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Clark HE, Trepanier LA, Wood MW. Oral cinacalcet administration decreases serum ionized calcium and parathyroid hormone concentrations in healthy dogs. J Vet Pharmacol Ther 2024; 47:274-279. [PMID: 38563476 DOI: 10.1111/jvp.13443] [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: 09/22/2023] [Revised: 02/29/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024]
Abstract
Cinacalcet is an oral calcimimetic that has potential to non-invasively treat primary hyperparathyroidism in dogs (Canis lupis familiaris). There is minimal data assessing its efficacy in dogs. This study aimed to determine whether a single dose of cinacalcet decreases serum ionized calcium (iCa), total calcium (tCa), and parathyroid hormone (PTH) concentrations. Twelve dogs received a median dose of 0.49 mg/kg (range 0.30-0.69 mg/kg) cinacalcet per os. Venous blood samples were collected at time 0 (before cinacalcet administration), 3, 8, and 24 h following cinacalcet administration. PTH, iCa, and tCa concentrations were measured at each time point and compared to 0 hour concentrations. A significant (50%) decrease in serum PTH occurred at 3 h with a median PTH of 4.6 pmol/L (range 2.7-10.8) at baseline and 1.65 pmol/L (range 0.5-14.7) at 3 h; p = .005. A significant, but not clinically relevant, decrease in serum iCa from a median baseline of 1.340 mmol/L (range 1.32-1.41) to a 3 h median of 1.325 mmol/L (range 1.26-1.39), p = .043, was also observed. tCa concentrations were not different. This study showed that a single dose of cinacalcet leads to transient decreases in iCa and PTH concentrations in healthy dogs.
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Affiliation(s)
- Hannah E Clark
- School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Lauren A Trepanier
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Michael W Wood
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
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2
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Young KM, Degner DA. Surgical description and outcome of ultrasound-guided minimally invasive parathyroidectomy in 50 dogs with primary hyperparathyroidism. Vet Surg 2023; 52:18-25. [PMID: 36221891 DOI: 10.1111/vsu.13897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/23/2022] [Accepted: 09/04/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To describe the surgical technique and clinical outcome of minimally invasive parathyroidectomy for primary hyperparathyroidism (PHPT) in the dog. ANIMALS Fifty client-owned dogs with PHPT that underwent minimally invasive parathyroidectomy. STUDY DESIGN Retrospective cohort study. METHODS An ultrasound-guided mini lateral approach was made via a plane established between the sternocephalicus muscle and sternohyoideus muscles to expose the thyroid gland and enlarged parathyroid gland. Abnormal parathyroid glands were removed en bloc via partial thyroidectomy. The technique for bilateral disease was similar, the skin incision was made on midline and moved laterally to develop the above-mentioned plane of dissection. Age, sex, breed, bodyweight, ultrasound findings, histopathological diagnosis, surgical time, preoperative clinical signs, and clinical outcome were extracted from the records for descriptive statistics. RESULTS A total of 62 glands were surgically removed, including 17 hyperplastic glands (17/62, 27.4%), 34 adenomas (34/62, 54.8%), and two carcinomas (2/62, 3.2%). Hypercalcemia resolved shortly after surgery in 44 dogs (44/45, 97.8%). One dog had recurrent hypercalcemia (1/45, 2.2%), one dog had persistent hypercalcemia (1/45, 2.2%), two dogs had permanent hypocalcemia requiring life-long calcitriol supplementation (2/45, 4.4%), and one dog died from clinical hypocalcemia (1/45, 2.2%). CONCLUSION Minimally invasive parathyroidectomy was associated with a low morbidity and led to favorable outcomes in 44/45 dogs in this series. CLINICAL SIGNIFICANCE The results of this study supports the use of minimally invasive parathyroidectomy to treat PHPT in dogs.
