Hyper And Hypo Calcemia Flashcards
What fractions are included in a typical measurement of total serum calcium?
.iCa (50%)
Completed/chelated Ca (10%)
Protein bound Ca (40%)
What is the normal range of calcium?
8.5-11.7mg/dL
What is the source of vitD in animals
Diet!
If Ca is too high, ___________ is released ti increased Ca deposition in bones and decreased Ca reabsorption from the kidney
Calcitonin (from the thyroid)
If Ca levels are too low, ________________ is released to increase Ca release from bone and increase Ca reabsorption from urine
PTH (parathyroid)
Vitamin D will have what effect on calcium?
Increased Ca absorption from the GI
Inhibit Calcitonin release from the thyroid
PU/PD, weakness, lethargy, inappetence, and v/d, are clinical signs of (hyper or hypo-)? Calcemia?
Hypercalcemia
What is the DDX for hypercalcemia
H- hyperparathyroidism A- addisons R- renal failure D- hypervitaminosis D I- idiopathic hypercalcemia of cats O- osteolysis N- neoplasia S- spurious
If you have a Ca X P product >70, what may you be concerned about?
Dystrophic mineralization
What should be your diagnostic approach to hypercalcemia ?
Recheck and check iCa
Hx of VitD exposure
PE: LN, rectal, vaginal, mammary gland, bone pain/lameness, fundic
Labwork: phos:Ca level
Labwork: renal failure, addisons, multiple myeloma
What is the body’s response to minor and major decreases in Ca?
Minor= increase PTH
Major= increase PTH, VitD3
Clinical signs are usually only seen in severe hypocalcemia, what can cause decreases in Ca of this magnitude ?
Eclampsia
Hypoparathyroidism
Diet?
What are the causes of primary hypoparathyroidism ?
Idiopathic - rare, small breed, female, ave age 4.8yrs
Iatrogenic- post thyroidectomy or parathyroidectomy
An excessive loss of Ca in milk is called?
Eclampsia
T/F: in a lactating bitch with tetany you can assume hypocalcemia as your clinical diagnosis
True
What is the first choice to diagnose hypocalcemia
Serum ionized calcium
Total calcium is second best
How would you diagnose hypoPTH?
Measure PTH levels
-will be normal to low in primary hypoPTH
What is the best emergency treatment for hypocalcemia?
10% calcium gluconate IV slow over 10-30mins
Monitor with ECG
Continue wit supportive IV or SQ Ca therapy
What is the maintenance therapy for eclampsia?
Wean pups
Oral calcium supplements
What is the maintenance therapy for primary hypoPTH?
Oral Ca (may or may not eventually wean off)
Oral vitD - lifelong
Which vit D supplement could be used to treat hypoPTH?
Calcitriol (most common)
Calciferol
