A probable case of hypoparathyroidism in a cat

Idiopathic hypoparathyroidism was suspected in a young female cat. The relevant historical and clinical findings were: anorexia, intermittent muscle tremors, hindlimb ataxia, behavioural changes and cataracts. Salient laboratory findings were: hypocalcaemia, hyperphosphataemia and normal renal function (normal serum urea and creatinine concentrations with hypersthenuria). No evidence of intestinal malabsorption, pancreatitis or nutritional secondary hyperparathyroidism was found. Treatment with oral synthetic vitamin D (1,25 dihydroxycholecalciferol) and intravenous and oral calcium supplements was successful in correcting the hypocalcaemia and abolishing the clinical signs.     

Effects of hyperparathyroidism and dietary calcium supplementation on bone healing.

Effects of nutritional secondary hyperparathyroidism and dietary calcium supplementation on bone healing were determined. Groups (n = 4) of 5 mature male dogs each were fed the following diets: group 1, control diet (0.48% Ca, 0.43% P); group 2, test diet (0.12% Ca, 1.14% P): group 3, control diet plus calcium; group 4, test diet plus calcium. The dietary calcium supplementation was calcium gluconate. Lesions were induced in the right tibial cortex by trephinization. Within the time limitations of this study, it was determined that nutritional secondary hyperparathyroidism does not inhibit bone healing and that dietary calcium supplementation does not aid bone healing.     

Suspected pseudohypoparathyroidism in a domestic ferret

A 1.5-year-old ferret examined because of seizures was found to have low serum calcium, high serum phosphorus, and extremely high serum parathyroid hormone concentrations. Common causes of these abnormalities, including nutritional secondary hyperparathyroidism, chronic renal secondary hyperparathyroidism, tumor lysis syndrome, and hypomagnesemia, were ruled out, and a tentative diagnosis of pseudohypoparathyroidism was made. Pseudohypoparathyroidism is a hereditary condition in people that, to our knowledge, has not been identified in ferrets previously and is caused by a lack of response to high serum parathyroid hormone concentrations, rather than a deficiency of this hormone. The ferret improved after treatment with dihydrotachysterol (a vitamin D analog) and calcium carbonate. It was still doing well after 3.5 years of continued treatment.     

Paresis secondary to an extradural hematoma in a Sumatran tiger (Panthera tigris sumatrae).

A 15-yr-old female Sumatran tiger (Panthera tigris sumatrae) was presented to the Boren Veterinary Medical Teaching Hospital at Oklahoma State University with a 3-wk history of progressive hind limb weakness. Neurologic evaluation was limited to review of videotape that demonstrated weakness and ataxia with conscious proprioceptive deficits of the tiger's pelvic limbs. Spinal radiography demonstrated disc space narrowing, and myelography demonstrated a large extradural compressive lesion at the level of L2-3. Computed tomography did not reveal bone involvement. Surgery was performed to decompress the spinal cord and obtain a definitive diagnosis. A right hemilaminectomy was performed after a dorsal approach to the lumbar spine. Histologic examination of the mass revealed a consolidated extradural spinal hematoma, presumed to be secondary to intervertebral disc herniation. Despite incomplete resection of the mass and plastic deformation of the spinal cord, the tiger returned to normal ambulation within 3 wk of surgical decompression.     

Unusual case of osteopenia associated with nutritional calcium and vitamin D deficiency in an adult dog

A 6-year-old, spayed female rottweiler was presented for facial enlargement from swelling of the maxilla and mandible. The dog was fed a homemade diet deficient in calcium and vitamin D, suggesting that rubber jaw syndrome was a secondary nutritional disorder. Radiographic and tomodensitometric examinations revealed diffuse bone resorption in the skull. The plasma parathormone concentration was high, and serum 25-hydroxycholecalciferol concentration was low. Based on these findings, nutritional calcium and vitamin D deficiency associated with secondary hyperparathyroidism was diagnosed. Dietary correction resulted in clinical and biological improvement, with an increase in skull mineralization.     

