Uses and Effectiveness of Pamidronate Disodium for Treatment of Dogs and Cats with Hypercalcemia

Abstract

Uncorrected hypercalcemia can cause clinical signs such as polyuria, polydipsia, vomiting, diarrhea, lethargy, and depression and contributes to the development of primary renal failure and soft tissue mineralization. Treatment of hypercalcemia includes diagnosis and treatment of the underlying disease process and some combination of excracellular fluid volume expansion by administration of fluids intravenously and administration of glococorticosteroids, salmon calcitonin, and furosemide. Bisphosphonates such as pamidronate disodium also may be safe and effective in the treatment of hypercalcemia. The purpose of our study was to characterize the efficacy and safety of pamidronate in the treatment of hypercalcemia attritutable to several different disease processes in the dog and cat. Seven dogs and 2 cats were administered pamidronate at a dose of 1.05-2.0 mg/kg IV for a variety of disease processes, including neoplasia (n = 4), calcipotriene toxicity (n = 3), nocardiosis (n = 1), and idiopathic hypercalcemia with chronic renal failure (n = 1). In all the animals, IV pamidronate administration rapidly decreased serum calcium concentrations without evident toxicosis. Two animals received pamidronate several times without obvious toxicosis. On the basis of the findings in our retrospective study, pamidronate may be a safe and effective drug with which to lower both serum total and ionized calcium concentrations in patients with hypercalcemia arising from a wide variety of underlying disease processes.

Pamidronate Disodium for Palliative Therapy of Feline Bone-Invasive Tumors

“…Pamidronate therapy has not previously been described in cancer-bearing cats; however, single dose intravenous pamidronate has been used to treat non-cancer-related hypercalcemia in three cats [18, 19]. One cat with idiopathic hypercalcemia developed moderate ionized hypocalcemia and worsening hypophosphatemia after pamidronate treatment [18].…”

“…One cat with idiopathic hypercalcemia developed moderate ionized hypocalcemia and worsening hypophosphatemia after pamidronate treatment [18]. One cat with nocardiosis developed mild reduction in total serum calcium but maintained normal ionized levels, and one cat with idiopathic hypercalcemia and chronic renal failure did not develop abnormal electrolyte changes [19]. Hypercalcemia was not a factor in our patient population, and no clinically significant reductions in calcium, phosphorus, or potassium were documented after pamidronate treatment in this population; however, feline hypercalcemia of malignancy related to malignant osteolysis may also represent a therapeutic target for pamidronate.…”

Reversal of hypercalcemic acute kidney injury by treatment with intravenous bisphosphonates

“…On the other hand, research studies in animals and adults have demonstrated treatment with i.v. bisphosphonates to be effective and safe in hypercalcemic AKI as well as in those with underlying kidney disease [14,19,[24][25][26][27].…”

Calcium Disorders

“…9 These drugs decrease osteoclastic activity, thus decreasing bone resorption. 9 These drugs decrease osteoclastic activity, thus decreasing bone resorption.…”