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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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Sumner JP, Espinheira Gomes FNCM, Flanders JA. Minimally invasive video-assisted parathyroidectomy in dogs: Technique description and feasibility study. Vet Surg 2022; 51 Suppl 1:O167-O173. [PMID: 35199354 DOI: 10.1111/vsu.13759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/15/2021] [Accepted: 12/11/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To describe a minimally invasive approach to the parathyroid gland for the treatment of primary hyperparathyroidism. STUDY DESIGN Surgical technique description and clinical case report. ANIMALS Five canine cadavers and 5 client-owned dogs with primary hyperparathyroidism. METHODS A surgical technique for minimally invasive video-assisted parathyroidectomy (MIVAP), described for humans, was adapted for dogs. With the dog in dorsal recumbency, a 15 mm incision was made on the midline, 1 finger width caudal to the cricoid cartilage of the larynx. A 5 mm 30° rigid endoscope was inserted into the peritracheal space with the aid of a blunt suction dissector, and fine elevators. The parathyroid was subsequently removed using electrocautery and blunt and sharp dissection. The technique was refined in 5 cadaver dogs to assess feasibility, and was subsequently performed in 5 clinical cases. RESULTS A minimally invasive approach to the parathyroid gland was possible and allowed successful removal of a parathyroid mass in 5 dogs without complication. The use of fluid ingress was trialed in 1 cadaver and not found to be helpful. The use of a blunt suction dissector greatly facilitated dissection of the peritracheal space. CONCLUSION Minimally invasive video-assisted parathyroidectomy is feasible in dogs and was not associated with complications in 5 clinical cases. CLINICAL SIGNIFICANCE Minimally invasive techniques tend to reduce morbidity and are popular with pet owners. This study demonstrates that a minimally invasive technique may be considered for parathyroidectomy in dogs.
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Affiliation(s)
- Julia P Sumner
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | | | - James A Flanders
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
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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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Gómez Ochoa P, Alférez MD, de Blas I, Fernendes T, Sánchez Salguero X, Balañá B, Meléndez Lazo A, Barbero Fernandez A, Caivano D, Corda F, Corda A. Ultrasound-Guided Radiofrequency Ablation of Chemodectomas in Five Dogs. Animals (Basel) 2021; 11:2790. [PMID: 34679812 PMCID: PMC8532905 DOI: 10.3390/ani11102790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022] Open
Abstract
Chemodectomas are low prevalence tumors with complex clinical management. Many present as an incidental finding however, in other dogs, they produce pericardial effusion and/or compression, leading to the appearance of severe clinical signs. There are currently several approaches: surgery, radiotherapy, stent placement and chemotherapy. This is the first description of percutaneous echo-guided radiofrequency ablation of aortic body tumors. This minimally invasive treatment is based on high frequency alternating electrical currents from an electrode that produces ionic agitation and generates frictional heat, causing coagulation necrosis. Five dogs with an echocardiographic and cytological diagnosis of chemodectoma underwent percutaneous echo-guided radiofrequency ablation. At the time of presentation, all the dogs showed clinical signs, such as ascites and/or collapse. There were no complications either during the procedure or in the following 24 hours. Rapid clinical improvement associated with a reduction in size and change in sonographic appearance of the mass were achieved with no complications. Six months follow-up was carried out in all dogs. A second percutaneous echo-guided RFA was performed eight months after the first procedure in one dog. Based on our experience, radiofrequency ablation seems to be a feasible and safe technique, making it a potential alternative therapeutic approach in the clinical management of aortic body tumors leading to severe clinical compromise.
