Peer-reviewed veterinary case report
Calcium tests compared for low albumin dogs in ICU
By Sharp, Claire R et al.·Published in Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)·2009·Department of Veterinary and Medicine and Surgery, United States·View original on PubMed →
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Original publication title: A comparison of total calcium, corrected calcium, and ionized calcium concentrations as indicators of calcium homeostasis among hypoalbuminemic dogs requiring intensive care.
- Species:
- dog
Plain-English summary
A group of 28 critically ill dogs with low albumin levels were evaluated for calcium levels to see how well different tests could identify low calcium (hypocalcemia). The study found that while total calcium levels were very good at detecting hypocalcemia, they often misclassified other calcium levels. In fact, the adjusted calcium tests were not reliable, missing many cases of low calcium. The researchers recommend that for dogs with low albumin, checking ionized calcium levels is the best way to accurately assess calcium status and ensure proper treatment.
People also search for: dog low calcium symptoms · hypoalbuminemia in dogs · dog calcium test results
Abstract
OBJECTIVE: (1) To evaluate whether total calcium (tCa) correlates with ionized calcium (iCa) in hypoalbuminemic dogs; (2) to evaluate whether calcium adjusted for albumin (Alb), or total protein (TP), or both accurately predict iCa concentrations and hence can be used to monitor calcium homeostasis in critically ill hypoalbuminemic dogs; and (3) to evaluate factors associated with any potential discrepancy in calcium classification between corrected total and ionized values. DESIGN: Prospective observational clinical study. SETTING: Small animal intensive care unit in a veterinary medical teaching hospital. ANIMALS: Twenty-eight client-owned dogs with hypoalbuminemia. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: iCa was determined using ion-specific electrode methodology, on heparinized plasma. The tCa concentration was adjusted for Alb and TP using published equations. In total 29% (8/28) of the hypoalbuminemic, critically ill dogs in this study were hypocalcemic at intensive care unit admission, as determined by iCa measurement. Corrected calcium values failed to accurately classify calcium status in 67.9% and 64.3% of cases, according to whether the Alb-adjusted or TP-adjusted values, respectively, were used. The sensitivity and specificity of the tCa to evaluate hypocalcemia was 100% and 47%, respectively. The sensitivity and specificity of the correction formulae were 37.5% and 79% for the Alb-adjusted values and 37.5% and 74% for TP-adjusted values. tCa overestimated the presence of hypocalcemia and underestimated the presence of normocalcemia, while corrected calcium values overestimated the presence of normocalcemia and underestimated the presence of hypocalcemia. CONCLUSIONS: Calcium homeostasis in hypoalbuminemic critically ill dogs should be evaluated by iCa concentrations rather than tCa or calcium adjusted for Alb or TP. Given that tCa has 100% sensitivity for detecting hypocalcemia in this population it is recommended that all hypoalbuminemic and critically ill patients with low tCa should be evaluated with an iCa measurement.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/20017763/