Calcium metabolism: an overview of its hormonal regulation and interrelation with skeletal integrity

Factorial calculation of calcium and phosphorus requirements of growing dogs

Calcium and phosphorus requirements for growing dogs can be calculated by different methods. The current standard feeding recommendations are based on experimental data derived from young giant breed puppies. In order to determine the absolute requirement, an extrapolation via metabolisable energy requirement is recommended. Another approach is to calculate the requirement factorially, taking into account the endogenous losses and the amount of calcium and phosphorus retained due to tissue accretion during growth as well as the expected availability of these nutrients. The working hypothesis was that both methods are valid and lead to comparable results in young puppies of a high mature body weight (BW). Yet, deviations for other age and mature BW groups were expected. Thus, the aim of the present study was to compare the results of both methods using exemplary puppies of different age and mature BW groups. The hypotheses could be verified for calcium. The extrapolated requirements overestimate the factorial requirements by up to 59.7% for puppies <60kg mature BW and/or >6 months of age. In case of phosphorus requirement, the deviations between both methods are overall very high in all stages. Taking into account the potentially harmful effects of calcium and phosphorus excess, the feeding recommendations based on the extrapolation should be reconsidered.

Osteochondrosis dissecans of the tarsus in Labrador Retrievers: Clinical signs, radiological data and force plate gait evaluation after surgical treatment

Objectives: To report the outcome of unilateral surgery, by a plantaromedial approach, in 15 Labrador Retrievers with osteochondrosis dissecans (OCD) of the medial trochlear ridge of the talus. To evaluate the influence on outcome of age at surgery, bilateral involvement, periarticular soft tissue increase (PSI), osteophyte size (OS), decrease of range of joint motion and follow-up. To assess the extent of tarsal hyperextension in the standing dog.

Methods: A retrospective clinical and radiographic study was conducted and the posttreatment gait was analysed using a force plate. Ground reaction force (GRF) data were compared with data derived from 24 healthy Labrador Retrievers (control group).

Results: Six dogs had an excellent or good clinical result. Significant differences were found between the patients and the control group for many GRF data. Propulsive and vertical forces significantly decreased in the operated limb and increased in the contralateral pelvic and ipsilateral or both thoracic limbs. The lameness was significantly correlated to the OS postoperatively, the range-of-motion, the PSI, the length of the follow-up period, and the vertical ground force. No hyperextension in stance was recorded.

Clinical significance: Although most dogs improved, the prognosis remains guarded. This seems to be independent of age, bilateral involvement, or preoperative OS in these dogs. No relation between medial talar OCD and tarsal hyperextension in stance was found in these dogs.

Mineral metabolism in growing cats: changes in the values of blood parameters with age

The purpose of this study was to describe changes in calcium, phosphorus, magnesium, parathyroid hormone, calcitriol and calcidiol in cats from 3 to 15 months of age. Fourteen European shorthair healthy cats of both sexes (seven males, seven females) belonging to a research colony were studied from 3 to 15 months of age. Plasma concentrations of total calcium, ionised calcium, albumin, phosphorus, magnesium, intact parathyroid hormone (I-PTH), whole parathyroid hormone (W-PTH), calcidiol and calcitriol were measured at 3, 6, 9, 12 and 15 months of age. From 3 months of age to adulthood cats showed a decrease in calcium (both total and ionised), phosphorus and magnesium. No major changes in PTH were evident, although the ratio of W-PTH:I-PTH decreased significantly with age. A reciprocal change in vitamin D metabolites (decrease in calcitriol and increase in calcidiol) was identified during the growing process. Our results, showing changes in most parameters of mineral metabolism during growth, reinforce the need to use adequate age-related reference values for diagnostic purposes.

Feline parathyroid hormone: validation of hormonal assays and dynamics of secretion