Hypocalcemia in a dog

A case of hypocalcemia was presented with a concurrent hyperphosphatemia. Normal renal function tests excluded primary renal insufficiency. The diet was thought to contain a normal ratio of calcium and phosphorus and, therefore, nutritional secondary hyperparathyroidism was not considered. The radiographs showed normal bone density and the dog was not lame. Concentrations of immunoreactive parathyroid hormone were measured in an attempt to classify the etiology. The dog was successfully managed with calcium supplementation and vitamin D(3) or oral calcium alone.     

Primary Hyperparathyroidism Associated With Atypical Headshaking Behavior in a Warmblood Gelding

A 14-year-old Zweibrücker Warmblood gelding was presented for evaluation of lethargy and headshaking. The horse had a history of bouts of lameness in different limbs and back problems. It also had many mild colic episodes in the past. Results of repeat laboratory tests had shown persistent hypercalcemia (4.8 mmol/L; reference interval [RI]: 2.0–3.2 mmol/L) for 1.5 years and later on hypophosphatemia (0.4 mmol/L; RI: 0.5–1.3 mmol/L) and mild hypermagnesemia (1.0 mmol/L; RI: 0.5–0.9 mmol/L). Parathyroid hormone (PTH) concentration was within the RI. Other causes of hypercalcemia, such as renal failure, vitamin D toxicosis, and granulomatous disease, and nutritional secondary hyperparathyroidism were ruled out. Furthermore, there was no evidence of neoplastic disease. Parathyroid hormone–related protein was measured but inconclusive. A diagnosis of primary hyperparathyroidism was established on the basis of hypercalcemia, hypophosphatemia, low fractional excretion of calcium, and high fractional excretion of phosphorus in combination with a PTH secretion refractory to high calcium levels. Because of the bad prognosis, the owner decided to euthanize the horse. Results of postmortem examination were unremarkable. Hypercalcemia should always be considered abnormal, and further examinations need to be performed to proof hypercalcemia and subsequently find the cause. The main differential diagnoses are renal insufficiency and humoral hypercalcemia of malignancy, but also rare diseases, such as hyperparathyroidism, have to be taken into account.     

A RADIOGRAPHIC STUDY ON THE DEVELOPMENT OF THE ANTEBRACHIUM IN GREAT DANE PUPS ON DIFFERENT CALCIUM INTAKES

Radiographic examination of the radius and ulna was performed in three groups of Great Danes fed diets containing high, normal, and low calcium contents from the ages of 7 to 21 weeks. Development and maturation of secondary ossification centers, architecture of the distal ulnar metaphysis, and growth in length of the radius were noted. In the dogs fed a high-calcium diet, there was retardation in the development of the ulnar styloid process, the humeral medial epicondyle, the olecranal apophysis, and the anconeal process. In addition, these dogs developed severe changes over the entire width of the distal ulnar metaphysis, whereas the other groups developed only focal changes. The dogs fed a low-calcium diet developed severe signs of nutritional hyperparathyroidism. It is concluded that the development of the secondary ossification centers and the growth in length of the radius are inversely related to calcium intake.     

Acute and chronic oxalate toxicity in Miniature Horses associated with soursob (Oxalis pes‐caprae) ingestion

Over the period of 11 years (2004–2015) 14 miniature horses in six separate outbreaks presented with clinical signs consistent with acute or chronic oxalate toxicity. All animals had access to Oxalis pes‐caprae or soursob. Miniature horses with acute oxalate toxicity and hypocalcaemia had muscle fasciculations, tremors and synchronous diaphragmatic flutter; these horses responded to treatment with intravenous and oral calcium. Chronic oxalate toxicity was associated with ill‐thrift, stiffness, enlarged heads, kyphosis and neurological signs. These animals had normal serum calcium concentrations, but increased serum alkaline phosphatase activity. Radiographs indicated that affected animals had bones that were osteopenic, often with pathological fractures. Bones that were examined histologically showed increased osteoclastic and osteoblastic activity, consistent with nutritional secondary hyperparathyroidism and fibrous osteodystrophy. These animals were treated, with mixed success, with oral calcium supplementation. A palatability trial showed that horses will readily eat soursobs, and measured total oxalate concentrations in soursobs collected from five different properties ranged from 13.5 to 18.5%. The presentation of affected animals with either acute hypocalcaemia or nutritional secondary hyperparathyroidism, together with a history of grazing soursobs, suggest that acute and chronic oxalate toxicity are the cause of the clinical signs seen in affected miniature horses.     

