biochemistry, urinalysis, ionized calcium, calcemic hormones, parathyroid hormone-related protein, and imaging of chest and abdomen. Based on different nutritional reasons, each cat was switched to a different high-moisture pet food as first-step in managing the disorder: a high-fiber diet, a diet formulated for chronic kidney disease management and a diet designed to prevent calcium oxalate urolithiasis. In the three cats, 6 weeks of dietary change alone did not result in normocalcemia. Before resorting to any pharmacological solution, supplementation to the diet of chia seeds (2 g/cat/day) was started. After 4 weeks from the introduction of Salvia hispanica L., all cats achieved normalization of ionized calcium concentration. Conclusion: Chia seeds (Salvia hispanica L.) supplementation could be a useful tool in managing feline idiopathic hypercalcemia.
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Affiliation(s)
- Marco Fantinati
- Nutrition Department, École Nationale Vétérinaire de Toulouse, University of Toulouse, Toulouse, France
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Lester M, Walton S, Vilaplana Grosso F, Shmalberg J. Treatment of abdominal granuloma and hypercalcaemia caused by
Cladophialophora bantiana
with combination antifungal chemotherapy and hyperbaric oxygen therapy in a dog. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-000993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Mary Lester
- Department of Small Animal Clinical SciencesCollege of Veterinary MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Stuart Walton
- Department of Small Animal Clinical SciencesCollege of Veterinary MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Federico Vilaplana Grosso
- Department of Small Animal Clinical SciencesCollege of Veterinary MedicineUniversity of FloridaGainesvilleFloridaUSA
| | - Justin Shmalberg
- Department of ComparativeDiagnostic and Population Medicine College of Veterinary MedicineUniversity of FloridaGainesvilleFloridaUSA
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UROLITH PREVALENCE AND RISK FACTORS IN ASIAN SMALL-CLAWED OTTERS ( AONYX CINEREUS). J Zoo Wildl Med 2019; 49:863-869. [PMID: 30592904 DOI: 10.1638/2018-0089.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Uroliths (urinary stones) are routinely found in both domestic and exotic animals kept under human care. In zoos, Asian small-clawed otters (ASCOs, Aonyx cinereus) have been identified as being particularly prone to this disease. Risk factors are thought to be nutritional; however, recommendations contradict each other, depending on which physiological model was used. Our study aimed to determine the prevalence of uroliths in ASCOs under human care and to evaluate which feeding patterns and nutrients may be linked to their occurrence. Questionnaires were sent to zoos holding ASCOs in North America (AZA), Europe (EAZA), and Japan and Southeast Asia (Asia) asking about diets and medical histories of all ASCOs alive or dead within the last 10 yr. A risk-factor style binary logistic regression was conducted on these data. A total of 94 questionnaires were received; however, only 56 were usable (15.6% return rate), representing 161 otter cases. AZA had the significantly highest incidence of kidney stones (62.8%), followed by EAZA (12.9%) and Asia (9.4%). Age and calcium were risk factors, whereas crude protein and sodium were protective. Therefore, calcium may need to be controlled within their diet. A diet high in fish and crustaceans may be beneficial and is consistent with wild ASCO diets. The feline model may be the best choice out of other models; however, many factors cannot be compared with ASCO, such as urinary pH.
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Abstract
BACKGROUND Calcium carbonate is a common urolith type in small ruminants with no high-yield experimental model to evaluate animal susceptibility or preventative measure response. HYPOTHESIS That novel plastic winged implants would allow accumulation and quantification of calcium carbonate calculus formation in goats on a high-calcium diet and identify individual variation between goats in the mass of calculi produced. ANIMALS Eight nonpregnant 3- and 4-year-old Boer-cross does, weighing 22.3-39.5 kg, determined to be healthy based on physical examination, were used in these experiments. METHODS Prospective cohort study for in vivo experimental model development. Implants were placed into the urinary bladder lumen in 8 goats over 2 evaluation periods. The alfalfa-based ration had a total ration Ca : P of 3.29 and 3.84 : 1, respectively. Urine was collected at 0, 28, 56, and 84 days in the 1st experiment; blood and urine at those timepoints in the 2nd experiment. For each evaluation period, the implants were removed 84 days after implantation and weighed. Accumulated calculi mass was calculated and compared between goats and was analyzed for composition. RESULTS Implant retention was 100% and 86% in the 2 studies. All goats with retained implants accumulated calcium carbonate at a mean implant gain per day across studies ranging from 0.44 to 57.45 mg. Two goats accumulated (0.44-7.65 mg/day and 33.64 & 57.45 mg/day) significantly more urolith material than the cohort across both studies (P = .047). No routine analytes on blood or urine were found to be explanatory for the difference observed. CONCLUSIONS AND CLINICAL IMPORTANCE These findings form a basis for implant and diet selection for use in future studies of urolithiasis development and for studies regarding individual susceptibility to urolithiasis.
