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Vose J, Jaffey J, Akin C, Spitzer A, DeCicco B, Bassiouny E, LaClair A, Petroff B, Brudvig J, Cridge H. Serum gastrin concentrations in dogs with primary hyperparathyroidism. J Vet Intern Med 2024; 38:123-129. [PMID: 38031928 PMCID: PMC10800197 DOI: 10.1111/jvim.16940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Hypercalcemia has been associated with hypergastrinemia in humans. Hypergastrinemia could be responsible for gastrointestinal (GI) signs in dogs with primary hyperparathyroidism (PHPT). HYPOTHESIS/OBJECTIVES (a) Determine whether hypergastrinemia occurs in dogs with PHPT, (b) assess for potential correlations among ionized calcium (iCa), parathyroid hormone (PTH), and serum gastrin concentrations, and (c) determine whether gastrin concentrations decrease after management of PHPT. ANIMALS Phase 1: 151 client-owned dogs at the time of PHPT diagnosis, Phase 2: 24 dogs that underwent treatment for PHPT. METHODS Dogs with azotemia, concurrent disease, or those receiving acid suppressants were excluded. Twenty-four treated dogs had baseline and repeat quantification of serum gastrin, PTH, and iCa concentrations 4 weeks after treatment. The effect of treatment on gastrin, iCa, and PTH concentrations was assessed using Wilcoxon signed rank sum tests. Fisher exact testing was used to compare the proportion of dogs with hypergastrinemia in dogs with and without GI signs. RESULTS Twenty-seven of 151 PHPT dogs (17.9%) had increased pre-treatment serum gastrin concentrations (median, 45.0 ng/L; interquartile range [IQR], 20.0 ng/L). Gastrin concentrations were not correlated with iCa (P = .92) or PTH (P = .60). Treatment of PHPT decreased PTH (P < .001) and iCa concentrations (P < .001), but not gastrin concentrations (P = .15). The proportion of dogs with hypergastrinemia with and without GI signs did not differ (P = 1.00). CONCLUSIONS AND CLINICAL IMPORTANCE Mild increases in serum gastrin concentrations may be seen in dogs with PHPT, but this finding is independent of the presence of GI signs.
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Affiliation(s)
- Julieann Vose
- Department of Small Animal Clinical Sciences, College of Veterinary MedicineMichigan State UniversityEast Lansing, MichiganUSA
| | - Jared Jaffey
- Department of Specialty Medicine, College of Veterinary MedicineMidwestern UniversityGlendale, ArizonaUSA
| | - Camille Akin
- Department of Small Animal Clinical Sciences, College of Veterinary MedicineMichigan State UniversityEast Lansing, MichiganUSA
| | - Alexander Spitzer
- Department of Small Animal Clinical Sciences, College of Veterinary MedicineMichigan State UniversityEast Lansing, MichiganUSA
| | - Barry DeCicco
- Center for Statistical Training and Consulting (CSTAT)Michigan State UniversityEast Lansing, MichiganUSA
| | - Enass Bassiouny
- Veterinary Diagnostic LaboratoryMichigan State UniversityLansing, MichiganUSA
| | - Ashley LaClair
- Veterinary Diagnostic LaboratoryMichigan State UniversityLansing, MichiganUSA
| | - Brian Petroff
- Veterinary Diagnostic LaboratoryMichigan State UniversityLansing, MichiganUSA
| | - Jean Brudvig
- Veterinary Diagnostic LaboratoryMichigan State UniversityLansing, MichiganUSA
| | - Harry Cridge
- Department of Small Animal Clinical Sciences, College of Veterinary MedicineMichigan State UniversityEast Lansing, MichiganUSA
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Townsend KL, Ham KM. Current Concepts in Parathyroid/Thyroid Surgery. Vet Clin North Am Small Anim Pract 2022; 52:455-471. [DOI: 10.1016/j.cvsm.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Clinical, CT and ultrasonographic features of renal secondary hyperparathyroidism in a juvenile dog. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Secrest S, Grimes J. Ultrasonographic size of the canine parathyroid gland may not correlate with histopathology. Vet Radiol Ultrasound 2019; 60:729-733. [PMID: 31353771 DOI: 10.1111/vru.12789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/18/2019] [Accepted: 06/06/2019] [Indexed: 11/29/2022] Open
Abstract
