Primary Hyperparathyroidism Associated With Atypical Headshaking Behavior in a Warmblood Gelding |
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| Institution: | 1. Pferdeinternist Dr. Bianca C. Schwarz, DipECEIM, Saarlouis, Germany;2. Department of Pathobiology, Institute of Pathology, University of Veterinary Medicine, Vienna, Austria;3. Clinical Pathology Platform, Department for Pathobiology, University of Veterinary Medicine, Vienna, Austria;1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA;2. Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA;1. School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia;2. Australian Infectious Diseases Research Centre, University of Queensland, St. Lucia, Queensland, Australia;1. Middleburg Agricultural Research and Extension Center, Middleburg, VA 20117, USA;2. Department of Animal and Poultry Sciences, Virginia Tech, Blacksburg, VA 24061, USA;3. Department of Biomedical Sciences and Pathobiology, Virginia Tech, Blacksburg, VA 24061, USA;4. Marion duPont Scott Equine Medical Center, Virginia Tech, Leesburg, VA 20177, USA;1. Neuroradiology Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland;2. Clinique Vétérinaire de la côte fleurie, Deauville, France;3. Neurology Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland;4. Haras de la haie neuve, Mondevert, France;5. Clinique Equine de la Boisrie, Chailloué, France;1. Department of Animal Sciences, University of Florida, Gainesville, FL;2. Large Animal Clinical Sciences, University of Florida, Gainesville, FL |
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| Abstract: | 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. |
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| Keywords: | Horse Headshaking Calcium Hypercalcemia Parathyroid hormone |
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