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Affiliation(s)
- Meredyth L Jones
- Department of Large Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas
| | - Brandon J Dominguez
- Department of Large Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas
| | - Michael A Deveau
- Department of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas
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Geddes RF, Jepson RE, Forcada Y, Elliott J, Syme HM. Associations between single nucleotide polymorphisms in the calcium sensing receptor and chronic kidney disease-mineral and bone disorder in cats. Vet J 2018; 235:34-41. [PMID: 29704936 DOI: 10.1016/j.tvjl.2018.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 02/14/2018] [Accepted: 02/15/2018] [Indexed: 11/26/2022]
Abstract
Feline chronic kidney disease (CKD) is associated with high variability in severity of CKD-mineral and bone disorder (CKD-MBD). The calcium sensing receptor (CaSR) regulates circulating parathyroid hormone (PTH) and calcium concentrations. Single nucleotide polymorphisms (SNPs) in the CaSR are associated with severity of secondary renal hyperparathyroidism and total calcium concentrations in human patients receiving haemodialysis. The objective of this study was to explore associations between polymorphisms in the feline CaSR (fCaSR) and biochemical changes observed in CKD-MBD. Client owned cats (≥9years) were retrospectively included. SNP discovery was performed in 20 cats with azotaemic CKD and normal or dysregulated calcium concentrations. Non-pedigree cats (n=192) (125 with azotaemic CKD and 66 healthy), Persians (n=40) and Burmese (n=25) were genotyped for all identified SNPs using KASP. Biochemical parameters from the date of CKD diagnosis or from first visit to the clinic (healthy cats) were used. Associations between genotype and ionized calcium, total calcium, phosphate, PTH and FGF-23 were performed for non-pedigree cats using logistic regression. Sequence alignment against the fCaSR sequence revealed eight novel exonic SNPs. KASP genotyping had high accuracy (99.6%) and a low failure rate (<6%) for all SNPs. Allele frequencies varied between breeds. In non-pedigree cats, one synonymous SNP CaSR:c.1269G>A was associated with logPTH concentration (adjusted for plasma creatinine concentration), with a recessive model having the best fit (G/G vs A/A-G/A, P=0.031). Genetic variation in the fCaSR is unlikely to explain the majority of the variability in presence and severity of CKD-MBD in cats.
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Affiliation(s)
- R F Geddes
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK.
| | - R E Jepson
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK
| | - Y Forcada
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, 4 Royal College Street, London, NW1 0TU, UK
| | - H M Syme
- Department of Clinical Sciences and Services, Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire, AL9 7TA, UK
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de Brito Galvão JF, Parker V, Schenck PA, Chew DJ. Update on Feline Ionized Hypercalcemia. Vet Clin North Am Small Anim Pract 2017; 47:273-292. [DOI: 10.1016/j.cvsm.2016.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Bartges JW. Feline Calcium Oxalate Urolithiasis: Risk factors and rational treatment approaches. J Feline Med Surg 2016; 18:712-22. [PMID: 27562981 PMCID: PMC11148900 DOI: 10.1177/1098612x16660442] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PRACTICAL RELEVANCE Uroliths occur commonly in the bladder and/or urethra of cats and can be lifethreatening if urethral obstruction occurs. Calcium oxalate accounts for 40-50% of urocystoliths and these stones are not amenable to medical dissolution; therefore, removal by surgery or minimally invasive techniques is required if uroliths must be treated. Medical protocols for prevention involve decreasing urine saturation for minerals that form uroliths. ETIOPATHOGENESIS Formation of uroliths is not a disease, but rather a complication of several disorders. Some disorders can be identified and corrected (such as infection-induced struvite urolith formation); others can be identified but not corrected (such as idiopathic hypercalcemia). In most cats with calcium oxalate urolith formation the underlying etiopathogenesis is not known. A common denominator of all these disorders is that they can from time to time create oversaturation of urine with one or more crystal precursors, resulting in formation of crystals. BASIC CONCEPTS In order to develop rational and effective approaches to treatment, abnormalities that promote urolith formation must be identified, with the goal of eliminating or modifying them. It is important, therefore, to understand several basic concepts associated with urolithiasis and the factors that promote urolith formation that may be modified with medical treatment; for example, the state of urinary saturation, modifiers of crystal formation, potential for multiple crystal types, and presence of bacterial infection or urinary obstruction.
