Hypercalcemia and Primary Hyperparathyroidism

Feldman, Edward C

doi:10.1016/b978-1-4557-4456-5.00015-8

Cited by 44 publications

(64 citation statements)

References 120 publications

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“…In healthy dogs, normal or increased serum iCa concentrations have a strong negative feedback effect on PTH secretion. The hypercalcemia observed in primary hyperparathyroidism (PHPTH) is caused by autonomous secretion of PTH by the parathyroid chief cells in the face of normal or increased iCa concentrations . Primary hyperparathyroidism most commonly is caused by a parathyroid adenoma, whereas parathyroid hyperplasia and parathyroid carcinoma are identified less frequently …”

mentioning

confidence: 99%

“…Previous studies showed a steep and linear decrease in serum PTH and serum iCa concentrations within the first 24 hours after parathyroidectomy, followed subsequently by a plateau. The largest decrease in serum iCa concentrations typically occurs in the first 24–48 hours after removal of the abnormal parathyroid gland, with most dogs becoming normocalcemic within 48 hours of surgery . This rapid decrease is a consequence of the short half‐life of PTH (3–5 minutes), and the plateau results from reestablishment of normal parathyroid axis and parathyroid gland function with respect to PTH production.…”

mentioning

confidence: 99%

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Effect of Prophylactic Calcitriol Administration on Serum Ionized Calcium Concentrations after Parathyroidectomy: 78 Cases (2005–2015)

Armstrong

Hauptman

Stanley

et al. 2017

Veterinary Internal Medicne

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BackgroundProphylactic 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/ObjectivesTo determine the effect of prophylactic calcitriol administration on postoperative serum ionized calcium (iCa) concentrations in dogs with primary hyperthyroidism (PHPTH) treated by parathyroidectomy.AnimalsSeventy‐eight dogs with primary hyperparathyroidism treated surgically.MethodsMulti‐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.ResultsSerial 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 ImportanceWe 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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confidence: 99%

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confidence: 99%

Effect of Prophylactic Calcitriol Administration on Serum Ionized Calcium Concentrations after Parathyroidectomy: 78 Cases (2005–2015)

Armstrong

Hauptman

Stanley

et al. 2017

Veterinary Internal Medicne

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“…Clinical signs are attributable to hypercalcaemia and may include PUPD and non-specific signs such as lethargy, weakness or inappetence (Feldman and Nelson 2004). …”

Section: Discussionmentioning

confidence: 99%

“…The hyperplasia may be primary, for example, with the ‘multiple endocrine neoplasia’ syndrome (Feldman and Nelson 2004) or secondary to chronic kidney failure or alimentary disease. In secondary cases, surgical treatment is unlikely to be helpful so identification of the primary disease, if it exists, is important.…”

Section: Discussionmentioning

confidence: 99%

“…Less commonly, parathyroid hyperplasia can be a part of the ‘multiple endocrine neoplasia’ syndrome. This refers to a group of syndromes in human beings, consisting of hyperplasia or neoplasia in two or more endocrine glands (pancreatic islet adenoma/carcinoma, adenoma/hyperplasia of the anterior pituitary, medullary carcinoma of the thyroid, pheochromocytoma can also be found in this syndrome; Feldman and Nelson 2004). …”

Section: Differential Diagnosismentioning

confidence: 99%

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Primary hyperparathyroidism associated with hyperplasia of multiple parathyroid glands in a dog

Vessieres

Selgas²,

Rasotto³

et al. 2015

Vet Record Case Reports

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A nine-year-old Italian Spinone dog presented with a history of urinary incontinence associated with polyuria/polydipsia (PUPD). Haematology and serum biochemistry identified hypercalcaemia. Subsequently, thoracic radiographs, abdominal ultrasound, urinalysis, serum assay of parathyroid hormone (PTH) and PTH-related protein concentrations and ultrasound of the parathyroid glands were consistent with a diagnosis of primary hyperparathyroidism. Unusually, however, all four parathyroid glands were noted to be enlarged on ultrasound, as opposed to a single parathyroid nodule (commonly an adenoma) as is normal in primary hyperparathyroidism. This presented a dilemma as to how best treat the dog; ultimately, two out of four parathyroid glands were removed. Postoperatively, normocalcaemia returned, and PUPD and incontinence resolved. Histopathological examination of the two removed glands was consistent with nodular hyperplasia of chief cells for one gland and nodular hyperplasia of chief cells and oxyphilic cells for the other gland, confirming a diagnosis of parathyroid hyperplasia.

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Hypoadrenocorticism

DACVECC

2018

Textbook of Small Animal Emergency Medicine

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Hypercalcemia and Primary Hyperparathyroidism

Cited by 44 publications

References 120 publications

Effect of Prophylactic Calcitriol Administration on Serum Ionized Calcium Concentrations after Parathyroidectomy: 78 Cases (2005–2015)

Effect of Prophylactic Calcitriol Administration on Serum Ionized Calcium Concentrations after Parathyroidectomy: 78 Cases (2005–2015)

Primary hyperparathyroidism associated with hyperplasia of multiple parathyroid glands in a dog

Hypoadrenocorticism

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