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Vet help
Vet help, Veterinarian
Category: Dog
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Experience:  9 years experience as small animal vet, 19 years experience in the animal care field
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High calcium in my dog

Customer Question

I have a spayed female Miniture Pincher who will be 9 years old in Dec. I took her in to the vet because she wet the bed while sound asleep. The vet did some blood work and found her calcium level to be 13.9mg/dl, so she did an ionized calcium test and that came back 1.87mmol/L. Her Phos is 3.1mg/dl. Chol 409mg/dl . Her PTH came back normal. We had exrays done and they show nothing. They now want us to go have ultra sounds done to see if she has Primary Hyperparathyroidism. Could all these tests be just normal in my dog and we are doing so much testing for nothing? Should I
wait or what would happen if I waited and had blood work done in a few months to see if there is any changes. She drinks more and urinates more then my two other minpins. But always has so that is not something new. Thanks for your help. Annette
Submitted: 7 years ago.
Category: Dog
Expert:  NancyH replied 7 years ago.
An elevated calcium level can be indicative of a cancer and it can also be indicative of a parathyroid problem or a kidney issue.
Changes in calcium levels in the blood can lead to heart and muscle disorders
from this site
http://www.bichonfriseusa.com/caninebloodwork.htm
"Blood calcium levels are influenced by diet, hormone levels and blood protein levels. Decreased levels indicate acute damage to the pancrease or undersctive parathyroid. Muscle twitches may occur in decreased level. Increased levels can be an indicator of certain types of tumors, parthyroid or kidney disease. Dr. Goldstein mentioned in his book, Nature of Animal Healing that low calcium level may indicate deficiency of pancreatic enzymes, and high calcium level may indicate poor metabolism of fats and protein. "
I think your vet is reasonable in seeking to find out if hyperparathyroidism is the underlying problem for your dog.
You may want to ask your vet what would be done if this is the diagnosis. Surgery might be a curative option.
You can read about hyperparathyroidism here
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/90313.htm
Hope this helps you!
Customer: replied 7 years ago.
Reply to Nancy Holmes's Post: I understood a Vet. would answer my question. I had already read everything you had replied before on my own. My question is about waiting and doing another set of blood work in a month or 2 how urgent is this ionized calcium level of 1.87. Thanks Annette
Expert:  NancyH replied 7 years ago.
This site doesn't have all vets working on it they indicate pretty clearly that other experts may answer you.
Just for future info stating you want a vet only to answer your question would be helpful.
Its also helpful if you say what you already know as, unlike an in person discussion, answers can only be based on information given.
I don't see any of the vets online at this moment but will see if I can get one for you.
Expert:  Vet help replied 7 years ago.
Since you are already familiar with the web sites that Nancy has provided, I won't re-hash the serious potential consequences related to elevated blood calcium levels. I believe that your vet is on the right track with test selections in trying to determine the cause of your dog's elevated blood calcium levels. The high ionized calcium level is very significant- ionized calcium is quite unstable in stored blood so collection of blood for an iCa measurement requires stringent adherence to proper collection and storage techniques. If the sample is improperly handled, the iCa will be degraded and the value will be lower than it actually is. The fact that it came out high in your dog's case, indicates that the level is truly high. This is not a normal finding under any circumstance and means that something is going on that warrants further investigation.
Based upon the other bloodwork results (phosphorus on the low side of the normal range, PTH normal, I'm assuming all kidney and electrolye levels came back normal and Addison's disease has been ruled out), there are basically two possible causes: primary hyperparathyroidism and cancer. In primary hyperPTH, PTH levels can be high or on the high end of the normal range, and phosphorus is usually low or in the low normal range. In hypercalcemia of malignancy, the same holds true for phosphorus and the PTH levels may be low or in the low normal range.
There are two measurements of parathyroid hormone, measuring intact PTH levels (iPTH) are more specific for primary hyperparathyroidim, so you should check with your vet to make sure that is the test that was performed.
The ultrasound of her neck would be very useful in determining if there is a nodule on the parathyroid gland. This is a non-invasive procedure, they'd just need to clip a little hair in that area. They may opt to do a fine needle aspirate of the gland (use needle and syringe to obtain some cells for analysis) as well, but a nodule would really clinch the diagnosis so FNA probably wouldn't be necessary.
If it is primary hyperparathyroidism, the prognosis after surgical removal of the affected gland is excellent. Waiting to treat the disease may result in kidney damage- which would not be reversible and would be progressive.
The cancerous causes of high blood calcium levels (lymphosarcoma, anal sac adenocarcinoma, and a variety of other carcinomas) have much worse long term prognoses. Lymphosarcoma would be the one to respond best to chemotherapy, but even under the best of circumstances survival time wouldn't be much more than 2 years.
I wouldn't wait- even just an additional month could result in serious problems and if it is something curable like primary hyperparathyroidism, it would be devastating to know that the kidney failure could have been prevented.
Hope this was helpful.
Vet help, Veterinarian
Category: Dog
Satisfied Customers: 2597
Experience: 9 years experience as small animal vet, 19 years experience in the animal care field
Vet help and 6 other Dog Specialists are ready to help you
Customer: replied 7 years ago.
Reply to RGK's Post: Thanks so much for your help we made an appointment with C.S.U. tomorrow for an ultra-sound of our little Annie. Hoping it is (iPTH) and not cancer. Thanks again all of you for your help. Annette
Expert:  Vet help replied 7 years ago.
You're welcome, I'm glad that we could be of service. Good luck with the ultrasound, I hope things work out well for Annie.
Customer: replied 7 years ago.
Reply to RGK's Post: UPDATE ON ANNIE.. We took her to CSU 8/21/06 for an ultrasound of her neck and they found a 3x7 mm nodule in the left parathyroid gland. On 8/22/06 during surgery they found it to be the left caudal parathyroid gland which necessitated the removal of the left throid as well. The histopathology came back as benign. Annie was watched closely for a couple of days to make sure her calcium levels didn't drop to much. And the greatest news was we were able to pick her up and come home on 8/25/06. She is doing great and will be checked in 10-14 days for her incision and have her calcium and electrolyte levels checked. So just letting you know Annie will be fine now, and thanks again for all your help. They said it was the best thing catching it so early. Before we had a sick dog and then so much longer recovery time.. Great school C.S.U. could not have been better. Thanks All.. Annette
Expert:  Vet help replied 7 years ago.
That's wonderful!!! I'm so glad everything went well and that Annie's recovery has been a smooth one. May she live at least another 9 healthy years for you. Thanks for the update!

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