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Affiliation(s)
- Joseph W Bartges
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, The University of Georgia, 501 D. W. Brooks Drive, Athens, GA 30602, USA
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Lulich JP, Berent AC, Adams LG, Westropp JL, Bartges JW, Osborne CA. ACVIM Small Animal Consensus Recommendations on the Treatment and Prevention of Uroliths in Dogs and Cats. J Vet Intern Med 2016; 30:1564-1574. [PMID: 27611724 PMCID: PMC5032870 DOI: 10.1111/jvim.14559] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/08/2016] [Accepted: 07/11/2016] [Indexed: 11/28/2022] Open
Abstract
In an age of advancing endoscopic and lithotripsy technologies, the management of urolithiasis poses a unique opportunity to advance compassionate veterinary care, not only for patients with urolithiasis but for those with other urinary diseases as well. The following are consensus-derived, research and experience-supported, patient-centered recommendations for the treatment and prevention of uroliths in dogs and cats utilizing contemporary strategies. Ultimately, we hope that these recommendations will serve as a foundation for ongoing and future clinical research and inspiration for innovative problem solving.
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Affiliation(s)
- J P Lulich
- Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN.
| | | | - L G Adams
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN
| | - J L Westropp
- Department of Veterinary Medicine and Epidemiology, University of California, Davis, CA
| | - J W Bartges
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA
| | - C A Osborne
- Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN
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Finch NC. Hypercalcaemia in cats: The complexities of calcium regulation and associated clinical challenges. J Feline Med Surg 2016; 18:387-99. [PMID: 27143041 PMCID: PMC11132202 DOI: 10.1177/1098612x16643248] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Calcium is essential for many normal physiological processes within the body. Aberrations in calcium homeostasis leading to hypercalcaemia can result in clinical signs such as polyuriav and polydipsia, lethargy and weakness due to depressed excitability of muscle and nervous tissue, and gastrointestinal (GI) signs due to effects on GI smooth muscle. Hypercalcaemia in cats is mostly idiopathic, with chronic kidney disease and neoplasia also being common causes. CLINICAL CHALLENGES Hypercalcaemia can be a diagnostic challenge and a good understanding of the regulation of calcium homeostasis can aid in interpreting results of diagnostic tests. Furthermore, the management approach may depend on the underlying cause of hypercalcaemia, and also its severity and chronicity. AUDIENCE This review offers a comprehensive discussion of the regulation of calcium homeostasis, with a focus on the normal response to hypercalcaemia. It also discusses the diagnostic approach to, and management of, hypercalcaemia in cats, as well as specific aetiologies. This is relevant to all clinicians working with feline patients. EVIDENCE BASE The review draws evidence from peer-reviewed publications and also the author's own clinical experience.
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Affiliation(s)
- Natalie C Finch
- Bristol Renal, School of Clinical Sciences, University of Bristol, Bristol BS1 3NY, UK
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16
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Hardy BT, de Brito Galvao JF, Green TA, Braudaway SR, DiBartola SP, Lord L, Chew DJ. Treatment of ionized hypercalcemia in 12 cats (2006-2008) using PO-administered alendronate. J Vet Intern Med 2015; 29:200-6. [PMID: 25619515 PMCID: PMC4858073 DOI: 10.1111/jvim.12507] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/02/2014] [Accepted: 10/21/2014] [Indexed: 11/28/2022] Open
Abstract
Background Long‐term treatment of cats with ionized hypercalcemia using alendronate has not been evaluated. Hypothesis/Objectives Alendronate is well tolerated in treatment of ionized hypercalcemia in cats. Animals A total of 12 cats with ionized hypercalcemia. Methods Prospective study of 12 cats with ionized hypercalcemia of idiopathic origin was identified by telephone and email communication with a convenience sample of consulting veterinarians. Cats were treated with alendronate at a dose of 5–20 mg per feline PO q7d. Serum ionized calcium concentration (iCa) was measured before beginning treatment with alendronate, and after 1, 3, and 6 months of treatment. Alendronate dosage was adjusted according to iCa. Evaluation included physical examination, CBC, biochemistry profile, and diagnostic imaging. The owners and referring veterinarians were questioned about any observed adverse effects. The Wilcoxon matched‐pairs signed rank test was used to compare baseline iCa to iCa at different time periods. Results Alendronate treatment resulted in a decrease in iCa in all 12 cats. The median percentage change in iCa was −13.2%, −15.9%, and −18.1% (range, −29.6 to +7.6; −30.5 to −1.9; −45.8 to +1.5%) at the 1, 3, and 6 month time points, respectively. Baseline iCa was significantly different from 1 month (P = .0042), 3 months (P = .0005), and 6 months (P = .0015). No adverse effects were reported for any of the cats. Conclusions and Clinical Importance Alendronate was well tolerated and decreased iCa in most cats for the 6‐month period of observation.
