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Hyperparathyroidism in Dogs

By: Dr. Arnold Plotnick

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Diagnosis In-depth

  • A complete medical history and physical examination should be performed.

  • Routine blood tests will be necessary to confirm the elevated calcium levels, and to help monitor treatment.

  • Special blood tests, such as measurement of the actual amount of PTH in the bloodstream, may be required for diagnosis. Measurement of the ionized calcium – the highly active, most important form of calcium – may also be necessary.

  • Urinalysis may be needed in cases where difficult or abnormal urination is a major clinical sign.

  • Ultrasound of the neck may identify a tumor in one of the parathyroid glands and confirm the diagnosis. If the kidneys or bladder are affected, ultrasound may also yield valuable information about these organs as well.

  • X-rays may be necessary to rule out cancer as a cause for the high calcium levels in the blood.

  • Lymph node and bone marrow evaluation may be necessary to rule out lymphosarcoma, a type of cancer that commonly causes elevated calcium levels.

  • An electrocardiogram (EKG) may be useful if the high calcium levels are causing an abnormal heart rhythm.

  • Surgical exploration of the neck to look for a parathyroid tumor is occasionally performed as a diagnostic tests when all other tests fail to yield a definite explanation for persistent elevations in calcium levels.

    Treatment In-depth

  • Surgical removal of the abnormal parathyroid gland is a relatively easy procedure that usually cures the condition. The parathyroid gland that is removed should be submitted to a pathologist to assess whether the tumor is benign (an adenoma) or malignant (a carcinoma).

  • In cases where the calcium level is dangerously high, hospitalization and administration of intravenous fluids (saline) may be necessary to lower the calcium and stabilize the patient before considering surgery.

  • A diuretic such as furosemide may be needed in addition to intravenous saline to enhance the excretion of calcium in the urine.

  • Glucocorticoids may also be given to enhance urinary excretion of calcium.

  • Calcitonin is a hormone that counteracts the effects of excessive parathyroid hormone (PTH), and helps lower the dangerously high calcium levels.

  • Plicamycin is another drug that is occasionally used to lower high levels of calcium.

  • Bicarbonate may be given, in conjunction with intravenous saline and diuretics, to shift the amount of ionized calcium (the dangerous form) to unionized calcium (a safer form).

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