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Affiliation(s)
- Pablo Gómez Ochoa
- VetCorner, 50012 Zaragoza, Spain;
- Department of Animal Pathology, University of Zaragoza, 50013 Zaragoza, Spain;
| | | | - Ignacio de Blas
- Department of Animal Pathology, University of Zaragoza, 50013 Zaragoza, Spain;
| | - Telmo Fernendes
- Imaginologia Veterinaria do Porto, 4490-479 Porto, Portugal;
| | - Xavier Sánchez Salguero
- Department of Animal Science, School of Agriculture, Food Science and Veterinary Medicine (ETSEA), University of Lleida, 25198 Lleida, Spain;
| | - Beatriz Balañá
- Hospital Aralar Veterinarios, Cuarte de Huerva, 50410 Zaragoza, Spain;
| | | | - Alicia Barbero Fernandez
- Department of Veterinary Medicine, University Alfonso X el Sabio, Villanueva de la Cañada, 28691 Madrid, Spain;
| | - Domenico Caivano
- Department of Veterinary Medicine, University of Perugia, 06126 Perugia, Italy
| | - Francesca Corda
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy; (F.C.); (A.C.)
| | - Andrea Corda
- Department of Veterinary Medicine, University of Sassari, 07100 Sassari, Italy; (F.C.); (A.C.)
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Wei Y, Peng CZ, Wang SR, He JF, Peng LL, Zhao ZL, Cao XJ, Li Y, Chai HH, Yu MA. Microwave ablation versus radiofrequency ablation for primary hyperparathyroidism: a multicenter retrospective study. Int J Hyperthermia 2021; 38:1023-1030. [PMID: 34219596 DOI: 10.1080/02656736.2021.1945689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To compare the clinical outcomes of microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of primary hyperparathyroidism (pHPT). METHOD This retrospective study included 104 pHPT patients treated by MWA or RFA between January 2015 and March 2020 in four centers. The clinical outcomes including effectiveness and complications were compared between the two groups. Ablation cure was defined as the reestablishment of normal values of serum calcium and intact parathyroid hormone (iPTH) at least more than 6 months. Clinical cure was defined as the reestablishment of normal values of serum calcium and iPTH throughout the entire follow-up period. RESULTS A total of 77 patients underwent MWA (mean age, 55.5 ± 16.4 years) and 27 underwent RFA (mean age, 58.9 ± 15.6 years). During the follow-up (median, 18.7 months in the MWA group; 12 months in the RFA group), no difference was observed between ablation cure rates (88.3% vs. 88.9%, p = 1.000), clinical cure rates (87.0% vs. 82.3%, p = .880), recurrent pHPT (5.2% vs. 3.7%, p = .447), persistent pHPT (11.7% vs. 11.1%, p = 1.000) and complication rate (9.1% vs. 3.7%, p = .677). A maximum diameter less than 0.7 cm was an independent prognostic factor of uncured pHPT in ablation (hazard ratio, 0.1; 95% confidence interval: 0.02, 0.54; p = .007). Major complication - voice change encountered in five patients (6.5%) in the MWA group and in one patient (3.7%) in the RFA group. CONCLUSION Both RFA and MWA are safe and effective techniques for patients with pHPT, with comparable clinical outcomes.
