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Cordella A, Bertaccini J, Rondena M, Zoia A, Bertolini G. Multidetector-Row CT Findings in Dogs with Different Primary Parathyroid Gland Diseases. Vet Sci 2022; 9:vetsci9060273. [PMID: 35737325 PMCID: PMC9228294 DOI: 10.3390/vetsci9060273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/30/2022] [Accepted: 06/03/2022] [Indexed: 11/29/2022] Open
Abstract
Primary hyperparathyroidism in dogs is a possibly life-threatening condition, characterized by the excess of parathyroid hormone (PTH) secretion, which leads to an increase in serum ionized calcium level. The utility of computed tomography (CT) in the detection and characterization of parathyroid diseases in dogs has not been assessed to date. Therefore, the aim of this study was to describe the use of multidetector-row CT (MDCT) for the diagnosis of parathyroid disease in dogs. For this descriptive, single-center study, the database of the San Marco Veterinary Clinic was searched for dogs having a suspicion of parathyroid disease who underwent contrast-enhanced MDCT in the period from 2005 to 2021. Dogs with histopathology of the affected parathyroid gland were subsequently considered for inclusion. A total of 22 parathyroid glands were included: 12 adenomas, 8 adenocarcinomas, and two glands with hyperplasia. Several CT features were evaluated, including parathyroid gland affected, lateralization, shape, size, attenuation, and contrast-enhancement. Although the overlap between the appearance of different diseases exists, contrast-enhanced CT was a useful method for the diagnosis of parathyroid disease in dogs.
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Affiliation(s)
- Alessia Cordella
- Diagnostic and Interventional Radiology Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy; (A.C.); (J.B.)
| | - Jessica Bertaccini
- Diagnostic and Interventional Radiology Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy; (A.C.); (J.B.)
| | - Marco Rondena
- Pathology Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy;
| | - Andrea Zoia
- Internal Medicine Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy;
| | - Giovanna Bertolini
- Diagnostic and Interventional Radiology Division, San Marco Veterinary Clinic and Laboratory, 35030 Veggiano, Italy; (A.C.); (J.B.)
- Correspondence:
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Tremolada G, Schaffer P, Pitt K. Non‐secreting parathyroid carcinoma in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Giovanni Tremolada
- Department of Veterinary Clinical Sciences College of Veterinary Medicine Ohio State University Columbus Ohio USA
- Flint Animal Cancer Centre College of Veterinary Medicine and Biological Sciences Colorado State University Fort Collins Colorado USA
| | - Paula Schaffer
- Veterinary Diagnostic Laboratory Department of Microbiology, Immunology and Pathology College of Veterinary Medicine and Biological Sciences Colorado State University Fort Collins Colorado USA
| | - Kathryne Pitt
- Flint Animal Cancer Centre College of Veterinary Medicine and Biological Sciences Colorado State University Fort Collins Colorado USA
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3
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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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4
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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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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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6
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Dear J, Kass P, Della Maggiore A, Feldman E. Association of Hypercalcemia Before Treatment With Hypocalcemia After Treatment in Dogs With Primary Hyperparathyroidism. J Vet Intern Med 2017; 31:349-354. [PMID: 28213926 PMCID: PMC5354003 DOI: 10.1111/jvim.14644] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 11/02/2016] [Accepted: 11/29/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Development of hypocalcemia after treatment of hyperparathyroidism results in increased costs and risk of poorer outcomes. Previous studies have shown conflicting data about predictors of hypocalcemia after these procedures. HYPOTHESIS/OBJECTIVES The objective of this study was to investigate whether ionized calcium (iCa) concentrations before treatment are predictive of hypocalcemia or its clinical signs after surgical removal or heat ablation in dogs with primary hyperparathyroidism. ANIMALS Fifty-four dogs with primary hyperparathyroidism (29 female, 25 male; 49 retrospective, 5 prospective). METHODS Dogs were enrolled if they met the inclusion criteria: persistent hypercalcemia (iCa >1.41 mmol/L) due to primary hyperparathyroidism and absence of preemptive calcitriol treatment. All dogs were treated with