Validated assays for quantification of intact parathyroid hormone (I-PTH) are no longer available. Moreover, the third-generation PTH assay that only detects the whole PTH molecule (W-PTH) has never been tested in cats. The work presented here is aimed to validate a commercially available assay for measurement of I-PTH and W-PTH in cats and to study the dynamics of PTH secretion in healthy cats. Our results show that both assays are reliable for the measurement of feline PTH. In healthy adult cats W-PTH concentration (15.1 ± 1.6 pg/mL) was greater (P < 0.001) than I-PTH concentration (9.1 ± 0.7 pg/mL). The dynamics of PTH secretion in response to changes in extracellular calcium (Ca(2+)) were investigated in 13 cats by studying PTH-Ca(2+) curves. PTH-Ca(2+) curves were obtained by intravenous infusion of disodium ethylenediaminetetraacetic acid and CaCl(2). PTH was measured using both I-PTH and W-PTH assays. During hypocalcemia a sigmoidal curve that was similar when measured with I-PTH or W-PTH was obtained. The maximal PTH concentration in response to hypocalcemia was greater with W-PTH (179.6 ± 41.9 pg/mL) than with I-PTH (67.6 ± 10.5 pg/mL; P = 0.01). However, hypercalcemia resulted in an equivalent PTH inhibition, with both assays yielding PTH concentrations as follows: W-PTH = 4.0 ± 0.4 pg/mL and I-PTH = 4.9 ± 0.3 pg/mL (NS). Parameters of the feline PTH-Ca(2+) curve are similar to what has been previously reported in dogs.

Composition and use of puppy milk replacers in German Shepherd puppies in the Netherlands

Enostosis or eosinophilic panosteitis is a common disease in young growing large-breed dogs, such as the German Shepherd, and the risk of developing the disease by 3-4 months of age is increased by a high calcium intake. The aim of the study was to investigate whether German Shepherd puppies raised on milk replacers receive more calcium and/or vitamin D than their requirements in the pre-weaning period and thus are at increased risk of developing skeletal diseases. To this end, we surveyed German Shepherd breeders in the Netherlands about the use of puppy milk replacers (PMR). The metabolizable energy, calcium, phosphorus and vitamin D content of the eight most used PMR were compared with that of bitch milk, as reported in the literature. The protein and fat content of most PMR were somewhat lower (range 24.4-33.2 g per 100 g on dmb and 18.3-37.5 g per 100 g on dmb respectively) compared with bitch milk (31.9 and 40.2 g on dmb respectively). The vitamin D content of one of the PMR samples was sevenfold the level recommended by the NRC (Nutrient Requirements of Dogs and Cats, National Academy Press, 2006) and threefold the average level of bitch milk. The clinical relevance of this high amount is questionable, as bitch milk contains mainly 25-hydroxy-vitamin D [3843 μg (96.1 IU) per 100 g on dmb] and only limited amounts of vitamin D [524 μg (13.3 IU) per 100 g on dmb], as was determined in this study. Dutch German Shepherd breeders tended to overfeed their puppies. We calculated that misguided use of PMR can increase the risk of excessive calcium, phosphorus and possibly vitamin D intake during a vulnerable period, potentially giving rise to bone and cartilage problems later in life.

Unusual Case of Osteopenia Associated With Nutritional Calcium and Vitamin D Deficiency in an Adult Dog

A 6-year-old, spayed female rottweiler was presented for facial enlargement from swelling of the maxilla and mandible. The dog was fed a homemade diet deficient in calcium and vitamin D, suggesting that rubber jaw syndrome was a secondary nutritional disorder. Radiographic and tomodensitometric examinations revealed diffuse bone resorption in the skull. The plasma parathormone concentration was high, and serum 25-hydroxycholecalciferol concentration was low. Based on these findings, nutritional calcium and vitamin D deficiency associated with secondary hyperparathyroidism was diagnosed. Dietary correction resulted in clinical and biological improvement, with an increase in skull mineralization.

24-Hydroxylase: potential key regulator in hypervitaminosis D3 in growing dogs

A group of growing dogs supplemented with cholecalciferol (vitamin D(3); HVitD) was studied vs. a control group (CVitD; 54,000 vs. 470 IU vitamin D(3)/kg diet, respectively) from 3 to 21 wk of age. There were no differences in plasma levels of P(i) and growth-regulating hormones between groups and no signs of vitamin D(3) intoxication in HVitD. For the duration of the study in HVitD vs. CVitD, plasma 25-hydroxycholecalciferol levels increased 30- to 75-fold; plasma 24,25-dihydroxycholecalciferol levels increased 12- to 16-fold and were accompanied by increased renal 24-hydroxylase gene expression, indicating increased renal 24-hydroxylase activity. Although the synthesis of 1,25-dihydroxycholecalciferol [1,25(OH)(2)D(3)] was increased in HVitD vs. CVitD (demonstrated by [(3)H]1,25(OH)(2)D(3) and increased renal 1alpha-hydroxylase gene expression), plasma 1,25(OH)(2)D(3) levels decreased by 40% as a result of the even more increased metabolic clearance of 1,25(OH)(2)D(3) (demonstrated by [(3)H]1,25(OH)(2)D(3) and increased gene expression of intestinal and renal 24-hydroxylase). A shift of the Ca set point for parathyroid hormone to the left indicated increased sensitivity of the chief cells. Effective counterbalance was provided by hypoparathyroidism, hypercalcitoninism, and the key regulator 24-hydroxylase, preventing the development of vitamin D(3) toxicosis.