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Affiliation(s)
- Ying Wei
- Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Cheng-Zhong Peng
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Shu-Rong Wang
- Department of Medical Ultrasound, Yantai Affiliated Hospital, Binzhou Medical University, Yantai, China
| | - Jun-Feng He
- Department of Ultrasound, The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Li-Li Peng
- Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Zhen-Long Zhao
- Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xiao-Jing Cao
- Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yan Li
- Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Hui-Hui Chai
- Department of Ultrasound, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Ming-An Yu
- Department of Interventional Medicine, China-Japan Friendship Hospital, Beijing, China
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Burkhardt SJ, Sumner JP, Mann S. Ambidirectional cohort study on the agreement of ultrasonography and surgery in the identification of parathyroid pathology, and predictors of postoperative hypocalcemia in 47 dogs undergoing parathyroidectomy due to primary hyperparathyroidism. Vet Surg 2021; 50:1379-1388. [PMID: 34365655 PMCID: PMC9290980 DOI: 10.1111/vsu.13707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 07/17/2021] [Accepted: 07/25/2021] [Indexed: 02/01/2023]
Abstract
Objective To investigate (1a) agreement of ultrasonographic, surgical, and histopathologic findings in the diagnosis of a neoplastic etiology underlying primary hyperparathyroidism (PHPT), (1b) the ability of ultrasonographically determined parathyroid gland size to distinguish between malignant (carcinoma) and non‐malignant (hyperplasia, adenoma) pathology, and (2) variables associated with postoperative hypocalcemia in dogs undergoing surgical treatment of PHPT. Study Design Ambidirectional cohort study. Animals Forty‐seven client owned dogs with PHPT (34 retrospective; 13 prospective). Methods Data were extracted from medical records. Method agreements were explored using Cohen's Kappa statistic. A receiver operating characteristic curve (ROC) was used to determine a cut‐off separating parathyroid pathologies. Univariable and multivariable models assessed associations between postoperative hypocalcemia and potential risk factors. Results Agreement of ultrasound and surgery for number and side of affected glands was 31/47 (65.9%) and 34/47 (72.3%), respectively. In 37/47 (78.7%) cases, parathyroid tissue was correctly assessed as pathologic by the surgeon. An ultrasonographic cut‐off of ≥8.0 mm (ROC AUC = 0.82) best distinguished malignant from benign pathologies. Dogs with a preoperative serum ionized calcium (iCa) concentration ≥1.75 mEq/L had 7.5 times greater odds of becoming hypocalcemic postoperatively. Conclusion A fair agreement existed between ultrasonographic and surgical findings in dogs with PHPT. A parathyroid mass ≥8.0 mm on ultrasonographic examination was suggestive of malignancy, while dogs with a preoperative serum iCa concentration ≥1.75 mEq/L were at increased risk for postoperative hypocalcemia in this study. Clinical significance This study supports the use of bilateral cervical surgical exploration to identify abnormal parathyroid glands for the treatment of PHPT.
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Affiliation(s)
- Samuel J Burkhardt
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States
| | - Julia P Sumner
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States
| | - Sabine Mann
- Department of Population Medicine and Diagnostic Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, United States
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Bullone M, Garberoglio R, Pregel P, Cannizzo FT, Gagliardo A, Martano M, Bollo E, Scaglione FE. Characterization of the ablation zones produced by three commercially available systems from a single vendor for radiofrequency thermoablation in an ex vivo swine liver model. Vet Med Sci 2020; 6:1041-1048. [PMID: 32613738 PMCID: PMC7738736 DOI: 10.1002/vms3.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 05/24/2020] [Accepted: 06/11/2020] [Indexed: 12/25/2022] Open
Abstract
Background Radiofrequency Ablation (RFA) is rarely performed in veterinary medicine. A rationale exists for its use in selected cases of canine liver tumours. RFA induces ablation zones of variable size and geometry depending on the technique used and on the impedance of the targeted organ. Objectives (a) to describe the geometry and reproducibility of the ablation zones produced by three commercially available systems from a single company, using isolated swine liver parenchyma as a model for future veterinary applications in vivo; (b) to study the effects of local saline perfusion into the ablated parenchyma through the electrode tip and of single versus double passage of the electrode on size, geometry and reproducibility of the ablation zones produced. Methods Size, and geometry of ablation zones reproduced in six livers with one cooled and perfused (saline) and two cooled and non‐perfused systems, after single or double passage (n = 6/condition), were assessed macroscopically on digitalized images by a blinded operator. Longitudinal and transverse diameters, equivalent diameter, estimated volume and roundness index were measured. Reproducibility was assessed as coefficient of variation. Results and Conclusions Ablation zone reproducibility was higher when expressed in terms of ablation zone diameters than estimated volume. Local saline perfusion of the parenchyma through the electrode tip during RFA increased the ablation zone longitudinal diameter. Ablation zone estimated volume increased with saline perfusion only when double passage was performed. These data may provide useful information for those clinicians who intend to include RFA as an additive tool in veterinary interventional radiology.