Computed tomography and magnetic resonance imaging of thoracic chordoma in a Bengal tiger (Panthera tigris tigris)

A Bengal tiger was presented for evaluation of weakness, ataxia and inappetance. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a mass extending from the T7-8 vertebral body to the left rib and compressing the spinal cord. On CT, the bone destruction and sequestrum were shown. On MRI, the multilobulated mass appeared hypo- to isointense in T1-weighted and hyperintense in T2-weighted images. The tiger died after imaging, most likely from renal failure. Chordoma without metastasis was diagnosed on necropsy. The imaging characteristics were similar to those found in chordoma in humans. This report describes the use of CT and MRI in an exotic species.     

Pancreatic acinar cell carcinoma with intracranial metastasis in a dog

This report concerns a case of pancreatic carcinoma with widespread metastases to many organs including intracranial metastasis. An eleven-year-old, male, mixed-breed dog showed emaciation, ataxia, and multiple visible tumors within the neck. A MRI examination of the patient was conducted because of ataxia, and it was found that the intracranial invasive growth had resulted in compression of the brain stem. Necropsy was performed after the patient died. Based on gross and microscopic examination, the primary tumor cells were located in the left lobe of the pancreas and widespread metastasis was found into various organs, including the brain, lungs, liver, kidneys, tonsils, serosal surface of the esophagus, and submandibular, pulmonary hilar, mediastinal, and mesenteric lymph nodes. This case indicates that pancreatic adenocarcinoma should be included in the differential diagnosis list when cervical neck masses are detected.     

人工饲养幼龄东北虎骨软症的诊治报告

某野生动物园饲养的6只4.5月龄东北虎,出现不愿活动、疼痛等症状,严重者后肢突然瘫痪,甚至出现骨折而死亡的现象。通过对临床症状观察、病原检测、血液常规及生化检查和病死虎腿骨的钙磷锌铁含量的测定,确诊为钙磷失调引起的骨软症。经饲喂活鸡、口服葡萄糖酸钙口服液、调整饲料结构等治疗措施,该病得到了控制。     

Ectopic mineralization and nutritional hyperparathyroidism in boars.

The influence of a high phosphorus (1.5%) and high calcium (2.2%) diet on ectopic mineralization in boars was examined over a four month period. The high phosphorus diet caused metastatic mineralization in the left atrial endocardium in 84% of animals and in the pulmonary and diaphragmatic pleura in 21 and 58% of animals, respectively. Mineralization, that apparently commenced as deposits of extraneous calcium and progressed by metastatic deposition, occurred also in the lamina propria mucosae of the respiratory airways and in the lamina muscularis mucosae of fundic stomach. Hyperplasia of osteoclasts and microfractures in costochondral junction, morphological features of activated parathyroid cells and a significant drop in serum phosphorus during the fourth month in boars fed high phosphorus, suggest that nutritional hyperparathyroidism was experimentally induced. No systemic bone disease developed. Feeding a high calcium diet resulted in 20% incidence of discrete lesions in the left atrial endocardium and no pleural involvement. Also, lesions in respiratory airways and fundic stomach were mild. The fact that high phosphorus but not high calcium increased the incidence and extent of ectopic mineralization suggests that hyperparathyroidism under normocalcemic conditions might be involved in the pathogenesis of these lesions.     

Blastomycosis in nondomestic felids.

