Serum vitamin D status in sick cats with and without cholestatic liver disease

Abstract

Objectives Vitamin D deficiency accompanies chronic cholestatic liver disease (CLD) in humans. The vitamin D status of cats with CLD is unknown. The objectives of this study were to describe serum vitamin D concentrations in cats with CLD and to determine if they correlated with indices of liver disease severity. Methods Thirty-six cats with CLD, defined by increases in serum bilirubin and serum alanine aminotransferase, and 23 sick cats with non-hepatobiliary diseases were prospectively enrolled. Serum 25-hydroxyvitamin D (25[OH]D), parathyroid hormone (PTH) and ionized calcium were measured. Signalment, clinical signs, comorbidities, diet history, serum bilirubin, liver enzyme activity, albumin, phosphorus, white blood cell count, prothrombin time and final hepatic cytologic/histopathologic diagnosis, when available, were recorded. Results Median serum 25(OH)D levels were similar in cats with CLD (89.5 nmol/l; range 21–112 nmol/l) and sick cats (89.0 nmol/l; range 49–115 nmol/l). Overall 12/36 (33%) of cats with CLD and 4/23 (17%) sick cats had 25(OH)D levels below the lower limit of the reference interval (<65 nmol/l). Median PTH concentrations in cats with CLD were significantly higher (0.95 pmol/l; range 0–11.3 pmol/l) than in sick cats (0.70 pmol/l; range 0.5–6 pmol/l). In cats with CLD, 6/36 (17%) had high PTH levels in contrast to only 1/23 (4%) sick cats. In cats with CLD, 25(OH)D concentrations did not correlate with serum bilirubin, albumin or serum liver enzymes but were moderately negatively correlated with white blood cell count (r = − 0.402, P = 0.013). Cats with hepatic lipidosis had the highest prevalence of 25(OH)D concentrations that fell below the reference interval. Conclusions and relevance Many cats with CLD have serum 25(OH)D concentrations below the lower limit of the reference interval. Further study is warranted to determine the clinical relevance and whether supplementation would provide benefits.

Vitamin D metabolism and disorders in dogs and cats

“…Low vitamin D status has been reported in cats and dogs with gastrointestinal disorders (compared to healthy controls), especially in dogs with a protein-losing enteropathy (PLE) (Mellanby et al 2005b, Gow et al 2011, Lalor et al 2014, as well as dogs with exocrine pancreatic insufficiency (EPI) (Barko & Williams 2018) acute pancreatitis (Kim et al 2017) and both dogs and cats with liver disease (Schulze et al 2000, Kibler et al 2020.…”

“…Vitamin D deficiency and rickets has occasionally been reported in dogs with liver diseases likely as a consequence of impaired intestinal absorption of vitamin D (Schulze et al 2000). Additionally, many cats with cholestatic liver disease, especially hepatic lipidosis, had suboptimal serum 25(OH)D levels, although the clinical importance of this remains uncertain given that that ionised calcium concentrations remained normal (Kibler et al 2020).…”

Dietary 25-hydroxyvitamin D3 effects on vitamin D status, plasma metabolites and urine mineral excretion in adult cats

“…1 Cats with inflammatory bowel disease, intestinal small cell lymphoma, cholestatic liver disease, feline immunodeficiency virus and infections have been found to have low levels of serum vitamin D concentrations, as measured by serum calcidiol. 3–5 In a study looking at vitamin D status in cats with cardiomyopathy, researchers found that age played an important negative relationship with vitamin D status. 6…”

“…1 Cats with inflammatory bowel disease, intestinal small cell lymphoma, cholestatic liver disease, feline immunodeficiency virus and infections have been found to have low levels of serum vitamin D concentrations, as measured by serum calcidiol. [3][4][5] In a study looking at vitamin D status in cats with cardiomyopathy, researchers found that age played an important negative relationship with vitamin D status. 6 Calcidiol, in the form of 25-hydroxycholecalciferol (25[OH]D 3 ), has been shown to be more potent and effective than cholecalciferol (D 3 ) in raising vitamin D status in humans when ingested.…”

Utility of vitamin D serum evaluation and supplementation in dogs and cats’ medical routine: a review

“…In addition, dogs that died from acute pancreatitis were found to be more deficient than those that survived the crisis, indicating a role for this vitamin as a prognostic marker during pancreatitis (Kim et al, 2017). In cats with cholestatic disease, serum concentration of vitamin D was identical when compared to felines sick from different systemic causes (Kibler et al, 2020).…”