parathyroidectomy (n = 37) or percutaneous ultrasound-guided heat ablation (n = 17). After treatment, iCa was monitored twice daily until plateau or intervention. RESULTS There was a moderate correlation between before-treatment hypercalcemia and after-treatment hypocalcemia. The prospective study was terminated due to ethical concerns given findings in the retrospective section. All dogs were placed into groups according to their pretreatment iCa: 1.46-1.61 mmol/L, 1.62-1.71 mmol/L, iCa 1.72-1.81 mmol/L, or >1.81 mmol/L. After treatment, the mean lowest iCa for each group, respectively, was 1.19, 1.18, 1.13, and 1.01 mmol/L. There was a significant association between higher group and proportion of dogs with iCa <1.00 mmol/L (P = .014). CONCLUSIONS AND CLINICAL IMPORTANCE This study demonstrates a moderate correlation between iCa concentration before treatment and hypocalcemia after treatment. Dogs with higher initial iCa concentrations should be treated to prevent rapid decline and development of clinical hypocalcemia.
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Affiliation(s)
- J.D. Dear
- Department of Medicine and EpidemiologyUniversity of CaliforniaDavisCA
| | - P.H. Kass
- Department of Population Health and ReproductionUniversity of CaliforniaDavisCA
| | | | - E.C. Feldman
- Department of Medicine and EpidemiologyUniversity of CaliforniaDavisCA
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7
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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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8
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Schaer M. Therapeutic Approach to Electrolyte Emergencies. Vet Clin North Am Small Anim Pract 2008; 38:513-33, x. [DOI: 10.1016/j.cvsm.2008.01.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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9
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Rasor L, Pollard R, Feldman EC. Retrospective Evaluation of Three Treatment Methods for Primary Hyperparathyroidism in Dogs. J Am Anim Hosp Assoc 2007; 43:70-7. [PMID: 17339283 DOI: 10.5326/0430070] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The medical records of 110 dogs treated for primary hyperparathyroidism were reviewed. Dogs were treated via parathyroidectomy (n=47), percutaneous ultrasound-guided ethanol ablation (n=15), or percutaneous ultrasound-guided heat ablation (n=48). Forty-five of 48 (94%) parathyroidectomies resulted in control of hypercalcemia for a median of 561 days. Thirteen of 18 (72%) ethanol ablation procedures resulted in control of hypercalcemia for a median of 540 days. Forty-four of 49 (90%) heat-ablation treatments resulted in control of hypercalcemia for a median of 581 days.
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Affiliation(s)
- Liberty Rasor
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, California 95616, USA
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10
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Gear RNA, Neiger R, Skelly BJS, Herrtage ME. Primary hyperparathyroidism in 29 dogs: diagnosis, treatment, outcome and associated renal failure. J Small Anim Pract 2006; 46:10-6. [PMID: 15682734 DOI: 10.1111/j.1748-5827.2005.tb00268.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To review the records of 29 dogs diagnosed with primary hyperparathyroidism and see if any factors correlate with renal failure. METHODS Dogs were selected retrospectively from case files from the QVSH and the QMH. RESULTS The majority of dogs were middle-aged and four were keeshonds. The primary presenting complaints were polyuria and polydipsia. All dogs had an elevated total and ionised plasma calcium concentration. Plasma phosphate concentrations were variable. Ultrasonography of the parathyroid gland revealed nodular enlargement which was found to correlate well with surgical findings. The majority of dogs underwent surgical parathyroidectomy. Five cases were treated by ultrasound-guided chemical ablation of the parathyroid gland, of which only two cases showed a partial response. Three dogs were euthanased within a week of presentation. Seven other dogs had renal failure diagnosed either at presentation or up to six months after parathyroidectomy. The development of renal failure was correlated with total calcium concentration but did not correlate with any other factor, including the calcium phosphate product. Thirteen treated dogs were known to be alive at the time of writing, which was six months to 3.5 years after parathyroidectomy. CLINICAL SIGNIFICANCE Primary hyperparathyroidism cases with high total calcium were more likely to develop renal failure in this group of dogs; however, the calcium phosphate product did not seem to be a useful predictor. Ultrasound-guided chemical ablation seemed to have limited advantage over surgery.