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Affiliation(s)
- B T Hardy
- Santa Cruz Veterinary Hospital, Santa Cruz, CA
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17
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Influence of nutrition on feline calcium oxalate urolithiasis with emphasis on endogenous oxalate synthesis. Nutr Res Rev 2011; 24:96-110. [PMID: 21338551 DOI: 10.1017/s0954422410000351] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The prevalence of calcium oxalate (CaOx) uroliths detected in cats with lower urinary tract disease has shown a sharp increase over the last decades with a concomitant reciprocal decrease in the occurrence of struvite (magnesium ammonium phosphate) uroliths. CaOx stone-preventative diets are available nowadays, but seem to be marginally effective, as CaOx urolith recurrence occurs in patients fed these diets. In order to improve the preventative measures against CaOx urolithiasis, it is important to understand its aetiopathogenesis. The main research focus in CaOx formation in cats has been on the role of Ca, whereas little research effort has been directed towards the role and origin of urinary oxalates. As in man, the exogenous origin of urinary oxalates in cats is thought to be of minor importance, although the precise contribution of dietary oxalates remains unclear. The generally accepted dietary risk factors for CaOx urolithiasis in cats are discussed and a model for the biosynthetic pathways of oxalate in feline liver is provided. Alanine:glyoxylate aminotransferase 1 (AGT1) in endogenous oxalate metabolism is a liver-specific enzyme targeted in the mitochondria in cats, and allows for efficient conversion of glyoxylate to glycine when fed a carnivorous diet. The low peroxisomal activity of AGT1 in cat liver is compatible with the view that felids utilised a low-carbohydrate diet throughout evolution. Future research should focus on understanding de novo biosynthesis of oxalate in cats and their adaptation(s) in oxalate metabolism, and on dietary oxalate intake and absorption by cats.
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18
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Bartges J, Kirk C. Nutrition and Urolithiasis. J Feline Med Surg 2007. [DOI: 10.1016/s1098-612x-07-00170-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Dru Forrester S, Roudebush P. Evidence-Based Management of Feline Lower Urinary Tract Disease. Vet Clin North Am Small Anim Pract 2007; 37:533-58. [PMID: 17466755 DOI: 10.1016/j.cvsm.2007.01.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Many treatments have been recommended for managing cats with feline urinary tract disease (FLUTD). Veterinarians making therapeutic decisions should consider the quality of evidence supporting a recommendation to use (or not use) a particular treatment for cats with FLUTD. Whenever possible, recommendations should be based on results of randomized and well-controlled scientific studies performed in clinical patients with the spontaneously occurring disease of interest. In the absence of such studies, one is left to make the best recommendation possible with consideration of all information, including the quality of the evidence. At this time, additional studies are needed to evaluate evidence for many currently recommended treatments for cats with FLUTD.
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Affiliation(s)
- S Dru Forrester
- Scientific Affairs, Hill's Pet Nutrition, 400 SW 8th Avenue, Topeka, KS 66603, USA.
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20
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Bartges JW, Kirk CA. Nutrition and lower urinary tract disease in cats. Vet Clin North Am Small Anim Pract 2007; 36:1361-76, viii. [PMID: 17085240 DOI: 10.1016/j.cvsm.2006.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Lower urinary tract disease occurs commonly in cats and is often associated with crystal-related disease. Dietary modification is beneficial in managing some of these diseases, including idiopathic cystitis, urolithiasis, and urethral matrix-crystalline plugs. Altering dietary formulation may result in decreasing urinary concentrations of crystallogenic compounds, increasing urinary concentrations fo crystallogenic inhibitors, and diluting urine composition.
