Hypercalcemia - repost due to editing error in previous message

t has been several years since I have posted to these two newsgroups but I
have continued to lurk on and off. My one 6 year old kitty after a full panel
had a full panel down last Thursday and I received the results on Friday.

All values were normal except Calcium at 14.4 mg/dL and phosphorus 2.94 mg/dL.
Albumen was slightly high at 40 g/L (she was a bit dehydrated due to diarrhoea
(more about this later). Urinalysis was almost all normal except for the
presence of a few oxalate crystals. Bun Creatinine, Alt, etc all fine as stated
above. However his T4 was close to the maximum of the high range 3.11 ug/dL

The history of the cat is a follows. He was a rescue 5 years ago when he turned
up at my place with a fractured pelvis (I used to only see him once a week when
he would come for a late night stack). After 4-6 weeks of rehabilitation in the
hospital he came out in relatively good shape but due to probably neural damage
he had problems defectating and could not urinate on his own.

The defecation problem was largely solved with Lactulose, cisapride (which I
got him off after about 3 months of being home) and a blend of psyllium
(primarily soluble fibre) and wheat bran (primarily insoluble).

This has generally worked very well for 5 years until a month ago when he did
not seem to be doing so well with the constipation. A vet visit then and we
discussed putting him back on the cisapride and also trying ranitidine in
conjunction firstly with the fibre and then trying a low residue diet.
Cisapride and ranitidine worked not that great and last week the full panel was
done with figures mentioned above.

Now to the hypercalcemia and the slight hypophosphatemea.

I have done a lot of research on this. The most popular one cited is:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=107 72491

This was a retrospective study of 71 cats and the most common diagnoses were
neoplasia 21 cats), renal disease (not applicable here)- 18 cats urolithiasis
and lastly in 4 cases there was hyperparathyroidism. 20 of the cats apparently
were deemed to suffer from idiopatic hypercalcemia.

Other studies I have looked at are here and these often referenced the above:

WSAVA 2001 congress:

http://www.vin.com/VINDBPub/SearchPB...00/PR00123.htm

(Hypercalcemia in cats - Dennis Chew)

WSAVA 2002 congress

(Hypercalcemia in dogs and cats Etiology and Diagnostic Approach - Richard
Nelson - University of California Davis)

http://www.vin.com/proceedings/Proce...2555&Category=
429

I have looked at various other full text and abstracts and I have been
hoping/dreaming that it is either transient hypercalcemia (which I don't think
due to the presence of the calcium oxalate crystals) or laboratory error (once
again not hoping much there). My main hope is that is primary
hyperparathyroidism as discussed he

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=181 3472

(Primary hyperparathyroidism in cats: seven cases (1984-1989).

Assuming it is persistent hypercalcemia it might be idiopathic (but prognosis
there is somewhat mixed)but propably some cancer, be it lymphoma or otherwise.

Tomorrow the boy is going in for an ionised calcium test and a PTH test (the
lab does not do PTHrp tests yet). I will also have a vitamin D test and another
retest of total calcium (another retest was done on Saturday). Depending on
results this will be followed up by full X-Rays and ultrasound.

So I don't really know what to say. I am massively concerned about it being a
malignant neoplasia and I suppose I will soon know.

Peter

So I don't really know what to say. I am massively concerned about it being
a
malignant neoplasia and I suppose I will soon know.

Peter

I'm sorry about your kitty. You have done so much for him; it's very admirable
but I'm sure he has rewarded you greatly in return. I hope the best for him,
please let us know how his tests go.

Candace
(take the litter out before replying by e-mail)

See my cats:
http://photos.yahoo.com/maccandace

"One does not meet oneself until one catches the reflection from an eye other
than human." (Loren Eisely)

So I don't really know what to say. I am massively concerned about it being
a
malignant neoplasia and I suppose I will soon know.

Peter

I'm sorry about your kitty. You have done so much for him; it's very admirable
but I'm sure he has rewarded you greatly in return. I hope the best for him,
please let us know how his tests go.

Candace
(take the litter out before replying by e-mail)

See my cats:
http://photos.yahoo.com/maccandace

"One does not meet oneself until one catches the reflection from an eye other
than human." (Loren Eisely)

"Peter Georgeu" wrote in message
...
All values were normal except Calcium at 14.4 mg/dL and phosphorus 2.94
mg/dL.
Albumen was slightly high at 40 g/L (she was a bit dehydrated due to
diarrhoea
(more about this later). Urinalysis was almost all normal except for the
presence of a few oxalate crystals. Bun Creatinine, Alt, etc all fine as
stated
above. However his T4 was close to the maximum of the high range 3.11
ug/dL

So I don't really know what to say. I am massively concerned about it
being a
malignant neoplasia and I suppose I will soon know.

.......Maybe, but I think when you've got elevated Ca due to cancer, the
phosphorus doesn't necessarily go up also. I'd vote for a
thyroid-parathyroid problem. Good you're doing further tests to rule this
out.

Keep us posted.
Hoping for the best.
buglady
take out the dog before replying

"Peter Georgeu" wrote in message
...
All values were normal except Calcium at 14.4 mg/dL and phosphorus 2.94
mg/dL.
Albumen was slightly high at 40 g/L (she was a bit dehydrated due to
diarrhoea
(more about this later). Urinalysis was almost all normal except for the
presence of a few oxalate crystals. Bun Creatinine, Alt, etc all fine as
stated
above. However his T4 was close to the maximum of the high range 3.11
ug/dL

So I don't really know what to say. I am massively concerned about it
being a
malignant neoplasia and I suppose I will soon know.