Accurate ultrasonographic differentiation of normal versus abnormal parathyroid glands is important for clinical workup and presurgical screening in dogs with hypercalcemia. In previous published studies, size has been the only ultrasonographic criterion correlated with histologic diagnoses of abnormal parathyroid glands. In this retrospective, cross-sectional study, the medical records of dogs with ultrasonographic examinations of the parathyroid glands and histologic diagnoses of parathyroid gland hyperplasia, adenoma, and adenocarcinoma were evaluated. Ultrasonographic characteristics were recorded for each gland and compared among histologic diagnosis groups. A total of 49 dogs and 59 parathyroid glands were sampled and assigned to the following groups for analyses: adenoma (n = 24), hyperplastic (n = 20), and adenocarcinoma (n = 15). There were no associations with dog age, sex, weight, breed; or gland laterality, location, ultrasonographic shape, or echogenicity among histologic diagnosis groups (P > .05). Parathyroid gland adenocarcinomas were found to be less likely to have a homogeneous echotexture on ultrasonographic evaluation, with hyperplastic glands being smaller (P = .022) and adenocarcinomas being larger (P = .042). While 3 mm was the optimum cutoff for differentiating hyperplastic and neoplastic parathyroid glands in this sample of dogs, values varied widely within groups and there were overlapping values between groups. Therefore, authors caution against using ultrasonographic size as a sole criterion for differentiating hyperplasia from neoplasia and normal versus abnormal parathyroid glands.
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Affiliation(s)
- Scott Secrest
- Department of Veterinary Biosciences and Diagnostic Imaging, University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Janet Grimes
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
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Singh A, Giuffrida MA, Thomson CB, Baum J, Kramek B, Liptak JM, Hyndman P, Ringwood B, Smeak D, Ham K, Berg J, Thieman-Mankin K, Blois SL, Boston SE. Perioperative characteristics, histological diagnosis, and outcome in cats undergoing surgical treatment of primary hyperparathyroidism. Vet Surg 2019; 48:367-374. [PMID: 30666680 DOI: 10.1111/vsu.13165] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 11/08/2018] [Accepted: 12/24/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To report perioperative characteristics, complications, histopathologic diagnosis and outcome in cats undergoing surgical treatment for primary hyperparathyroidism (PHPT). STUDY DESIGN Multi-institutional, retrospective case series. ANIMALS Thirty-two client-owned cats. METHODS Medical records of cats treated with surgical removal of 1 or more parathyroid gland(s) with confirmed histopathologic evaluation were reviewed. Cats were divided into preoperative ionized calcium (iCa) groups corresponding to the 33rd, 67th, and 100th percentiles of the preoperative iCa results of the study population. Follow-up consisted of phone conversation with owners or primary veterinarian. RESULTS Ionized calcium was above reference range in all cats (median 1.8 mmol/L [interquartile range, 1.5-1.9]). Abnormal tissue was excised after cervical exploration in all cats. The most common histopathologic diagnoses were parathyroid adenoma in 20 of 32 (62.5%) cats and parathyroid carcinoma in 7 of 32 (21.9%) cats. At discharge, 6 of 32 (18.8%) cats had hypercalcemia, 5 of 32 (15.6%) had hypocalcemia, and 21 of 32 (65.6%) were normocalcemic. Preoperative iCa did not correlate with postoperative iCa. The median follow-up time was 332 days (range, 7-3156). Overall median survival time was 1109 days (95% CI, 856-1332). Survival time was not associated with preoperative iCa group, hypocalcemia at discharge, hypercalcemia at discharge, or diagnosis of carcinoma. CONCLUSION In this cohort of cats, parathyroid adenoma was the most common cause of PHPT, and surgical treatment resulted in very good median survival time. Preoperative iCa was not predictive of postoperative hypocalcemia. CLINICAL SIGNIFICANCE Surgical parathyroidectomy for treatment of PHPT in cats provides a favorable prognosis.