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Affiliation(s)
- Joseph W Bartges
- Department of Small Animal Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN 37996-4544, USA.
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21
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Unterer S, Gerber B, Glaus TM, Hässig M, Reusch CE. Evaluation of an electrolyte analyser for measurement of concentrations of ionized calcium and magnesium in cats. Vet Res Commun 2006; 29:647-59. [PMID: 16369879 DOI: 10.1007/s11259-005-3301-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2004] [Indexed: 10/25/2022]
Abstract
The goal of this study was to evaluate the Nova CRT 8 electrolyte analyser for determination of concentrations of ionized calcium (Ca(i)) and magnesium (Mg(i)) in cats, to determine the effects of sample handling and storage and to establish reference ranges. The precision and analytical accuracy of the Nova CRT 8 analyser were good. The concentrations of Ca(i) and Mg(i) were significantly lower in aerobically handled serum samples than in those handled anaerobically. The concentrations of Ca(i) and Mg(i) differed significantly among whole blood, plasma and serum. In anaerobically handled serum, the concentration of Ca(i) was stable for 8 h at 22 degrees C, for 5 days at 4 degrees C and for 1 week at -20 degrees C. The concentration of Mg(i) was stable for 4 h at 22 degrees C but for less than 24 h at 4 degrees C and for less than 1 week at -20 degrees C. In serum from 36 cats, the reference ranges were 1.20-1.35 mmol/L for Ca(i) and 0.47-0.59 mmol/L for Mg(i). The Nova CRT 8 electrolyte analyser is suitable for determination of Ca(i) and Mg(i) concentrations in cats. Anaerobically handled serum samples are recommended and, stored at room temperature, they yield accurate results when analysed within 4 h.
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Affiliation(s)
- S Unterer
- Clinic of Small Animal Internal Medicine, University of Zurich, Winterthurerstr. 260, CH-8057, Zurich, Switzerland
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22
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Aronson LR, Kyles AE, Preston A, Drobatz KJ, Gregory CR. Renal transplantation in cats with calcium oxalate urolithiasis: 19 cases (1997–2004). J Am Vet Med Assoc 2006; 228:743-9. [PMID: 16506941 DOI: 10.2460/javma.228.5.743] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine outcome of renal transplantation in cats with renal failure associated with calcium oxalate urolithiasis. DESIGN Retrospective case series. ANIMALS 19 cats. PROCEDURE Medical records were reviewed for evaluation of signalment, preoperative clinical signs, physical examination results, dietary history, clinicopathologic data, abdominal imaging, postoperative diet, complications, and long-term outcome. RESULTS The domestic shorthair was the most common breed represented. There were 13 spayed females and 7 castrated males. Mean age was 6.8 years. Clinical signs included weight loss, lethargy, vomiting, anorexia, polyuria, and polydipsia. Before surgery, cats received commercially available canned or dry food (n = 10), a prescription renal failure diet (5), a commercial diet to manage struvite crystalluria (1), or an unknown diet (3). Seventeen cats were anemic. All cats were azotemic. Hypercalcemia was detected in 7 cats. Abdominal imaging revealed nephrolithiasis, ureterolithiasis, or both in all cats. Median duration of survival of all cats was 605 days. Eight cats were alive 282 to 2,005 days (median, 1,305 days) after surgery. Eleven cats died 2 to 1,197 days (median, 300 days) after surgery. Five cats formed calculi in their allograft (120 to 665 days). Two of the 5 cats that formed calculi were hypercalcemic. Four of the 5 cats died following complications associated with formation of calculi. CONCLUSIONS AND CLINICAL RELEVANCE Renal transplantation appears to be a viable option for cats in renal failure secondary to calcium oxalate urolithiasis. In addition to reported complications in renal transplant recipients, formation of calculi within the allograft may also occur.
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Affiliation(s)
- Lillian R Aronson
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010, USA
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23
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Bartges JW, Kirk C, Lane IF. Update: management of calcium oxalate uroliths in dogs and cats. Vet Clin North Am Small Anim Pract 2004; 34:969-87, vii. [PMID: 15223211 DOI: 10.1016/j.cvsm.2004.03.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Calcium oxalate has become the most common mineral occurring in canine and feline uroliths. Although calcium oxalate urolith formation may be a consequence of metabolic disease, the underlying cause is not identified in many dogs and cats. Currently, there is no successful medical dissolution protocol, and calcium oxalate uroliths must be removed physically if causing problems. Effective preventative protocols are available for dogs and cats, although they are not uniformly successful.