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Affiliation(s)
- Michela Bullone
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Roberto Garberoglio
- Division of endocrinology, diabetology and metabolism - Department of Medical Sciences, University of Turin, Torino, Italy
| | - Paola Pregel
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | | | - Arianna Gagliardo
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Marina Martano
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Enrico Bollo
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Frine E Scaglione
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
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Riehl V, Hartmann A, Rohrberg A, Neiger R. Percutaneous ultrasound-guided ethanol ablation for treatment of primary hyperparathyroidism in a cat. JFMS Open Rep 2019; 5:2055116919860276. [PMID: 31308957 PMCID: PMC6607573 DOI: 10.1177/2055116919860276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Case summary A 9-year-old male neutered European Shorthair cat was presented owing to vomiting and mild weight loss. Clinical examination was normal, but biochemistry results showed increased concentrations of total calcium (4.05 mmol/l; reference interval [RI] 2.20-2.90 mmol/l) and ionised calcium (iCa) (2.19 mmol/l; RI 1.12-1.40 mmol/l), as well as hypophosphataemia (2.5 mg/dl; RI 3.1-7.5 mg/dl). Parathyroid hormone (PTH) concentration (>1000 pg/ml) was markedly increased, while parathyroid hormone-related protein concentration (<0.8 pmol/l) was normal. Neck ultrasound showed a large left parathyroid mass (13 × 7 × 6 mm). Under general anaesthesia and with ultrasonographic guidance, a fine-needle aspiration of the mass followed by chemical ablation with 2 ml 96% ethanol was performed. The cat was re-evaluated and iCa concentration measured 24 h, 72 h, 5 days, 4 weeks and 4 months post-ablation. Normocalcaemia was reached within 24 h, remained stable throughout the whole evaluation period and the concentration of PTH normalised 4 months later. Vomiting stopped promptly after chemical ablation and a slight change in voice, as well as a mild prolapse of the nictitating membrane, were the only side effects after the treatment but resolved some weeks later. Relevance and novel information To our knowledge, this is the first report of successful chemical ablation of a parathyroid mass in a cat with primary hyperparathyroidism. Chemical ablation might therefore be a possible alternative to parathyroidectomy in cats.
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Affiliation(s)
| | | | | | - Reto Neiger
- Veterinary Clinic Hofheim, Hofheim am Taunus, Germany
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Abstract
Over the past decade, interventional oncology techniques have become integrated into the treatment plans of companion animals with cancer on a regular basis. Although procedures such as stenting are performed commonly, other less frequently utilized techniques for locoregional therapy, such as embolization and ablation, are emerging and demonstrating promise. Tumor ablation techniques are categorized into two subgroups: chemical ablation and energy-based ablation. Increased utilization of ablation will allow for the determination of specific indications and evaluation of outcomes for these techniques.
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Leal RO, Frau Pascual L, Hernandez J. The Use of Percutaneous Ultrasound-Guided Radiofrequency Heat Ablation for Treatment of Primary Hyperparathyroidism in Eight Dogs: Outcome and Complications. Vet Sci 2018; 5:vetsci5040091. [PMID: 30340351 PMCID: PMC6313915 DOI: 10.3390/vetsci5040091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 09/26/2018] [Accepted: 10/16/2018] [Indexed: 11/17/2022] Open
Abstract
Percutaneous ultrasound-guided radiofrequency heat-ablation (UG-RHA) is a therapeutic option for dogs with primary hyperparathyroidism (PHPTH) but information about its outcome is still controversial. This retrospective study aimed to evaluate the outcome and complications of UG-RHA in dogs with PHPTH. The medical records of dogs with PHPTH submitted to UG-RHA between June 2012 and September 2015 in a French referral center were retrospectively reviewed. Eight cases were included. No sex predisposition was found. The median age at diagnosis was 12 years. The most common clinical sign was polyuria/polydipsia. All of the dogs were hypercalcaemic prior to UG-RHA, and all showed a parathyroid nodule identified upon cervical ultrasound. UG-RHA was uneventful, allowing a successful resolution of hypercalcemia in all dogs (8/8). Six out of eight dogs did not receive vitamin D supplementation either pre- or post-procedure. From these, three dogs developed biochemical hypocalcemia, but only one required therapy. Other short-term complications included Horner's syndrome (1/8) and aspiration bronchopneumonia, which led to cardio-respiratory arrest in one large-breed dog (1/8). Long-term complications were scarce, with no recurrence reported in all of the cases that were assessed in follow-up (4/7). This study demonstrates that UG-RHA has few short or long-term complications, and it is a good therapeutic alternative for dogs with PHPTH.