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Affiliation(s)
- Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Michelle A Giuffrida
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California
| | - Christopher B Thomson
- Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, Minnesota
| | - Jared Baum
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Betty Kramek
- Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, Minnesota
| | - Julius M Liptak
- Department of Surgery, VCA Canada-Alta Vista Animal Hospital, Ottawa, Ontario, Canada
| | - Philip Hyndman
- Department of Surgery, Veterinary Emergency Clinic, Toronto, Ontario, Canada
| | - Brendon Ringwood
- Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, Minnesota
| | - Daniel Smeak
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Kathleen Ham
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio
| | - John Berg
- Department of Clinical Sciences, Tufts University, North Grafton, Massachusetts
| | - Kelley Thieman-Mankin
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Sarah E Boston
- VCA Canada-404 Veterinary Emergency and Referral, Newmarket, Ontario, Canada
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Kaiser AM, Kempker L, Neiger R. Parathyroid immunohistochemistry in a 12-year-old mixed-breed dog with parathyroid adenocarcinoma. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
SummaryA 12-year-old, female, spayed, mixed-breed dog with acute lethargy, anorexia and weakness and markedly elevated total and ionised calcium concentration showed an enlarged left cranial parathyroid gland on ultrasonography of the ventral neck. Despite preoperative therapy with furosemide and calcitonin, there was no decline of plasma ionised calcium concentration. The dog deteriorated rapidly and was euthanased two days after initial presentation. Postmortem histopathology revealed parathyroid tissue with characteristics of malignancy as local and vascular invasion. Immunohistochemistry showed parathyroid hormone positive staining of these cells. Unusual clinical presentation and histopathological characteristics are discussed.
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Galac S, Grinwis G. Concurrent endocrine neoplasia: more common than you thought? Vet Rec 2018; 182:320-322. [DOI: 10.1136/vr.k1094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sara Galac
- Department of Clinical Sciences of Companion Animals; Utrecht University; the Netherlands
| | - Guy Grinwis
- Department of Pathobiology, Faculty of Veterinary Medicine; Utrecht University; the Netherlands
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Armstrong AJ, Hauptman JG, Stanley BJ, Klocke E, Burneko M, Holt DE, Runge JJ, Rubin JA. Effect of Prophylactic Calcitriol Administration on Serum Ionized Calcium Concentrations after Parathyroidectomy: 78 Cases (2005-2015). J Vet Intern Med 2017; 32:99-106. [PMID: 29280194 PMCID: PMC5787196 DOI: 10.1111/jvim.15028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 11/07/2017] [Accepted: 11/28/2017] [Indexed: 01/24/2023] Open
Abstract
Background Prophylactic 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/Objectives To determine the effect of prophylactic calcitriol administration on postoperative serum ionized calcium (iCa) concentrations in dogs with primary hyperthyroidism (PHPTH) treated by parathyroidectomy. Animals Seventy‐eight dogs with primary hyperparathyroidism treated surgically. Methods Multi‐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. Results Serial 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 Importance We 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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Affiliation(s)
- A J Armstrong
- Department of Small Animal Clinical Studies, Michigan State University, East Lansing, MI
| | - J G Hauptman
- Department of Small Animal Clinical Studies, Michigan State University, East Lansing, MI
| | - B J Stanley
- Department of Small Animal Clinical Studies, Michigan State University, East Lansing, MI
| | - E Klocke
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