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Affiliation(s)
- Joseph W Bartges
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, C247 Veterinary Teaching Hospital, University of Tennessee, Knoxville, TN 39996-4544, USA.
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Escolar E, Bellanato J. Analysis of feline urinary calculi and urethral plugs by infrared spectroscopy and scanning electron microscopy. Vet Rec 2003; 152:625-8. [PMID: 12790167 DOI: 10.1136/vr.152.20.625] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The chemical constituents of 34 feline urinary calculi and five urethral plugs were analysed by infrared spectroscopy. The analysis revealed that 18 (52.9 per cent) of the calculi contained magnesium ammonium phosphate hexahydrate (struvite) as the major component; 10 (29.4 per cent) contained complex ammonium urates (three of them also containing calcium phosphate, mainly on the surface); three were composed of calcium phosphates and three were composed mainly of calcium oxalate mono and dihydrates. The urethral plugs were composed primarily of struvite, but also contained large amounts of organic matter. The examination of 16 selected samples by scanning electron microscopy and electron dispersive x-ray analysis revealed that their crystalline structures were similar to those of canine stones.
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Affiliation(s)
- E Escolar
- Departamento de Patología Animal II, Hospital Clínico Veterinario, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Bolliger AP, Graham PA, Richard V, Rosol TJ, Nachreiner RF, Refsal KR. Detection of parathyroid hormone-related protein in cats with humoral hypercalcemia of malignancy. Vet Clin Pathol 2002; 31:3-8. [PMID: 12019470 DOI: 10.1111/j.1939-165x.2002.tb00268.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Increased serum parathyroid hormone-related peptide (PTHrP) concentration is used to diagnose humoral hypercalcemia of malignancy (HHM) in humans and animals. A commercially available assay for human PTHrP has diagnostic utility in the dog, but has not been assessed in cats. OBJECTIVE The goals of this study were to determine serum or plasma levels of PTHrP in a population of hypercalcemic cats and to determine whether increased PTHrP concentration was associated with malignancy. In addition, we validated immunoradiometric assays (IRMAs) for intact parathormone (iPTH) and PTHrP for use with feline samples. METHODS A retrospective analysis of iPTH and PTHrP results from 322 hypercalcemic cats (ionized calcium concentration > 1.4 mmol/L) was performed. Immunoassays for human iPTH and PTHrP (residues 1-84) were validated using standard methods, and reference intervals were calculated using values from 31 healthy adult cats. Hypercalcemic cats were classified as parathyroid-independent (iPTH < 2.3 pmol/L), equivocal (iPTH 2.3-4.6 pmol/L), or parathyroid-dependent (iPTH > 4.6 pmol/L). Seven cats with detectable or increased PTHrP concentrations were evaluated further for underlying disease. Formalin-fixed neoplastic tissues were immunohistochemically stained using rabbit antibody to human midregion PTHrP. RESULTS Assays for iPTH and PTHrP showed acceptable precision for feline samples. The reference interval for iPTH was 0.8-4.6 pmol/L and for PTHrP was < 1.5 pmol/L. The majority of hypercalcemic cats (263/322, 81.7%) were parathyroid-independent, with fewer cats in the equivocal (32/322, 9.9%) and parathyroid-dependent (27/322, 8.4%) groups. In 31 (9.6%) cats, PTHrP concentration was > 1.5 pmol/L (range 1.5-26.6 pmol/L). All 7 cats for which follow-up information was available had HHM; 6 had carcinomas (4 lung carcinomas, 1 undifferentiated carcinoma, 1 thyroid carcinoma) and 1 had lymphoma. All tumors had mild to moderate positive staining for PTHrP; however, lung carcinomas from normocalcemic cats also stained positive. CONCLUSIONS Human IRMA for PTHrP (1-84) can be used to measure PTHrP in cats. Malignancies, particularly carcinomas, appear to secrete PTHrP and induce HHM in this species. Immunohistochemistry alone cannot predict the occurrence of HHM in cats.
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Affiliation(s)
- Anne Provencher Bolliger
- Endocrine Diagnostic Section, Animal Health Diagnostic Laboratory, Michigan State University, East Lansing, MI 48824, USA.
