How Long Can a Dog Live With Hypercalcemia?

When a canine presents with abnormally elevated blood calcium levels, it is imperative that their veterinarian conducts a detailed diagnostic investigation, including testing kidneys, adrenal glands and parathyroid glands to establish health issues.

Initial treatment for hypercalcemia involves replacing fluids to address dehydration and improve kidney function. Drugs like phosphate binders, diuretics and prednisone may be administered to reduce bone resorption while increasing urine excretion.

Causes

Dogs suffering from hypercalcemia have an elevated total or ionized calcium concentration above physiologically normal homeostatic levels, disrupting biological activities that normally take place within cells, tissues and organs.

Hypercalcemia may present itself with either no visible symptoms or with noticeable ones; typically the dog will become lethargic and frequently urinate (polyuria). Hypercalcemia also has detrimental effects on kidneys by altering calcium-phosphorus balance; this imbalance may result in calculi formation causing pain and discomfort for patients as well as intestinal distress with vomiting, nausea and loss of appetite as a consequence of its presence. The heart may become compromised with arrhythmias occurring.

Idiopathic hypercalcemia in dogs with early signs of organ dysfunction typically has an excellent prognosis and treatment options include restricting calcium intake and increasing calcium excretion via urine. Patients treated for their condition typically enjoy normal quality of life and survival rates.

Malignancies such as lymphoma, thymoma and histiocytic sarcoma have been associated with humoral hypercalcemia of malignancy due to secretion of parathyroid hormone (PTHrP), which increases calcium synthesis and release. Measurement of intact PTH, free ionized calcium and 25-hydroxyvitamin D can be helpful in differentiating between this cause of hypercalcemia and others.

Other conditions that can contribute to hypercalcemia include gastrointestinal ulcers, hyperparathyroidism and renal failure. If these disorders go untreated in time, they will likely lead to severe and persistent hypercalcemia.

Hypercalcemia may be triggered by medications including cholecalciferol-containing rodenticides, calcitriol, glycosides and certain plants such as Cestrum diurnum (Day-blooming jessamine), Solanum species or Trisetum flavescens. Furthermore, hypercalcemia has also been observed in horses suffering from granulomatous disease due to production of vitamin D by macrophages.

Diagnosing hypercalcemia requires extensive diagnostic testing. Laboratory tests should include a complete blood count, biochemical panel, electrolytes and complete blood chemistry screen including renal panel. Blood urea nitrogen (BUN), creatinine and BUN should also be measured. Hypercalcemia in cats may become fatal if kidney or gastrointestinal dysfunction develops; in these instances prognosis remains uncertain but treatment such as hydration, diuretics and bisphosphonates can extend patient quality of life and prolong survival.

Symptoms

Hypercalcemia is an electrolyte abnormality which can result from many diseases and conditions in dogs, often including dehydration, heart failure and neurological problems. Unfortunately, treating this condition can be extremely challenging and even fatal in extreme cases; therefore if your pet exhibits any signs of hypercalcemia you should seek veterinary advice immediately.

High calcium levels can force the kidneys to work harder than necessary, leading to dehydration and appetite loss. Furthermore, this imbalance may interfere with your nervous system causing confusion or even coma if left unchecked; additionally preventing the liver from filtering waste out of your system.

Dogs that have high calcium levels may suffer from swollen abdomen or constipation. Additionally, this condition may create issues in their digestive tract, kidneys, bones and cardiovascular system.

The gastrointestinal tract may become inflamed and ulcerated, leading to vomiting and diarrhea. Meanwhile, kidney inflammation can reduce glomerular filtration rate and increase renal tubule dysfunction; calcium may precipitate within kidney tissues leading to mineralization or urolithiasis of tissues while bone weakening can occur due to decalcification, making them very dangerous.

Cardiovascularly, an excessively high calcium level can cause heart failure and shortening of the QT interval on an electrocardiogram, potentially leading to potentially life-threatening arrhythmias and bone densification; potentially leading to fractures and osteoporosis.