| | - M Burneko
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - D E Holt
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - J J Runge
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - J A Rubin
- Department of Small Animal Clinical Studies, Michigan State University, East Lansing, MI
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Pope JP, Steeil J, Ramsay EC, Reel D, Newman SJ. Spontaneous proliferative and neoplastic lesions in thyroid and parathyroid glands of nondomestic felids. J Vet Diagn Invest 2016; 29:8-13. [PMID: 27852814 DOI: 10.1177/1040638716672253] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Based on microscopic and immunohistochemical characterization, we documented spontaneous proliferative and neoplastic lesions in the thyroid and parathyroid glands of nondomestic felids. Ten animals (4 leopards, 3 tigers, and 3 cougars), all with a previous diagnosis of thyroid neoplasia were identified from the University of Tennessee College of Veterinary Medicine database. The mean age of affected animals was 15.9 y. Twelve neoplasms were identified; 2 animals had 2 concurrent neoplasms. After immunohistochemical characterization using a panel of chromogranin A, thyroglobulin, and calcitonin, 7 of the former thyroid neoplasms were diagnosed as thyroid adenomas, 1 was diagnosed as a thyroid carcinoma, and 4 were diagnosed as parathyroid adenomas. No thyroid medullary neoplasms (C-cell tumors) were diagnosed in the current study. Most of the diagnosed neoplasms were benign (11 of 12), and metastasis was not documented in the single carcinoma. Only 2 animals were suspected to have functional neoplasms (1 thyroid adenoma and 1 parathyroid adenoma), based on associated tissue lesions or serum biochemistry. Other documented lesions in the thyroid and parathyroid glands included thyroid nodular hyperplasia ( n = 7), parathyroid hyperplasia associated with chronic renal disease ( n = 2), a thyroid abscess, and a branchial cyst. Parathyroid adenomas were more commonly diagnosed than expected in comparison with domestic cats. We demonstrated that an immunohistochemistry panel for thyroglobulin, calcitonin, and chromogranin A can be used to differentiate neoplasms of thyroid from parathyroid origin in nondomestic felids.
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Affiliation(s)
- Jenny P Pope
- Departments of Biomedical and Diagnostic Sciences (Pope, Reel, Newman), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Small Animal Clinical Sciences (Steeil, Ramsay), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Current addresses: Thompson Bishop Sparks State Diagnostic Laboratory, Auburn, AL (Pope).,KDL VetPath, Knoxville, TN (Reel).,Department of Animal Health, National Zoological Park, Smithsonian Institution, Washington, DC (Steeil)
| | - James Steeil
- Departments of Biomedical and Diagnostic Sciences (Pope, Reel, Newman), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Small Animal Clinical Sciences (Steeil, Ramsay), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Current addresses: Thompson Bishop Sparks State Diagnostic Laboratory, Auburn, AL (Pope).,KDL VetPath, Knoxville, TN (Reel).,Department of Animal Health, National Zoological Park, Smithsonian Institution, Washington, DC (Steeil)
| | - Edward C Ramsay
- Departments of Biomedical and Diagnostic Sciences (Pope, Reel, Newman), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Small Animal Clinical Sciences (Steeil, Ramsay), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Current addresses: Thompson Bishop Sparks State Diagnostic Laboratory, Auburn, AL (Pope).,KDL VetPath, Knoxville, TN (Reel).,Department of Animal Health, National Zoological Park, Smithsonian Institution, Washington, DC (Steeil)
| | - Danielle Reel
- Departments of Biomedical and Diagnostic Sciences (Pope, Reel, Newman), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Small Animal Clinical Sciences (Steeil, Ramsay), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Current addresses: Thompson Bishop Sparks State Diagnostic Laboratory, Auburn, AL (Pope).,KDL VetPath, Knoxville, TN (Reel).,Department of Animal Health, National Zoological Park, Smithsonian Institution, Washington, DC (Steeil)