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Affiliation(s)
- Rodolfo Oliveira Leal
- Centre Hospitalier Vétérinaire Fregis, 43 Av. Aristide Briand, 94110 Arcueil, France.
- CIISA-Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal.
- Hospital Escolar Veterinário-Faculty of Veterinary Medicine, University of Lisbon, Av. Universidade Técnica, 1300-477 Lisbon, Portugal.
| | - Laura Frau Pascual
- Centre Hospitalier Vétérinaire Fregis, 43 Av. Aristide Briand, 94110 Arcueil, France.
- Ciutat d'Inca Veterinary Hospital. Av. General Luque, 372, 07300 Inca, Spain.
| | - Juan Hernandez
- Centre Hospitalier Vétérinaire Fregis, 43 Av. Aristide Briand, 94110 Arcueil, France.
- Internal Medecine Unit of Oniris, Nantes-Atlantic College of Veterinary Medicine and Food Sciences, Atlanpole La Chantrerie, CS 40706, 44307 Nantes CEDEX 3, France.
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Ballhausen BD, Wehner A, Zöllner M, Hartmann K, Unterer S. [Diagnostic approach and management of hypercalcaemia in dogs exemplary of primary hyperparathyroidism]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2017; 45:122-133. [PMID: 28352923 DOI: 10.15654/tpk-160923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/22/2017] [Indexed: 06/06/2023]
Abstract
Hypercalcaemia can be caused by many different diseases. This article summarizes the causes, pathophysiologic mechanisms and diagnostic procedures as well as treatment recommendations. The main focus is on hypercalcaemia in primary hyperparathyroidism (PH), complemented by a case report. An elevated total calcium level should generally be investigated and verified by measurement of ionized calcium concentration. The further diagnostic approach depends on the phosphate level. Tumour screening, measurement of parathormone and parathromone-related protein and sonography of parathyroid glands may be necessary. If the calcium-phosphate-product exceeds 60 mg/dl, there is a risk of tissue mineralisation and a rapid treatment of hypercalcaemia is required. For acute therapy, sodium chloride infusion, furosemide and glucocorticoids can be used. Glucocorticoids should only be given after strict indication and after a definite diagnosis. For long-term management, bisphosphates, particularly alendronate, are increasingly used successfully. Causal therapy of PH can be performed by parathyreoidectomy, heat ablation or ethanol ablation. Thereafter, particularly in cases of severe preoperative hypercalcaemia, hypocalcaemia can occur. Treatment is performed using vitamin D3 (calcitriol), which may also be given preoperatively in cases of severe hypercalcaemia. A concomitant oral calcium supplementation using calcium carbonate as medication of choice is contentious. Due to a potential relapse after successful excision of the affected parathyroid gland in PH, the serum calcium level should be monitored periodically.
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Affiliation(s)
- B Désirée Ballhausen
- Dr. B. Désirée Ballhausen, Tierärztliche Fachklinik für Kleintiere, Keferloher Straße 25, 85540 Haar, E-Mail:
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