Hypercalcaemia in otherwise healthy cat

Re: Hypercalcaemia in otherwise healthy cat

Kate Richardson — Wed, 03 Aug 2011 21:25:22 GMT

[quote user="Hannah Wynne Richards"]You've been honest with the owner-so don't worry about GG[/quote]

Ditto!

Re: Hypercalcaemia in otherwise healthy cat

Hannah Wynne Richards — Wed, 03 Aug 2011 15:33:33 GMT

You've been honest with the owner-so don't worry about GG

Wynne

Re: Hypercalcaemia in otherwise healthy cat

Rob Davis — Wed, 03 Aug 2011 15:14:18 GMT

I've just had a long conversation with the cat's owner about the various options. It transpires that she has recently lost a dog to an unusual form of lymphoma (this was dealt with by one of my colleagues so I wasn't aware of it). As a result she is particularly concerned about the possibility of neoplasia. We have deciced to do survey radiographs and ultrasound as a first step. She is aware that there may be nothing wrong with her cat. Would Germaine Greer disapprove.....?

Re: Hypercalcaemia in otherwise healthy cat

Rob Loxley — Wed, 03 Aug 2011 13:47:07 GMT

[quote user="Alicia Gonzalez"]the Calcium intake in its diet (some low Q brand diets are overdosed in Ca)[/quote]

How much does excess food calcium content affect blood levels (given normal Ca:Phos balance of the food)? Isn't the gut very good at not taking up excess calcium (IIRC almost any diet will have well in excess of any calcium that the body needs), unless calcium regulation mechanisms are not working, and in that case I'd be chasing those down rather than the diet?

Re: Hypercalcaemia in otherwise healthy cat

Rob Davis — Wed, 03 Aug 2011 12:55:19 GMT

[quote user="Kate Richardson"]Remember a 'normal' reference range only includes the middle 95/100 animals. 1 in 20 could fall outside of the range with no concern - this cat might just be one of those. I try not to chase numbers but look at the animal. [/quote]

I agree completely and feel this cat may be absolutely fine and a tumour hunt may be fruitless, but I feel I have to discuss this option with the owner. Would you ignore it?

[quote user="Robin Grimmer"]

No, but hypercalcaemia in itself can be a cause of pu/pd.

[/quote]

But how would that help me diagnostically?

Re: Hypercalcaemia in otherwise healthy cat

Robin Grimmer — Wed, 03 Aug 2011 12:08:43 GMT

[quote user="Rob Davis"]

No PUPD noticed by owners. Given normal urea/creatinine is there any value in checking USG - I thought that renal disease would not cause hypercalcaemia unless it is severe enough to cause azotaemia (urea 8.3 (5.7-12.8), creat 136 (71-212)).

[/quote]

No, but hypercalcaemia in itself can be a cause of pu/pd.

Re: Hypercalcaemia in otherwise healthy cat

Kate Richardson — Wed, 03 Aug 2011 09:53:28 GMT

[quote user="Michael Woodhouse"]

Remember a 'normal' reference range only includes the middle 95/100 animals. 1 in 20 could fall outside of the range with no concern - this cat might just be one of those. I try not to chase numbers but look at the animal.

[/quote]

I would agree with Michael on this, but would monitor regularly. I f the owners are keen to check further, then it will do no harm to check PTH/PTHrp/xray thorax/scan abdomen, for peace of mind.

[quote user="Rob Davis"]No PUPD noticed by owners. Given normal urea/creatinine is there any value in checking USG -[/quote]

Yes, just because the owners haven't noticed any pupd, doesn't mean the cat isn't. Especially if the cat goes outside. And PUPD has to be extreme for most owners to notice IME.

Re: Hypercalcaemia in otherwise healthy cat

Michael Woodhouse — Wed, 03 Aug 2011 09:22:36 GMT

Re: Hypercalcaemia in otherwise healthy cat

Rob Davis — Wed, 03 Aug 2011 08:42:42 GMT

[quote user="Robin Grimmer"]

Were the ALB/TP levels normal? Have you done an ionized Ca level?

Is there any pu/pd? Worth checking a urine SG?

[/quote]

ALB = 37 (normal 26-39)

TP= 73 (57-89)

[quote user="Robin Grimmer"]Have you done an ionized Ca level?[/quote]

See original post, ionic Ca++ slightly raised yesterday.

EDIT: oops, just realised I forgot to put in the original post that ionised Ca++ yesterday was 1.39 (1.2-1.32)

[quote user="Alicia Gonzalez"]Na/K+ ions blood levels (also because slgt deHyd without app cause the dentals day, maybe a rare cat Adisson?)[/quote]

Yesterday Na+ 149 (147-162) and K+ 3.3 (2.9-4.2).

Many thanks for replies so far. I will discuss with the owner this morning and let you know what the plan is.

Re: Hypercalcaemia in otherwise healthy cat

Alicia Gonzalez — Wed, 03 Aug 2011 01:27:08 GMT

I would also check:

the Calcium intake in its diet (some low Q brand diets are overdosed in Ca)

Albumine level to correlate with Ca+ for each recheck.

Na/K+ ions blood levels (also because slgt deHyd without app cause the dentals day, maybe a rare cat Adisson?)

Cheers

Re: Hypercalcaemia in otherwise healthy cat

Robin Grimmer — Tue, 02 Aug 2011 20:48:52 GMT

Were the ALB/TP levels normal? Have you done an ionized Ca level?

Is there any pu/pd? Worth checking a urine SG?

Re: Hypercalcaemia in otherwise healthy cat

Alex Gough — Tue, 02 Aug 2011 18:57:52 GMT

Hi Rob,

sounds like it could be idiopathic hypercalcaemia at that level, and the cat isn't in immediate danger of the calcium causing renal damage. However, it could be lymphoma or something rarer (other neoplasia, PHPTH, granulomatous disease etc), so see where the owners are coming from. Screening chest rads and abdo ultrasound would be a good start.

Cheers

alex