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Toribio RE, Kohn CW, Chew DJ, Capen CC, Rosol TJ. Cloning and sequence analysis of the complementary DNA for feline preproparathyroid hormone. Am J Vet Res 2002; 63:194-7. [PMID: 11843117 DOI: 10.2460/ajvr.2002.63.194] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To clone and sequence the cDNA for feline preproparathyroid hormone (preproPTH) and to compare that sequence with other known parathyroid hormone (PTH) sequences. SAMPLE POPULATION Parathyroid glands from 1 healthy cat. PROCEDURES A cDNA library was constructed in lambda phage from feline parathyroid gland mRNA and screened with a radiolabeled canine PTH probe. Positive clones were sequenced, and nucleic acid and deduced amino acid sequences were analyzed and compared with known preproPTH and PTH sequences. RESULTS Screening of approximately 2 X 10(5) recombinant plaques revealed 3 that hybridized with the canine PTH probe; 2 clones comprised the complete sequence for feline preproPTH. Feline preproPTH cDNA consisted of a 63-base pair (bp) 5'-untranslated region (UTR), a 348-bp coding region, and a 326-bp 3'-UTR. The coding region encoded a 115-amino acid peptide. Mature feline PTH consisted of 84 amino acids. Amino acid sequence analysis revealed that feline PTH was > 83% identical to canine, bovine, swine, equine, human, and macaque PTH and 69, 71, and 44% identical to mouse, rat, and chicken PTH, respectively. Within the region responsible for hormonal activity (amino acids 1 to 34), feline PTH was > 79% identical to other mammalian PTH sequences and 64% identical to the chicken sequence. CONCLUSIONS AND CLINICAL RELEVANCE The amino acid sequence of PTH is conserved among mammalian species. Knowledge of the cDNA sequence for feline PTH may be useful to investigate disturbances of calcium metabolism and alterations in PTH expression in cats.
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Affiliation(s)
- Ramiro E Toribio
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus 43210, USA
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Refsal KR, Provencher-Bolliger AL, Graham PA, Nachreiner RF. Update on the diagnosis and treatment of disorders of calcium regulation. Vet Clin North Am Small Anim Pract 2001; 31:1043-62. [PMID: 11570125 DOI: 10.1016/s0195-5616(01)50012-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The availability of PTH, iCa, PTHrP, and 25OHD assays for evaluation of calcium abnormalities in companion animals has been well received [table: see text] by clinicians and diagnosticians. Use of these assays has heightened awareness that some of these disorders are more common than originally thought. Also, there is added insight of alterations of calcium homeostasis as a consequence of other illness or environmental factors such as diet. Animal counterparts of other disorders of calcium metabolism in people are likely to be identified, and use of these assays should play a significant role. As already emphasized, the foundation of using [table: see text] these assays is first assessing whether the calcium abnormality is of a parathyroid-dependent or parathyroid-independent classification.
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Affiliation(s)
- K R Refsal
- Diagnostic Endocrinology Section, Animal Health Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
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Abstract
This article highlights the advances in feline endocrinology, excluding diabetes mellitus and hyperadrenocorticism, which have recently been reviewed elsewhere. The goal will be to provide clinically relevant information regarding pathogenesis, diagnosis, and treatment options for these feline endocrine disorders.
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Affiliation(s)
- D S Bruyette
- VCA West Los Angeles Animal Hospital, Los Angeles, California, USA.
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Byrne KM, Bynum K, Robinette L, Brownlee L. Calcium oxalate stones in feline littermates. J Feline Med Surg 2000; 2:111-4. [PMID: 11716603 PMCID: PMC10829148 DOI: 10.1053/jfms.2000.0075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2000] [Indexed: 11/11/2022]
Abstract
Two feline littermates were diagnosed with calcium oxalate uroliths. Both had been maintained on a commercially available dry diet with reduced magnesium and urine acidifying properties. One female littermate was diagnosed by visualising the stones by radiographs while the second littermate, also female, became blocked when one of the uroliths lodged in the urethra. Two other, unrelated cats in the household, of similar age and raised under the same conditions, did not develop calcium oxalate uroliths.
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Affiliation(s)
- K M Byrne
- Department of Animal Sciences, Washington State University, Pullman, WA 99164-6351, USA
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Savary KCM, Price GS, Vaden SL. Hypercalcemia in Cats: A Retrospective Study of 71 Cases (1991-1997). J Vet Intern Med 2000. [DOI: 10.1111/j.1939-1676.2000.tb02234.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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