Secondary hypoparathyroidism attributed to hypomagnesemia in a dog with protein-losing enteropathy

Abstract

Severe hypomagnesemia (0.8 mg/dl; reference range, 1.6 to 2.3 mg/dl), hypocalcemia, and protein-losing enteropathy were identified in a 5-year-old castrated male 3-kg (6.6 lb) Shih Tzu examined because of anorexia, lethargy, paresis, and abdominal distention. Histologic examination of intestinal biopsy specimens revealed lymphangiectasia and lymphocytic, plasmacytic, neutrophilic infiltrates. Initial treatment included administration of magnesium (0.80 mEq/kg [0.36 mEq/lb]) of body weight in a balanced electrolyte solution. This treatment resulted in normalization of the serum magnesium concentration (1.7 mg/dl); resolution of the lethargy, paresis, and tachycardia; and an increase in the serum parathyroid hormone and ionized calcium concentrations. Findings were consistent with secondary hypoparathyroidism attributable to hypomagnesemia. Magnesium concentration should be monitored in all dogs with gastrointestinal tract disease, especially those with protein-losing enteropathy, anorexia, and weakness.

Hypovitaminosis D is associated with negative outcome in dogs with protein losing enteropathy: a retrospective study of 43 cases

“…Several studies have described dogs with gastrointestinal disease and low total and iCa serum concentrations are often prone to hypocalcemia even after clinical improvement [9, 18, 19]. This could possibly be due to serum vitamin D levels not being corrected and/or increased fraction of serum ionized calcium.…”

Disorders of Magnesium

“…114 A prospective study of cats with diabetes mellitus or diabetic ketoacidosis (DKA) reported a point prevalence of ionized hypomagnesemia of 62% of diabetic and 57% of DKA cats. 27,83 The significance of these studies cannot be overlooked, and they lend strong support to the central concept that magnesium deficit in ill and hospitalized dogs and cats is common. 189 Interestingly, concurrent hypocalcemia and hypokalemia were documented in the majority of cats with magnesium deficiency in this study.…”

Epileptic seizure in a cocker spaniel associated with hypocalcaemia, hypovitaminosis D and a protein‐losing enteropathy

“…Hypomagnesaemia has been reported in PLE cases10 and has been suggested to contribute to the development of an ionised hypocalcaemia state. Low magnesium may lead to a functional hypoparathyroidism as magnesium ions are required for successful exocytosis and release of PTH into the systemic circulation 10.…”

“…Low magnesium may lead to a functional hypoparathyroidism as magnesium ions are required for successful exocytosis and release of PTH into the systemic circulation 10. This can also have severe effects on calcium homeostasis and has been postulated to be an important contributor towards the hypocalcaemic state commonly observed in PLE patients.…”