Peer-reviewed veterinary case report
Ionized high calcium levels in 238 cats at a referral hospital
By Broughton, Sophie E et al.·Published in Journal of veterinary internal medicine·2023·Department of Clinical Science and Services, United Kingdom·View original on PubMed →
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Original publication title: Ionized hypercalcemia in 238 cats from a referral hospital population (2009-2019).
- Species:
- cat
Plain-English summary
A group of 238 cats was found to have high levels of ionized calcium, which can lead to serious health issues like kidney problems and urinary stones. The most common causes of this condition included acute kidney injury, cancer, and idiopathic hypercalcemia (a condition with no known cause). Many of these cats also had urinary stones, especially those with kidney injury or chronic kidney disease. Understanding these causes can help veterinarians treat affected cats more effectively and prevent complications.
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Abstract
BACKGROUND: Ionized calcium concentration ([iCa]) is more sensitive for detecting calcium disturbances than serum total calcium concentration but literature on ionized hypercalcemia in cats is limited. Urolithiasis is a possible adverse consequence of hypercalcemia. HYPOTHESIS/OBJECTIVES: To describe clinical details of diagnoses associated with ionized hypercalcemia in cats and association with urolithiasis. ANIMALS: Cats (238) seen between 2009 and 2019 at a referral hospital with [iCa] above the normal reference interval. METHODS: Observational cross-sectional study. Signalment, serum biochemical and imaging findings were reviewed for cats with ionized hypercalcemia considered to be clinically relevant (>1.41 mmol/L). Data were summarized by cause of hypercalcemia (i.e., diagnosis). RESULTS: Diagnoses for the 238 cats with [iCa] >1.41 mmol/L included: acute kidney injury (AKI; 13%), malignancy-associated (10.1%), idiopathic hypercalcemia (IHC; 10.1%), chronic kidney disease/renal diet-associated (8.4%), iatrogenic (5.5%), primary hyperparathyroidism (2.1%), vitamin D toxicity (2.1%) and granulomatous disease (1.7%). In 112 cases (47.1%), no cause for ionized hypercalcemia could be determined (n = 95), hypercalcemia was transient (n = 12), or the cat was juvenile (<1 year; n = 5). Urolithiasis was identified in 83.3% of AKI, 72.7% of iatrogenic, 61.1% of CKD/renal diet-associated and 50% of IHC cases that were imaged (<50% for other diagnoses). Diagnoses with a high proportion of concurrent total hypercalcemia included primary hyperparathyroidism (100%), vitamin D toxicity (100%), malignancy-associated (71.4%), granulomatous disease (66.7%) and IHC (65.2%). CONCLUSIONS AND CLINICAL IMPORTANCE: Ionized hypercalcemia was most commonly associated with kidney diseases, neoplasia or IHC. The proportion of urolithiasis cases varied by diagnosis.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36645022/