.......Maybe, but I think when you've got elevated Ca due to cancer, the
phosphorus doesn't necessarily go up also. I'd vote for a
thyroid-parathyroid problem. Good you're doing further tests to rule this
out.

Keep us posted.
Hoping for the best.
buglady
take out the dog before replying

In article ,
said...
t has been several years since I have posted to these two newsgroups but I
have continued to lurk on and off. My one 6 year old kitty after a full panel
had a full panel down last Thursday and I received the results on Friday.

All values were normal except Calcium at 14.4 mg/dL and phosphorus 2.94 mg/dL.
Albumen was slightly high at 40 g/L (she was a bit dehydrated due to diarrhoea
(more about this later). Urinalysis was almost all normal except for the
presence of a few oxalate crystals. Bun Creatinine, Alt, etc all fine as stated
above. However his T4 was close to the maximum of the high range 3.11 ug/dL


snip

First of all,

Thanks very much for the follow-ups. Much appreciated.

Things have changed - and not for the better.

The first blood test I mentioned above was a full panel and was done on
Thursday. On Saturday (just two days later) I took my boy in just to have a
look over by the other veterinarian at the practice. I also decided to do a
retest but not the whole panel. I received the results this morning.

Calcium declined in the two days from the high of 14.4 to 11.7 mg/dL and
phosphorus increased (he was hypophosphatemic) from 2.88 to 3.38 mg/dL (low
range of normal).

But suddenly in the 2 day gap his liver values rocketed up from being normal.
Alt and Ast which were fine went respectively to 1189 and 290! Today the PTH
and the ionised calcium were tested together with repeats.

Now the Calcium was up to 13.04 and phosphorus dropped a bit. However his Alt
dropped from 1189 to 605 and the Ast dropped from 290 to 95.

Tomorrow or Wednesday the result of the PTH and ionised Calcium but I am
getting even further depressed with the liver problems. I hope I will get
within 48 hours and ultrasound appointment (I will know tomorrow).

Peter

In article ,
said...
t has been several years since I have posted to these two newsgroups but I
have continued to lurk on and off. My one 6 year old kitty after a full panel
had a full panel down last Thursday and I received the results on Friday.

All values were normal except Calcium at 14.4 mg/dL and phosphorus 2.94 mg/dL.
Albumen was slightly high at 40 g/L (she was a bit dehydrated due to diarrhoea
(more about this later). Urinalysis was almost all normal except for the
presence of a few oxalate crystals. Bun Creatinine, Alt, etc all fine as stated
above. However his T4 was close to the maximum of the high range 3.11 ug/dL


snip

First of all,

Thanks very much for the follow-ups. Much appreciated.

Things have changed - and not for the better.

The first blood test I mentioned above was a full panel and was done on
Thursday. On Saturday (just two days later) I took my boy in just to have a
look over by the other veterinarian at the practice. I also decided to do a
retest but not the whole panel. I received the results this morning.

Calcium declined in the two days from the high of 14.4 to 11.7 mg/dL and
phosphorus increased (he was hypophosphatemic) from 2.88 to 3.38 mg/dL (low
range of normal).

But suddenly in the 2 day gap his liver values rocketed up from being normal.
Alt and Ast which were fine went respectively to 1189 and 290! Today the PTH
and the ionised calcium were tested together with repeats.

Now the Calcium was up to 13.04 and phosphorus dropped a bit. However his Alt
dropped from 1189 to 605 and the Ast dropped from 290 to 95.

Tomorrow or Wednesday the result of the PTH and ionised Calcium but I am
getting even further depressed with the liver problems. I hope I will get
within 48 hours and ultrasound appointment (I will know tomorrow).

Peter

"Peter Georgeu" wrote in message
...
Things have changed - and not for the better.
Calcium declined in the two days from the high of 14.4 to 11.7 mg/dL and
phosphorus increased (he was hypophosphatemic) from 2.88 to 3.38 mg/dL
(low
range of normal).

But suddenly in the 2 day gap his liver values rocketed up from being
normal.

Now the Calcium was up to 13.04 and phosphorus dropped a bit. However his
Alt
dropped from 1189 to 605 and the Ast dropped from 290 to 95.

...........To me this is just further proof his endocrine system is
unregulated. I don't think you'd get these kinds of fluctuations with
cancer. Don't know if liver values get affected with parathyroid problems,
but they sure do with Cushings (another endocrine problem, but rarely seen
in cats). Perhaps Josh can tell us. Don't remember the treatment for
parathyroid problems either though because this gland is so tiny I figure
they'll have to destroy it somehow. Should be plenty of info on Google
though.

buglady
take out the dog before replying

"Peter Georgeu" wrote in message
...
Things have changed - and not for the better.
Calcium declined in the two days from the high of 14.4 to 11.7 mg/dL and
phosphorus increased (he was hypophosphatemic) from 2.88 to 3.38 mg/dL
(low
range of normal).

But suddenly in the 2 day gap his liver values rocketed up from being
normal.

Now the Calcium was up to 13.04 and phosphorus dropped a bit. However his
Alt
dropped from 1189 to 605 and the Ast dropped from 290 to 95.

...........To me this is just further proof his endocrine system is
unregulated. I don't think you'd get these kinds of fluctuations with
cancer. Don't know if liver values get affected with parathyroid problems,
but they sure do with Cushings (another endocrine problem, but rarely seen
in cats). Perhaps Josh can tell us. Don't remember the treatment for
parathyroid problems either though because this gland is so tiny I figure
they'll have to destroy it somehow. Should be plenty of info on Google
though.

buglady
take out the dog before replying