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Affiliation(s)
- R N A Gear
- Queen's Veterinary School Hospital, University of Cambridge, Madingley Road, Cambridge
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11
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Feldman EC, Hoar B, Pollard R, Nelson RW. Pretreatment clinical and laboratory findings in dogs with primary hyperparathyroidism: 210 cases (1987–2004). J Am Vet Med Assoc 2005; 227:756-61. [PMID: 16178397 DOI: 10.2460/javma.2005.227.756] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate pretreatment clinical and laboratory findings in dogs with naturally occurring primary hyperparathyroidism. DESIGN Retrospective study. ANIMALS 210 dogs with primary hyperparathyroidism and 200 randomly selected, age-matched control dogs that did not have primary hyperparathyroidism. PROCEDURE Medical records for dogs with primary hyperparathyroidism were reviewed for signalment; clinical features; and results of clinicopathologic testing, serum parathyroid hormone assays, and diagnostic imaging. RESULTS Mean age of the dogs with primary hyperparathyroidism was 11.2 years (range, 6 to 17 years). The most common clinical signs were attributable to urolithiasis or urinary tract infection (ie, straining to urinate, increased frequency of urination, and hematuria). Most dogs (149 [71%]) did not have any observable abnormalities on physical examination. All dogs had hypercalcemia, and most (136 [65%]) had hypophosphatemia. Overall, 200 of the 210 (95%) dogs had BUN and serum creatinine concentrations within or less than the reference range, and serum parathyroid hormone concentration was within reference limits in 135 of 185 (73%) dogs in which it was measured. Urolithiasis was identified in 65 (31 %) dogs, and urinary tract infection was diagnosed in 61 (29%). Mean serum total calcium concentration for the control dogs-was significantly lower than mean concentration for the dogs with primary hyperparathyroidism, but mean BUN and serum creatinine concentrations for the control dogs were both significantly higher than concentrations for the dogs with primary hyperparathyroidism. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that urolithiasis and urinary tract infection may be associated with hypercalcemia in dogs-with primary hyperparathyroidism, but that development of renal insufficiency is uncommon.
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Affiliation(s)
- Edward C Feldman
- Departments of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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Abstract
The purpose of this study was to evaluate the applicability of ultrasonographic imaging of the vagosympathetic trunk in the dog. Cervical ultrasound was performed in 30 healthy dogs. In all 30 dogs the vagosympathetic trunk was detected as a hypoechoic structure in the carotid sheath, adhering the dorsomedial surface of the common carotid artery. The echotexture of the nerve was heterogeneous with anechoic areas separated by hypoechoic bands. A scanner equipped with a 5 to 8 MHz linear array probe was used for imaging and measurements. The diameter of the vagosympathetic trunk ranged from 0.59 to 2.48 mm varying in correlation to the body weight. In summary, ultrasonography is a helpful noninvasive method to image and evaluate the cervical vagosympathetic trunk in the dog.
