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

Larson, Melinda J.; Oakes, Ashley B.; Epperson, Ember; Chew, Dennis J.

doi:10.1111/jvim.15409

Cited by 19 publications

(22 citation statements)

References 34 publications

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

Section: Acquired Vitamin D Disorders -Excessmentioning

confidence: 99%

Vitamin D metabolism and disorders in dogs and cats

Clarke

Hurst

Mellanby

2021

J of Small Animal Practice

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

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Section: Acquired Vitamin D Disorders -Excessmentioning

confidence: 99%

Vitamin D metabolism and disorders in dogs and cats

Clarke

Hurst

Mellanby

2021

J of Small Animal Practice

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“…At the time of publication only one other case report is available documenting changes suggestive of BRONJ in a cat following alendronate therapy, for the management of idiopathic hypercalcaemi7 a. A major limitation of this case report is that biopsies of the lesion were not taken to confirm the osteonecrotic nature of the lesions seen, although given the potential for exacerbating the condition, the argument can be made that this was the appropriate decision for the welfare of the cat in this case.…”

Section: Discussionmentioning

confidence: 99%

“…An association between osteonecrosis of the jaw and bisphosphonate therapy has been described in the human literature and in an experimental beagle population. There is one other documented case of suspect bisphosphonate related osteonecrosis of the jaw in a cat (Larson et al, 2019) 7…”

Section: Introductionmentioning

confidence: 99%

Suspected bisphosphate‐related osteonecrosis of the jaw in a cat being treated with alendronate for idiopathic hypercalcaemia

Rogers-Smith¹,

Whitley²,

Elwood³

et al. 2019

Vet Record Case Reports

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An 8-year-old female neutered domestic shorthair diagnosed with idiopathic hypercalcaemia and undergoing weekly treatment with alendronate presented to Davies Veterinary Specialists for progressive facial swelling and discomfort 12 months after commencement of bisphosphonate treatment. Progression of the pathology was documented through clinical history from the referring practice when the patient underwent dental treatment with dental radiographs and then subsequently CT evaluation of the lesions. Proliferative and lytic, multifocal bony changes to the jaw, with a strikingly similar radiographic appearance to that seen in humans suffering from bisphosphonate-related osteonecrosis of the jaw (BRONJ), were seen. BRONJ is a well-recognised side effect of bisphosphonate therapy in people undergoing bisphosphonate therapy for the management of malignant hypercalcaemia. The cat was eventually euthanised due to the development of an abdominal mass and declining quality of life.

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“…169 Early in the 2000s, efforts to study ONJ in a variety of dog models were begun but have been stymied by lack of consistent exposure of jaw bones after BP administration, even after 3 years of treatment. 170 BP with corticosteroid therapy generally predisposes to the occurrence of ONJ-like lesions after tooth extraction and has been reported in cats; 171 however, in beagle dogs, even with high doses of zoledronic acid combined with dexamethasone, exposed bone following dental extraction was absent. 172 Matrix necrosis was not noted, and all extraction sites healed without incident.…”

Section: Larger Animal Modelsmentioning

confidence: 99%

Mitigating osteonecrosis of the jaw (ONJ) through preventive dental care and understanding of risk factors

et al. 2020

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It is well established that alterations in phosphate metabolism have a profound effect on hard and soft tissues of the oral cavity. The present-day clinical form of osteonecrosis of the jaw (ONJ) was preceded by phosphorus necrosis of the jaw, ca. 1860. The subsequent removal of yellow phosphorus from matches in the early 20th century saw a parallel decline in “phossy jaw” until the early 2000s, when similar reports of unusual jaw bone necrosis began to appear in the literature describing jaw necrosis in patients undergoing chemotherapy and concomitant steroid and bisphosphonate treatment. Today, the potential side effect of ONJ associated with medications that block osteoclast activity (antiresorptive) is well known, though the mechanism remains unclear and the management and outcomes are often unsatisfactory. Much of the existing literature has focused on the continuing concerns of appropriate use of bisphosphonates and other antiresorptive medications, the incomplete or underdeveloped research on ONJ, and the use of drugs with anabolic potential for treatment of osteoporosis. While recognizing that ONJ is a rare occurrence and ONJ-associated medications play an important role in fracture risk reduction in osteoporotic patients, evidence to date suggests that health care providers can lower the risk further by dental evaluations and care prior to initiating antiresorptive therapies and by monitoring dental health during and after treatment. This review describes the current clinical management guidelines for ONJ, the critical role of dental-medical management in mitigating risks, and the current understanding of the effects of predominantly osteoclast-modulating drugs on bone homeostasis.

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

Cited by 19 publications

References 34 publications

Vitamin D metabolism and disorders in dogs and cats

Vitamin D metabolism and disorders in dogs and cats

Suspected bisphosphate‐related osteonecrosis of the jaw in a cat being treated with alendronate for idiopathic hypercalcaemia

Mitigating osteonecrosis of the jaw (ONJ) through preventive dental care and understanding of risk factors

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