Vitamin D3 metabolism in dogs

Plasma concentrations of the main vitamin D(3) metabolites (i.e., 25(OH)D(3), 1,25(OH)(2)D(3), and 24,25(OH)(2)D(3)) were measured in 14 weeks old large- and small-breed dogs (adult body weight 60 kg vs. 6 kg), raised under the same conditions. Levels of 25(OH)D(3) (approx. 22 microg/l) and 1,25(OH)(2)D(3) (approx. 40 ng/l) were similar in both groups, whereas plasma 24,25(OH)(2)D(3) concentrations were lower in large-breed dogs (7 microg/l vs. 70 microg/l, large- vs. small-breed dogs, respectively). The lower plasma 24,25(OH)(2)D(3) concentrations could be explained by the higher plasma GH and IGF-I concentrations in the large- vs. small-breed dogs, and these hormones are known to suppress 24-hydroxylation. Plasma 24,25(OH)(2)D(3) concentrations increased during Ca supplementation in small-breed but not in large-breed dogs (100 microg/l vs. 7 microg/l, respectively). Hypophosphatemia induced by a high dietary Ca content was only seen together with increased plasma 1,25(OH)(2)D(3) concentrations in euparathyroid dogs and not in hypoparathyroid dogs. Hyperparathyroidism due to Ca deficiency was accompanied by increased plasma 1,25(OH)(2)D(3) concentrations and decreased plasma 24,25(OH)(2)D(3) concentrations in both large- and small-breed dogs, together with generalized osteoporosis. Large-breed pups fed on a standard diet supplemented with Ca and P had decreased plasma concentrations of both 25(OH)D(3) and 1,25(OH)(2)D(3), which may indicate an increased clearance of these metabolites; the low plasma concentrations of the di-hydroxylated vitamin D metabolites were considered responsible for the disturbance in cartilage maturation (i.e., osteochondrosis) in these dogs. Even lower concentrations of all vitamin D(3) metabolites were seen in young dogs raised on a vitamin D(3)-deficient diet, and led to disturbed osteoid and cartilage mineralization (i.e., rickets). These studies indicate that there is a hierarchy of factors regulating vitamin D(3) metabolism in dogs, i.e., GH and IGF-I suppress 24-hydroxylase more than hypercalcemia or hypophosphatemia does; 1,25(OH)(2)D(3) and 24,25(OH)(2)D(3) are only reciprocally related in hyperparathyroidism; excessive Ca and P intake increases the turnover of vitamin D(3) metabolites; and the synergism between parathyroid hormone and 1,25(OH)D(3) seems to play a role in skeletal mineralization. The low plasma 24,25(OH)(2)D(3) concentrations in large-breed dogs raised on standard dog food may play a role in the etiology of disturbances in endochondral ossification during the rapid growth phase.

Intestinal calcium absorption in growing dogs is influenced by calcium intake and age but not by growth rate

The effects of calcium (Ca) intake (V(I)), age and growth rate on intestinal Ca absorption were studied in growing dogs. Two breeds of dogs differing in their growth rate (67 Great Danes and 23 Miniature Poodles) were raised on diets differing only in their Ca content (range 0.33 to 3.3 g/100 g diet on a dry matter basis). Repetitive Ca balance studies were performed with the aid of (45)Ca from 6 wk (i.e., after weaning) until 6 mo of age. Several models were investigated expressing true Ca absorption (V(a)) as a function of V(I), breed and age. V(a) was directly proportional to a function close to V(I)(0.82) being a continuation of the high Ca needs for mineralization of the growing skeleton. This curvilinear relationship between V(a) and V(I) and the inverse relationship between fractional Ca absorption and V(I) indicated the presence of active and passive Ca absorption in weaned growing dogs. A model in which these two components of Ca absorption can be discerned revealed that active Ca absorption underwent age-dependent changes, whereas passive absorption remained constant and accounted for 53% absorption of the V(I). At low V(I), active absorption contributed to a significant part of the V(a), whereas at excessive V(I) active absorption was negligible and passive absorption was the driving force for causing supra positive Ca balance. Intestinal Ca handling did not differ between breeds with dramatically different mature body size and growth rates.