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Affiliation(s)
- S Reese
- Department of Veterinary Anatomy, Ludwig-Maximilians-Universität München, Germany
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Pollard RE, Long CD, Nelson RW, Hornof WJ, Feldman EC. Percutaneous ultrasonographically guided radiofrequency heat ablation for treatment of primary hyperparathyroidism in dogs. J Am Vet Med Assoc 2001; 218:1106-10. [PMID: 11318360 DOI: 10.2460/javma.2001.218.1106] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of ultrasonographically guided radiofrequency heat ablation of parathyroid masses in dogs with primary hyperparathyroidism. DESIGN Clinical trial. ANIMALS 11 dogs. PROCEDURE In all dogs, either 1 or 2 parathyroid masses were evident ultrasonographically. Dogs were anesthetized, and a 20-gauge over-the-needle catheter was directed into the parathyroid mass via ultrasonographic guidance. Radiofrequency heat was applied to the stylet of the catheter until there was sonographically apparent change to the entire parenchyma of the mass. Serum total and ionized calcium and parathyroid hormone concentrations were monitored daily for 5 days after the ablation procedure and again at 1, 2, and 3-month intervals, if possible. Dogs were monitored for adverse effects. RESULTS One treatment was required in 6 dogs, 2 treatments were required in 2 dogs, and treatment was unsuccessful in 3 dogs. Serum total and ionized calcium concentrations were within reference ranges within 2 days of the last procedure in all 8 successfully treated dogs. Serum parathyroid hormone concentration was decreased 24 hours after treatment in all 8 dogs. Hypocalcemia developed in 5 of the 8 successfully treated dogs, all of which required treatment. One dog had a transient voice change. Other adverse effects were not reported. CONCLUSIONS AND CLINICAL RELEVANCE Ultrasonographically guided radiofrequency heat ablation of parathyroid masses is a safe and effective alternative to surgery in dogs with primary hyperparathyroidism.
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Affiliation(s)
- R E Pollard
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616, USA
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Reusch CE, Tomsa K, Zimmer C, Hoerauf A, Nett C, Unterer S, Glaus TM, Schlittner E, Pospischil A. Ultrasonography of the parathyroid glands as an aid in differentiation of acute and chronic renal failure in dogs. J Am Vet Med Assoc 2000; 217:1849-52. [PMID: 11132890 DOI: 10.2460/javma.2000.217.1849] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate whether determination of parathyroid gland size by use of ultrasonography is helpful in differentiating acute renal failure (ARF) from chronic renal failure (CRF) in dogs. DESIGN Prospective study. ANIMALS 20 dogs with renal failure in which serum creatinine concentration was at least 5 times the upper reference limit. Seven dogs had ARF, and 13 dogs had CRF. Twenty-three healthy dogs were used as controls. PROCEDURE Dogs were positioned in dorsal recumbency for ultrasonographic examination of the ventral portion of the neck, A 10-MHz linear-array high-resolution transducer was used. The size of the parathyroid gland was determined by measuring the maximal length of the gland on the screen when it was imaged in longitudinal section. For comparison among groups, the longest linear dimension of any of the parathyroid glands of each dog was used. RESULTS Size of the parathyroid glands in the control dogs varied from 2.0 to 4.6 mm (median, 3.3 mm). In the dogs with ARF, gland size ranged from 2.4 to 4.0 mm (median, 2.7), which was not significantly different from controls. In dogs with CRF, the glands were more distinctly demarcated from the surrounding thyroid tissue, than those of controls and dogs with ARF. Sizes ranged from 3.9 to 8.1 mm (median, 5.7 mm), which was significantly larger, compared with controls and dogs with ARF. CONCLUSIONS AND CLINICAL RELEVANCE In dogs with severe azotemia, ultrasonographic examination of the parathyroid glands was helpful in differentiating ARF from CRF Size of the parathyroid glands appeared to be related to body weight.
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Affiliation(s)
- C E Reusch
- Clinic for Small Animal Internal Medicine, Faculty of Veterinary Medicine, University of Zurich, Switzerland
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15
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Sueda MT, Stefanacci JD. Ultrasound evaluation of the parathyroid glands in two hypercalcemic cats. Vet Radiol Ultrasound 2000; 41:448-51. [PMID: 11052369 DOI: 10.1111/j.1740-8261.2000.tb01869.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Two parathyroid masses were identified using ultrasound in two hypercalcemic cats. The masses were identified as parathyroid adenomas on surgical biopsy. Both parathyroid masses contained hypoechoic regions with distal acoustic enhancement. Both masses were greater than 1.0 cm in diameter.
