Update on Feline Ionized Hypercalcemia

Galvão, Joao Felipe de Brito; Parker, Valerie J.; Schenck, Patricia A.; Chew, Dennis J.

doi:10.1016/j.cvsm.2016.09.004

Cited by 32 publications

(61 citation statements)

References 55 publications

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“…There are three fractions of serum total calcium (tCa): ionized, protein‐bound, and complexed calcium. Ionized calcium is the free, biologically active form of calcium within the blood that is tightly regulated . Ionized calcium concentration, measured by analyzers with ion‐specific electrodes, is considered the gold standard for evaluation of calcium homeostasis in both humans and animals .…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a multivariate predictive model to estimate serum ionized calcium concentration from serum biochemical profile results in cats

Hodgson

McMichael

Jepson

et al. 2019

Veterinary Internal Medicne

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Background Measurement of serum ionized calcium is not always available in practice. Total calcium (tCa) might not be reliable for determination of calcium status in cats. Objectives To predict serum ionized calcium concentration from signalment, biochemistry profile and T4, and compare predicted ionized calcium (piCa) to tCa. Animals A total of 1701 cats from two hospitals. Methods Cross‐sectional study. Cats with serum ionized calcium, biochemistry profile and T4 available were screened over 6 years and included in the training set (569 cats) to create a multivariate adaptive regression splines model to calculate piCa. Diagnostic performances of tCa and piCa and its prediction interval (PI) were compared in 652 cats from the same institution (test set) and 480 cats from a different hospital (external set). Results The final model included tCa, chloride, albumin, cholesterol, creatinine, BUN, body condition score, GGT, age, and potassium. For hypercalcemia, piCa was highly specific (test set: 99.8%; confidence interval [CI]: 99.5‐100; external set: 97%; CI: 95.3‐98.7) but poorly sensitive (test set: 30.4%; CI: 18.3‐42.4; external set: 42.5%; CI: 31.7‐53.3). For hypocalcemia, piCa was also highly specific (test set: 81.6%; CI: 78‐85; external set: 99.6%; CI: 99‐100) but poorly sensitive (test set: 57.6%; CI: 50.6‐64.6; external set: 0%). These diagnostic performances were comparable to those of tCa. The upper and lower limits of piCa PI had high sensitivity for detecting ionized hypercalcemia and hypocalcemia, respectively. Conclusions and clinical importance Predicted ionized calcium is useful to confirm suspected hypercalcemia in cats and screen for hypercalcemia and hypocalcemia.

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Section: Introductionmentioning

confidence: 99%

Development and validation of a multivariate predictive model to estimate serum ionized calcium concentration from serum biochemical profile results in cats

Hodgson

McMichael

Jepson

et al. 2019

Veterinary Internal Medicne

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“…Dietary restriction of calcium is considered important in managing idiopathic hypercalcemia. Recommendations start with a calcium level in the diet at least below 0.48 g/MJ (<2 g/Mcal), lowering to less than 0.14 g/MJ (<0.6 g/Mcal) when normocalcemia is not achieved (2).…”

Section: Discussionmentioning

confidence: 99%

“…Hypercalcemia in cats may be associated with a variety of conditions which can be either parathyroid-dependent or, as in the majority of cases, parathyroid-independent (1). Between the latter, idiopathic hypercalcemia is the one diagnosis considered exclusive of the feline species, and the diagnosis of which is made per exclusionem (2).…”

Section: Introductionmentioning

confidence: 99%

“…According to a review by de Brito Galvão and colleagues, idiopathic hypercalcemia should be addressed as main cause of hypercalcemia in cats ( 2 ), while recent analysis on the Cornell University's database (2007-2017) suggests that malignancy and renal failure are more common causes ( 3 ). Regardless of which place claims on the podium, being first or third in terms of frequency, it is clear that idiopathic hypercalcemia is one of the important diagnoses of hypercalcemia in cats.…”

Section: Introductionmentioning

confidence: 99%

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Managing Feline Idiopathic Hypercalcemia With Chia Seeds (Salvia hispanica L.): A Case Series

Fantinati

Priymenko

2020

Front. Vet. Sci.

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Background: We describe for the first time the use of chia seeds (Salvia hispanica L.) as a non-pharmacological solution in managing feline idiopathic hypercalcemia when dietary change alone fails. Case Summary: Over a 2-year period of time, three female spayed, middle-aged, Domestic Shorthair cats were diagnosed with idiopathic hypercalcemia. Reason for consultation were lethargy and dysorexia, with a single episode of vomiting described in one cat and dysuria in another. Thorough diagnostic work-up included complete blood count, serum biochemistry, urinalysis, ionized calcium, calcemic hormones, parathyroid hormone-related protein, and imaging of chest and abdomen. Based on different nutritional reasons, each cat was switched to a different high-moisture pet food as first-step in managing the disorder: a high-fiber diet, a diet formulated for chronic kidney disease management and a diet designed to prevent calcium oxalate urolithiasis. In the three cats, 6 weeks of dietary change alone did not result in normocalcemia. Before resorting to any pharmacological solution, supplementation to the diet of chia seeds (2 g/cat/day) was started. After 4 weeks from the introduction of Salvia hispanica L., all cats achieved normalization of ionized calcium concentration. Conclusion: Chia seeds (Salvia hispanica L.) supplementation could be a useful tool in managing feline idiopathic hypercalcemia.

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“…In blood, ionised calcium is the metabolically active form and most accurately reflects the calcium status of dogs, cats and humans (De Brito Galvao et al . , Sava et al . , Messinger et al .…”

Section: Introductionmentioning

confidence: 99%

Investigation of the relationship between ionised and total calcium in dogs with ionised hypercalcaemia

Tørnqvist‐Johnsen

Schnabel

Gow

et al. 2020

J of Small Animal Practice

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Objectives To investigate the relationship between total and ionised calcium concentrations in dogs with ionised hypercalcaemia and to evaluate how albumin influences this relationship. Methods Initially, a reference interval for ionised and total calcium was established using a large population of healthy adult dogs. Our teaching hospital clinical database was searched to identify adult dogs with ionised hypercalcaemia between 2012 and 2017, a time frame when the same sample handling and analysis protocols were in place as for the healthy reference interval population. The relationship between ionised and total calcium concentrations was then examined in the ionised hypercalcaemia population. Results Based on biochemical analysis of 351 healthy adult dogs, a reference interval of 1.18 to 1.53 mmol/L for ionised calcium and 2.24 to 2.85 mmol/L for total calcium was established. Using these reference intervals, 63 dogs with ionised hypercalcaemia were identified, of which 23 did not have total hypercalcaemia. Only seven of the 23 dogs with ionised hypercalcaemia and total calcium below the upper limit of the reference interval had hypoalbuminemia. The majority of dogs with ionised hypercalcemia and normal total calcium had a modest increase in ionised calcium. Clinical Significance If relying on total calcium alone, more than one third of dogs with ionised hypercalcaemia will be classified as normocalcaemic and the majority of these dogs had normal serum albumin.

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Update on Feline Ionized Hypercalcemia

Cited by 32 publications

References 55 publications

Development and validation of a multivariate predictive model to estimate serum ionized calcium concentration from serum biochemical profile results in cats

Development and validation of a multivariate predictive model to estimate serum ionized calcium concentration from serum biochemical profile results in cats

Managing Feline Idiopathic Hypercalcemia With Chia Seeds (Salvia hispanica L.): A Case Series

Investigation of the relationship between ionised and total calcium in dogs with ionised hypercalcaemia

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