| | - Shelley J Newman
- Departments of Biomedical and Diagnostic Sciences (Pope, Reel, Newman), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Small Animal Clinical Sciences (Steeil, Ramsay), College of Veterinary Medicine, University of Tennessee, Knoxville, TN.,Current addresses: Thompson Bishop Sparks State Diagnostic Laboratory, Auburn, AL (Pope).,KDL VetPath, Knoxville, TN (Reel).,Department of Animal Health, National Zoological Park, Smithsonian Institution, Washington, DC (Steeil)
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Vessieres F, Gomez Selgas A, Rasotto R, Raffan E. Primary hyperparathyroidism associated with hyperplasia of multiple parathyroid glands in a dog. VETERINARY RECORD CASE REPORTS 2015. [DOI: 10.1136/vetreccr-2015-000191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Aida Gomez Selgas
- Department of Small Animal Internal MedicineAnimal Health TrustNewmarketUK
| | | | - Eleanor Raffan
- University of Cambridge Metabolic Research LaboratoriesCambridgeUK
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Tomlinson JE, Johnson AL, Ross MW, Engiles JB, Levine DG, Wisner WA, Sweeney RW. Successful detection and removal of a functional parathyroid adenoma in a pony using technetium Tc 99m sestamibi scintigraphy. J Vet Intern Med 2014; 28:687-92. [PMID: 24417704 PMCID: PMC4858011 DOI: 10.1111/jvim.12285] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 10/20/2013] [Accepted: 11/20/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- J E Tomlinson
- New Bolton Center, University of Pennsylvania, Kennett Square, PA
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Dumas S, Grandys T, Stern A, Garrett E, Ridgway M. Primary hyperparathyroidism with chronic renal failure in a Vietnamese pot-bellied pig (Sus scrofa). Vet Q 2013; 33:195-200. [DOI: 10.1080/01652176.2013.864429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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de Brito Galvao JF, Nagode LA, Schenck PA, Chew DJ. Calcitriol, calcidiol, parathyroid hormone, and fibroblast growth factor-23 interactions in chronic kidney disease. J Vet Emerg Crit Care (San Antonio) 2013; 23:134-62. [PMID: 23566108 PMCID: PMC3677418 DOI: 10.1111/vec.12036] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Accepted: 02/05/2013] [Indexed: 12/13/2022]
Abstract
Objective To review the inter-relationships between calcium, phosphorus, parathyroid hormone (PTH), parent and activated vitamin D metabolites (vitamin D, 25(OH)-vitamin D, 1,25(OH)2-vitamin D, 24,25(OH)2-vitamin D), and fibroblast growth factor-23 (FGF-23) during chronic kidney disease (CKD) in dogs and cats. Data Sources Human and veterinary literature. Human Data Synthesis Beneficial effects of calcitriol treatment during CKD have traditionally been attributed to regulation of PTH but new perspectives emphasize direct renoprotective actions independent of PTH and calcium. It is now apparent that calcitriol exerts an important effect on renal tubular reclamation of filtered 25(OH)-vitamin D, which may be important in maintaining adequate circulating 25(OH)-vitamin D. This in turn may be vital for important pleiotropic actions in peripheral tissues through autocrine/paracrine mechanisms that impact the health of those local tissues. Veterinary Data Synthesis Limited information is available reporting the benefit of calcitriol treatment in dogs and cats with CKD. Conclusions A survival benefit has been shown for dogs with CKD treated with calcitriol compared to placebo. The concentrations of circulating 25(OH)-vitamin D have recently been shown to be low in people and dogs with CKD and are related to survival in people with CKD. Combination therapy for people with CKD using both parental and activated vitamin D compounds is common in human nephrology and there is a developing emphasis using combination treatment with activated vitamin D and renin-angiotensin-aldosterone-system (RAAS) inhibitors.