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Affiliation(s)
- M T Sueda
- Department of Medicine, The Animal Medical Center, New York, New York 10021, USA
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16
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Matwichuk CL, Taylor SM, Daniel GB, Wilkinson AA, Matte GG, Dudzic EM, Shmon CL. Double-phase parathyroid scintigraphy in dogs using technetium-99M-sestamibi. Vet Radiol Ultrasound 2000; 41:461-9. [PMID: 11052372 DOI: 10.1111/j.1740-8261.2000.tb01872.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The purpose of this study was to evaluate the utility of double-phase parathyroid scintigraphy using 99mTc-sestamibi for detecting and localizing hyperfunctioning parathyroid glands in hypercalcemic dogs. Fifteen hypercalcemic dogs that underwent parathyroid scintigraphy were included in this study: 3 dogs with hypercalcemia of malignancy, and 12 dogs with hyperfunctioning parathyroid tissue (parathyroid adenoma or parathyroid hyperplasia). The presence of parathyroid adenoma or parathyroid hyperplasia was documented by histopathologic examination. In 3 dogs with hypercalcemia of malignancy, parathyroid scintigraphy was negative for hyperfunctioning parathyroid tissue and the scans were classified as true negative. Parathyroid scintigraphy correctly identified the presence and location of hyperfunctioning parathyroid tissue in only 1 of 6 dogs with a parathyroid adenoma. False positive and false negative results occurred in dogs with parathyroid adenomas. Parathyroid scintigraphy failed to detect hyperfunctioning parathyroid tissue in 5 of 6 dogs with parathyroid hyperplasia and were classified as false negative. False positive results were obtained in the remaining dog with parathyroid hyperplasia. Sensitivity of parathyroid scintigraphy for detecting and localizing hyperfunctioning parathyroid tissue was 11%, specificity was 50%, and overall accuracy was 27%. Positive and negative predictive value were 25% and 27%, respectively. Sensitivity for detection of parathyroid adenomas was 25%, and sensitivity for detection of hyperplastic glands was 0 %. Results of this study indicate that double-phase parathyroid scintigraphy does not appear to have acceptable accuracy in detecting hyperfunctioning parathyroid glands in dogs. Due to the poor sensitivity and specificity of the technique in dogs, parathyroid scintigraphy is not recommended for definitive identification of abnormal parathyroid glands as the cause of hypercalcemia in dogs.
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Affiliation(s)
- C L Matwichuk
- Department of Veterinary Internal Medicine, Western College of Veterinary Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon, Canada
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Abstract
High-resolution thyroid and parathyroid ultrasonography can play an integral part in the diagnosis and management of patients with clinically undifferentiated cervical masses, thyroid carcinomas or adenomas, and primary parathyroid hyperplasia or neoplasia. Because the study is inexpensive, noninvasive, and easily performed, ultrasonography can be performed as a screening test early in the evaluation of a patient, and ultrasound findings can corroborate the results of other diagnostic procedures, leading to a more accurate diagnosis.