Blastomycosis was diagnosed in six nondomestic felids from eastern Tennessee, including two Asian lions (Panthera leo persicus), one African lion (Panthera leo), one Siberian tiger (Panthera tigris), one cheetah (Acinonyx jubatus), and one snow leopard (Panthera uncia). Clinical signs included lethargy, anorexia, weight loss, dyspnea, sneezing. ataxia, and paresis. Variable nonspecific changes included leukocytosis, monocytosis, moderate left shift of neutrophils, moderate hypercalcemia, hyperproteinemia, and hyperglobulinemia. Thoracic radiographs revealed interstitial and alveolar changes, consolidation or collapse of a lung lobe, bullae formation, and a pulmonary mass. Agar gel immunodiffusion (AGID) serology for Blastomyces dermatitidis was performed in five felids and was positive in three. The tiger had cerebral blastomycosis and was positive for AGID serologic tests of both cerebrospinal fluid and serum. One percutaneous lung aspirate in the snow leopard and one bronchial aspirate in an Asian lion demonstrated B. dermatitidis organisms. whereas tracheal wash samples and a nasal discharge were nondiagnostic in others. Treatment with itraconazole was attempted in four cats. The tiger improved before euthanasia, whereas the others did not survive beyond initial treatments. In four felids, B. dermatitidis was found in the lungs and tracheobronchial lymph nodes associated with a florid pyogranulomatous reaction; the tiger had a pyogranulomatous encephalomyelitis, and the cheetah had a single pulmonary granuloma. Thoracic radiography, cytologic examination of lung lesion aspirates, and B. dermatitidis AGID serology should be performed on clinically ill zoo felids in endemic areas to rule out blastomycosis.     

Chordoma of the thoracic vertebrae in a Bengal tiger (Panthera tigris tigris)

A 19-year-old female Bengal tiger (Panthera tigris tigris) was presented with hind limb weakness, ataxia and respiratory distress. Computed tomography revealed a mass between the left side of the T7 vertebra and the base of the left 7th rib. The tiger then died, and necropsy was performed. Grossly, the vertebral mass was 6 × 5.7 × 3 cm, and invaded the adjacent vertebral bone and compressed the T7 spinal cord. Histologically, the mass was composed of large, clear, vacuolated and polygonal cells with osteochondral matrix. Cellular and nuclear atypia were moderate. The vacuolated cells stained positively for cytokeratin and vimentin and negatively for S-100. Based on these findings, the present case was diagnosed as a vertebral chordoma; the first report in a tiger.     

Calcium urolithiasis in two dogs with parathyroid adenomas

Primary hyperparathyroidism resulted in calcium urolith formation and calcium nephropathy in 2 dogs. Uroliths composed of calcium phosphate were surgically removed from the bladder of one dog 3 months after surgical removal of a parathyroid adenoma. Five years later, hypercalcemia and urolithiasis had not recurred. In a second dog, calcium oxalate renal and bladder uroliths remained unchanged in size at 11 months after removal of a parathyroid adenoma. The possibility of primary hyperparathyroidism should be considered in any dog with calcium urolithiasis.     

Hypocalcaemia associated with low serum vitamin D metabolite concentrations in two dogs with protein-losing enteropathies

Protein-losing enteropathies were diagnosed in two dogs that were initially presented with diarrhoea and weight loss. Plasma biochemistry in both cases revealed low concentrations of albumin, calcium and ionised calcium. Both dogs had an elevated plasma parathyroid hormone concentration and low serum 25-hydroxyvitamin D (25[OH]D) concentration. The first dog was diagnosed with lymphangiectasia on postmortem examination, and the second dog was diagnosed with chronic lymphocytic/ plasmacytic enteritis and severe cystic mucoid changes based on endoscopic duodenal biopsies. While a causal effect was not demonstrated, the protein-losing enteropathies may have caused reduced intestinal absorption of vitamin D leading to low plasma concentrations of ionised calcium and secondary hyperparathyroidism. To the authors' knowledge, this is the first report of low ionised calcium concentrations, low 25(OH)D and 1,25-dihydroxyvitamin D concentrations, and high parathyroid hormone concentrations in dogs with protein-losing enteropathies.     