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Milovancev M, Schmiedt CW. Preoperative factors associated with postoperative hypocalcemia in dogs with primary hyperparathyroidism that underwent parathyroidectomy: 62 cases (2004–2009). J Am Vet Med Assoc 2013; 242:507-15. [DOI: 10.2460/javma.242.4.507] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Graham KJ, Wilkinson M, Culvenor J, Dhand NK, Churcher RK. Intraoperative parathyroid hormone concentration to confirm removal of hypersecretory parathyroid tissue and time to postoperative normocalcaemia in nine dogs with primary hyperparathyroidism. Aust Vet J 2012; 90:203-9. [PMID: 22632282 DOI: 10.1111/j.1751-0813.2012.00918.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine (1) whether the intraoperative parathyroid hormone concentration ([PTH]) during parathyroidectomy (PTX) can be used to indicate cure in dogs with primary hyperparathyroidism and (2) the time taken for postoperative serum calcium concentration to normalise. DESIGN Retrospective study (2005-10) from a private referral hospital in Sydney, New South Wales, Australia. PROCEDURE Nine client-owned dogs underwent surgical PTX for naturally occurring primary hyperparathyroidism. [PTH] was measured from serum samples taken immediately post-induction (pre-PTX]) and at least 20 min after adenoma removal (post-PTX) for all dogs, and during parathyroid gland manipulation (intra-PTX) for six dogs. The concentration of ionised calcium (iCa) was measured at various time points postoperatively until it normalised, then stabilised or decreased below reference ranges. Statistical analysis compared the mean pre-, intra- and post-PTX [PTH] and the average rate of decline of iCa concentration postoperatively. RESULTS All dogs demonstrated a significant decrease from mean pre-PTX [PTH] (168.51 pg/mL) to mean post-PTX [PTH] (29.20 pg/mL). There was a significant increase in mean intra-PTX [PTH] (279.78 pg/mL). The average rate of decline of iCa concentration postoperatively to within the reference range (1.12-1.40 mmol/L) occurred after 24 h. CONCLUSION Intraoperative measurements of [PTH] can be used clinically to determine cure of primary hyperparathyroidism. Parathyroid hormone increases significantly during parathyroid gland manipulation. Plasma iCa concentration returns to within the reference range on average 24 h after successful PTX. Not all dogs require vitamin D or calcium supplementation pre- or postoperatively.
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Affiliation(s)
- K J Graham
- North Shore Veterinary Specialist Centre, 64 Atchison Street, Crows Nest, New South Wales 2065, Australia.
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Lazaretti P, Kogika M, Hagiwara M, Lustoza M, Mirandola R. Concentração sérica de paratormônio intacto em cães com insuficiência renal crônica. ARQ BRAS MED VET ZOO 2006. [DOI: 10.1590/s0102-09352006000400006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Estudou-se a ocorrência de hiperparatireoidismo secundário renal e determinaram-se as concentrações séricas de paratormônio intacto (PTHi-c), cálcio total e fósforo em 30 cães com insuficiência renal crônica (IRC) e em 40 cães sadios. Para a determinação do PTHi-c, foi utilizado o método imunofluorométrico, com o emprego de anticorpos anti-aminoterminal (extraídos de gema de ovo da galinha) e de anticorpos monoclonais anti-carboxiterminal (H5P10), marcados com Europium. As concentrações séricas de PTHi-c (717,23±469,13pg/ml no grupo IRC e 36,76±34,40pg/ml no grupo-controle; P=0,0001), cálcio total (11,46±2,03mg/dl no grupo IRC e 10,11±0,91mg/dl no grupo-controle; P=0,003) e fósforo (12,01±8,06mg/dl no grupo IRC e 4,33±0,74mg/dl no grupo-controle; P=0,0001) foram mais altas nos cães com IRC. Observou-se estreita correlação entre PTHi-c e fósforo (r=0,56; P=0,0006), o que não ocorreu entre PTHi-c e cálcio. Hipercalcemia em cães com alta concentração de PTHi-c demonstrou a possível ocorrência de hiperparatireoidismo terciário em 11 animais. A hiperfosfatemia pode indicar, de forma indireta, a ocorrência de hiperparatireoidismo secundário nos cães com IRC.
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Abstract
Renal osteodystrophy (ROD) associated with chronic kidney disease (CKD) involves a complex interrelationship of the loss of divalent mineral homeostasis, hyperparathyroidism, and gene modulation. In affected children, ROD leads to impaired linear growth as well as to the development of other significant skeletal and extraskeletal manifestations. Despite the success of kidney transplantation, many ROD complications cannot be completely reversed; and thus, patients with CKD and ROD require long-term follow-up. Although the availability of vitamin D analogues has advanced ROD management, it has also created new issues for clinicians to address, motivating future investigations of calcimimetic therapies. An algorithmic approach to the management of ROD in children is presented; to be most effective, this approach requires close and frequent surveillance to prevent side effects related to potent therapies.
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Affiliation(s)
- Craig B Langman
- Feinberg School of Medicine, Northwestern University, and Children's Memorial Hospital, 2300 Children's Plaza, MS #37, Chicago, IL 60614, USA.
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