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Affiliation(s)
- E R Wisner
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, USA
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18
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Wisner ER, Penninck D, Biller DS, Feldman EC, Drake C, Nyland TG. High-resolution parathyroid sonography. Vet Radiol Ultrasound 1997; 38:462-6. [PMID: 9402714 DOI: 10.1111/j.1740-8261.1997.tb00872.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The purpose of this study was to assess the diagnostic utility of parathyroid ultrasonography to differentiate causes of hypercalcemia in dogs. We analyzed qualitative and quantitative ultrasound imaging findings and clinical pathology data from 33 dogs that underwent parathyroid ultrasound examination as part of the diagnostic evaluation for hypercalcemia. Diagnoses of the diseases causing hypercalcemia included parathyroid carcinoma (n = 5), parathyroid adenoma (n = 15), parathyroid adenomatous hyperplasia (n = 6), chronic renal insufficiency (n = 3), and hypercalcemia of malignancy (n = 4). All parathyroid lesions were round or oval and hypoechoic compared with surrounding thyroid parenchyma. Adenomatous and adenocarcinomatous glands were 4 mm or larger in longest linear measurement on US examination and were statistically significantly larger than hyperplastic glands. (p < 0.001) Linear measurements of parathyroid glands acquired at the time of ultrasound examination correlated well with direct size determination after surgical excision. (r2 = 0.9, p < 0.0001) Parathyroid lesions > or = 4 mm are highly suspicious for parathyroid adenoma or carcinoma, while US lesions < 4 mm most likely represent primary adenomatous hyperplasia or secondary parathyroid hyperplasia. Parathyroid size estimation from ultrasound examination is an accurate predictor of true size.
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Affiliation(s)
- E R Wisner
- Dept. of Radiology, School of Medicine, School of Veterinary Medicine, University of California, Davis, USA
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Abstract
Ultrasonographic imaging of the tongue and larynx was performed in 10 dogs with no previous history of upper airway disease. The ultrasonographic findings were compared with the normal canine anatomy of this area and with the results described in the human literature. This study shows that the anatomical features of the canine larynx are adequately detectable using ultrasonography. This finding is in accordance with the findings described in the human literature. It is concluded that ultrasonography may offer a means of investigating canine laryngeal abnormalities.
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Affiliation(s)
- H Rudorf
- Division of Companion Animals, University of Bristol, Langford
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20
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den Hertog E, Goossens MM, van der Linde-Sipman JS, Kooistra HS. Primary hyperparathyroidism in two cats. Vet Q 1997; 19:81-4. [PMID: 9225438 DOI: 10.1080/01652176.1997.9694746] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Primary hyperparathyroidism (PHP) is an infrequently diagnosed disorder in cats. In this report the signs and symptoms of two cats with hypercalcaemia due to PHP are described, together with diagnostic approach, results of treatment, and immunohistochemical findings. A 9-year-old and a 13-year-old neutered male domestic shorthair cat were presented with signs of lethargy, anorexia, and vomiting. Both cats had persistent hypercalcaemia and normo- to hypophosphataemia. Cytological examination of a fine-needle aspiration biopsy sample of a palpable cervical mass revealed groups of benign glandular-epithelial cells in one cat. In the other cat no cervical mass was palpable. In this cat plasma parathyroid hormone (PTH) levels were measured repeatedly and these values exceeded the maximum reference value on two occasions. Following exclusion of other causes of hypercalcaemia both cats were subjected to neck surgery and in both a solitary parathyroid adenoma was removed. The adenomas contained an abundance of PTH, as demonstrated by immunohistochemical techniques. Plasma calcium and phosphate concentrations returned to within, reference ranges postoperatively. Recovery was uncomplicated and there were no signs of recurrence on follow-up examinations.
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Affiliation(s)
- E den Hertog
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrechi University, The Netherlands
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Wisner ER, Nyland TG, Mattoon JS. ULTRASONOGRAPHIC EXAMINATION OF CERVICAL MASSES IN THE DOG AND CAT. Vet Radiol Ultrasound 1994. [DOI: 10.1111/j.1740-8261.1994.tb02047.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Wisner ER, Nyland TG. Clinical vignette. Localization of a parathyroid carcinoma using high-resolution ultrasonography in a dog. J Vet Intern Med 1994; 8:244-5. [PMID: 8064665 DOI: 10.1111/j.1939-1676.1994.tb03226.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
- E R Wisner
- School of Veterinary Medicine, University of California, Davis
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