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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