Pretreatment clinical and laboratory findings in dogs with primary hyperparathyroidism: 210 cases (1987-2004)

OBJECTIVE: To evaluate pretreatment clinical and laboratory findings in dogs with naturally occurring primary hyperparathyroidism. DESIGN: Retrospective study. ANIMALS: 210 dogs with primary hyperparathyroidism and 200 randomly selected, age-matched control dogs that did not have primary hyperparathyroidism. PROCEDURE: Medical records for dogs with primary hyperparathyroidism were reviewed for signalment; clinical features; and results of clinicopathologic testing, serum parathyroid hormone assays, and diagnostic imaging. RESULTS: Mean age of the dogs with primary hyperparathyroidism was 11.2 years (range, 6 to 17 years). The most common clinical signs were attributable to urolithiasis or urinary tract infection (ie, straining to urinate, increased frequency of urination, and hematuria). Most dogs (149 [71%]) did not have any observable abnormalities on physical examination. All dogs had hypercalcemia, and most (136 [65%]) had hypophosphatemia. Overall, 200 of the 210 (95%) dogs had BUN and serum creatinine concentrations within or less than the reference range, and serum parathyroid hormone concentration was within reference limits in 135 of 185 (73%) dogs in which it was measured. Urolithiasis was identified in 65 (31 %) dogs, and urinary tract infection was diagnosed in 61 (29%). Mean serum total calcium concentration for the control dogs-was significantly lower than mean concentration for the dogs with primary hyperparathyroidism, but mean BUN and serum creatinine concentrations for the control dogs were both significantly higher than concentrations for the dogs with primary hyperparathyroidism. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that urolithiasis and urinary tract infection may be associated with hypercalcemia in dogs-with primary hyperparathyroidism, but that development of renal insufficiency is uncommon.     

Rickets in growing pigs and response to treatment

The clinical, radiological and pathological findings in a natural outbreak of rickets affecting 82 pigs are described. An interesting feature was the presence of gross articular abnormalities including resorption of subchondral bone with folding and ulceration of the articular cartilage. The diet was deficient in calcium and vitamin D. A diagnosis of rickets complicated by nutritional secondary hyperparathyroidism was made. The results of treatment and the economics of the outbreak are discussed.     

Barbiturate ingestion in three adult captive tigers (Panthera tigris) and concomitant fatal botulism of one

Zoo animals, including tigers, have been reported to suffer from barbiturate intoxication, with pentabarbitone being most commonly recorded. Clinical signs range from mild ataxia to general anaesthesia with recovery over hours to days with several factors affecting hepatic barbiturate metabolism and tissue partitioning. Botulism is an often fatal intoxication in man, animals, birds and certain fish. The occurrence in carnivores is uncommon to rare, with only 2 reports found of botulism in felids. This report relates to 3 adult captive cohabiting tigers that simultaneously developed signs of abdominal discomfort, progressive ataxia, recumbency and comatose sleep resembling stage 2 anaesthesia, alternating with periods of distracted wakefulness and ataxic movements. These signs occurred 4 days after being fed the carcass of a horse that had ostensibly died of colic and not been euthanased. The male tiger that was the dominant animal in the feeding hierarchy was worst affected and had to be given intravenous fluids. The female that was lowest in hierarchy was unaffected. After 48-72 hours of treatment at the Onderstepoort Veterinary Academic Hospital the females could eat and made an uneventful recovery. The male tiger showed partial recovery but died during the night a few hours after drinking water on his return to the owner. Necropsy revealed severe oesophageal dilation and impaction with decaying grass; some of this material and water were present in the pharynx and trachea, and had been aspirated causing acute widespread bronchopneumonia. Colon content tested negative for common pesticides but, together with liver, tested positive for barbiturate. Serum taken on the day of admission had tested negative for barbiturate and the residual serum from the 3 animals later tested negative for botulinum toxin. Colon and oesophageal content from the male at necropsy were positive for Clostridium botulinum toxin type C by the mouse bioassay neutralisation test, confirming that this male had had concomitant barbiturate toxicity and botulism, and had succumbed to aspiration bronchopneumonia secondary to pharyngeal, laryngeal and oesophageal paralysis and oesophageal