Zoledronate‐Associated Osteonecrosis of the Jaw in a Dog with Appendicular Osteosarcoma

Lundberg, Alycen P.; Roady, Patrick J.; Somrak, Amy J.; Howes, Mark; Fan, Timothy M.

doi:10.1111/jvim.13980

Cited by 19 publications

(15 citation statements)

References 31 publications

(60 reference statements)

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“…Concerns regarding potential development and prevention of MRONJ in companion animals undergoing bisphosphonate treatment recently were reviewed . Our case report, in addition to the recent case report of mandibular osteonecrosis in a dog secondary to zoledronate treatment, confirms that MRONJ is a possible complication of long‐term bisphosphonate use in small animal patients. A substantial decrease in MRONJ frequency occurs in people when dental hygiene is optimized before bisphosphonate initiation, and full dental cleaning, dental radiographs, and complete healing of any extraction sites are strongly recommended before starting bisphosphonate treatment .…”

Section: Discussionsupporting

confidence: 68%

“…Similarly, no adverse effects were reported in 3 other studies involving chronic alendronate treatment (ranging from 6 to 30 months) of idiopathic hypercalcemia in cats . However, a dog with appendicular osteosarcoma developed oral mucosal ulceration and exposed mandibular bone after 46 consecutive monthly IV injections of zoledronate; histopathological evaluation of the mandible showed osteonecrosis, bacterial osteomyelitis, and metastatic osteosarcoma . Most recently, a cat was diagnosed with bilateral patellar fractures and radiographically thickened cortices after 8 years of alendronate treatment …”

Section: Discussionmentioning

confidence: 82%

“…Although this time to development seems prolonged, the duration between a potential inciting cause and onset of BRONJ in people is highly variable . Furthermore, the dog in the previous report similarly had a history of mandibular bacterial osteomyelitis approximately 13 months earlier …”

Section: Discussionmentioning

confidence: 96%

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Medication‐related osteonecrosis of the jaw after long‐term bisphosphonate treatment in a cat

Larson¹,

Oakes²,

Epperson³

et al. 2019

Veterinary Internal Medicne

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A 12‐year‐old, neutered female, domestic medium hair cat was evaluated for a nonhealing, oral mucosal ulceration. The cat had a history of idiopathic hypercalcemia that had been treated with a bisphosphonate for 41 months. Oral examination identified exposed maxillary bone adjacent to a previous extraction site. Histopathology of the exposed bone and associated mucosa was most consistent with medication‐related osteonecrosis of the jaw. Treatment involved both medical and surgical interventions. Oral mucosal healing occurred after 6 months of treatment.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 82%

See 1 more Smart Citation

Medication‐related osteonecrosis of the jaw after long‐term bisphosphonate treatment in a cat

Larson¹,

Oakes²,

Epperson³

et al. 2019

Veterinary Internal Medicne

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“…Both experimentally and clinically, bisphosphonates have been successfully used to treat hypervitaminosis D, with intravenous pamidronate or zolendronate the most widely utilised (Rumbeiha et al 1999, Schenk et al 2018. Whilst bisphosphonates are effective and generally well tolerated in companion animals (Hostutler et al 2005), complications such as osteonecrosis are increasingly well recognised (Lundberg et al 2016, Larson et al 2019. The lipid-soluble properties of vitamin D can lead to sequestration of the vitamin into fat deposits in the body.…”

Section: Acquired Vitamin D Disorders -Excessmentioning

confidence: 99%

Vitamin D metabolism and disorders in dogs and cats

Clarke

Hurst

Mellanby

2021

J of Small Animal Practice

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Vitamin D plays an important role in regulating calcium metabolism and in the development and maintenance of skeletal health of companion animals. There is also a growing interest in understanding the role vitamin D plays in non-skeletal health in both human and veterinary patients. This review provides an update of our current understanding of vitamin D biology in dogs and cats and gives an overview of how vitamin D metabolism can be assessed in companion animals. Congenital and acquired vitamin D disorders are then summarised before the review concludes with a summary of recent studies which have explored the role of vitamin D in the development and outcomes of non-skeletal diseases of dogs and cats.

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“… 11 Bisphosphonate related osteonecrosis of the jaw in humans is a complication of cumulative doses of ZA and is reported in 1 dog. 12 , 13 …”

Section: Introductionmentioning

confidence: 99%

Toxicity of zoledronic acid after intravenous administration: A retrospective study of 95 dogs

Brewer

Macfarlane

O’Connell

et al. 2021

Veterinary Internal Medicne

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Background There is a paucity of veterinary literature on the safety or outcome of zoledronic acid (ZA) use in dogs for either bone pain or hypercalcemia. Hypothesis/Objectives The primary aim was to report the adverse events in dogs receiving intravenous administration of ZA. Animals Ninety‐five dogs with ZA use. Methods A retrospective cohort study was performed; all dogs that received at least 1 dose of ZA and had a serum biochemistry profile performed before and after treatment were reviewed. Diagnosis, indication for treatment, adverse events and survival times were recorded. Results Ninety‐five dogs met the inclusion criteria. Thirty‐one (33%) received multiple intravenous infusions of ZA (range, 2‐7), making a total of 166 administrations in all dogs. The dose range was 0.13 to 0.32 mg/kg, given at intervals of 4 to 6 weeks. Thirteen adverse events were recorded in 10 dogs: azotemia (n = 8), vomiting (n = 2), pancreatitis (n = 1), cutaneous ulceration (n = 1), and diarrhea (n = 1). Zoledronic acid could not be confirmed as the cause of azotemia in any case. The change in serum creatinine concentration from dose to dose was not related to the total dose received ( P = .46). Five dogs (5%) changed Veterinary Comparative Oncology Group Common Terminology Criteria (VCOG‐CTAE) renal/genitourinary grade after administration of ZA; their total dose 0.4 mg/kg (range, 0.26‐0.66) was not significantly different to the group which did not change VCOG‐CTAE renal/genitourinary grade 0.35 mg/kg (range, 0.2‐1.50; P = .93). Conclusions and Clinical Importance Multiple doses of ZA were well tolerated in dogs within this study. A small number of dogs developed progressive azotemia which was not associated with cumulative dose.

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Zoledronate‐Associated Osteonecrosis of the Jaw in a Dog with Appendicular Osteosarcoma

Cited by 19 publications

References 31 publications

Medication‐related osteonecrosis of the jaw after long‐term bisphosphonate treatment in a cat

Medication‐related osteonecrosis of the jaw after long‐term bisphosphonate treatment in a cat

Vitamin D metabolism and disorders in dogs and cats

Toxicity of zoledronic acid after intravenous administration: A retrospective study of 95 dogs

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