If a blood test shows both high calcium levels and low parathyroid hormone levels, this could indicate the presence of a parathyroid tumor. Other cancer types that have been associated with hypocalcemia and hyperparathyroidism include lymphoma, thymoma and histiocytic sarcoma.

Dogs suffering from uncomplicated hypercalcemia do not necessarily require follow up from a specialist; however, at least once annually it would be wise to visit the Veterinary Specialty Center just in case their symptoms worsened. Dogs experiencing complex forms of hypercalcemia or complications from disease processes related to it should be closely monitored by an internal medicine specialist as often as necessary.

Treatment

If your pet’s calcium levels become extremely elevated, it should be treated immediately as a medical emergency and emergency treatment may include fluid therapy as well as administration of glucocorticoids, bisphosphonates or calcitonin injections.

High calcium levels in your pet’s bloodstream can be detrimental to all tissues, particularly kidneys and nervous system. They also put pressure on cardiovascular system which leads to heart abnormalities (ventricular arrhythmias). The longer these high calcium levels remain untreated the greater their damage becomes.

Diagnoses of hypercalcemia can be made through physical examination, blood work and laboratory tests administered at your veterinarian’s office. Test results should reveal both total and ionized calcium in your pet’s bloodstream as well as its source.

Humoral hypercalcemia associated with malignancy is one of the primary causes of high serum calcium in domestic animals, often accompanied by elevated vitamin D levels and PTHrP production. Phosphate levels may remain normal while total and ionized calcium concentrations rise rapidly – many tumors including lymphoid neoplasms of T cell origin, thymoma, histiocytic sarcoma, and pheochromocytoma have been implicated as causes.

Treatment options depend on the underlying condition. Low dose steroids may help promote calcium excretion in some patients; however, this should only be used as a temporary solution until its cause has been addressed and addressed effectively.

Hyperparathyroidism patients may take bisphosphonates, medications originally designed to treat osteoporosis in women. They suppress osteoclast activity and decrease blood calcium levels by suppressing osteoclast activity; giving this drug in very small doses to avoid long-term side effects; oral veterinary products including Alendronate and Zoledronate may be given once or twice weekly; in severe cases your veterinarian may suggest intravenous administration of these medicines.

Prognosis

Prognosis for canines suffering from hypercalcemia varies based on its cause. IV fluid therapy should help bring down their calcium level while blood tests, chest x-rays and abdominal imaging will be conducted to ascertain why their calcium is so elevated.

One of the primary causes of elevated calcium in dogs is kidney disease, which prevents their body from reabsorbing calcium from their diet and leads to excess levels in urine. A second cause may be vitamin D toxicity; essential for calcium absorption from food sources but too much may become toxic and cause symptoms including hypercalcemia.

Cancer is another leading cause of hypercalcemia in dogs. Cancer cells produce hormones that interfere with calcium regulation. Tumors producing PTHrP (parathyroid hormone-related protein) often induce hypercalcemia by stimulating bone release into circulation – cancer of the anal sac or lymphoma can also contribute to hypercalcemia through this mechanism.

Pancreatic cancer can also lead to hypercalcemia in dogs. An animal experiencing exocrine pancreatic adenocarcinoma-related hypercalcemia will likely display severe signs, including polyuria, polydipsia and vomiting.

If the source of hypercalcemia can be identified, treatment will focus on its source. For instance, chemotherapy could help lower calcium levels; or in cases involving an anal gland neoplasm surgery may be necessary.

Hypercalcemia in dogs is a serious health concern that requires immediate care. Without treatment, complications could arise including urolithiasis, renal failure and cardiac arrhythmias. Luckily, hypercalcemia is usually treatable condition.

An initial blood test to measure free, ionized calcium concentration levels is typically used to diagnose hypercalcemia; however, this only provides part of the picture as much of the calcium found in bloodstream is bound by proteins and other substances making it hard for labs to accurately measure this amount of free ionized calcium. A follow up calcium test should also be completed once treatment has been initiated to make sure concentrations have indeed decreased.

Lisa Thompson
 

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