Veterinary Medicine - July 2008 - (Page 392) CE PEER-REVIEWED Guidelines for evaluating hypercalcemic cats Cats with hypercalcemia exhibit clinical signs less frequently than dogs do. However, with this article’s helpful mnemonics for recalling the causes of feline hypercalcemia and a diagnostic algorithm, you will be prepared to provide the best care for your feline patients. Audrey K. Cook, BVM&S, MRCVS, DACVIM, DECVIM-CA C alcium plays an essential role in numerous biochemical pathways, and adequate amounts are required for optimal cell growth, neuromuscular function, blood coagulation, and cell membrane stability. Consequently, the serum concentration of ionized (active) calcium is tightly controlled through complex interplay among parathyroid hormone (PTH), calcitonin, and vitamin D metabolites. In healthy individuals, calcium absorption from the intestinal tract, calcium release from bone, and calcium conservation or excretion by the kidneys are all carefully regulated to optimize ionized calcium (iCa) concentrations. Hypercalcemia is a fairly uncommon disorder in cats, but it can cause substantial patient morbidity and is associated with serious medical disorders such as neoplasia and renal failure.1 In this article, I review the de nition of hypercalcemia and the steps to take when clinically evaluating a hypercalcemic cat. DEFINING AND CONFIRMING HYPERCALCEMIA Circulating calcium exists in three distinct forms: bound to serum proteins (40%); complexed with citrate, phosphate, and other anions (8%); or ionized (52%).2 The ionized fraction is the biologically active form, and an elevated iCa concentration de nes true hypercalcemia. The calcium reported on standard serum chemistry pro les is a total calcium value (tCa; i.e. bound, complexed, and ionized), so changes in acidbase status and serum protein concentrations frequently affect this result. In dogs, the effect of serum proteins may be mitigated by calculating the corrected or adjusted total calcium value. This formula has not been validated in cats and should not be used.3 Instead, measure serum iCa concentrations in cats Audrey K. Cook, BVM&S, MRCVS, DACVIM, DECVIM-CA Department of Small Animal Clinical Sciences College of Veterinary Medicine Texas A&M University College Station, TX 77843 392 July 2008 VETERINARY MEDICINE Illustration by Paul Petersen
Table of Contents Feed for the Digital Edition of Veterinary Medicine - July 2008 Veterinary Medicine - July 2008 Contents Leading Off Practical Matters Idea Exchange Clarification Dental Corner The Diagnostic Approach to Hematuria Guidelines for Evaluating Hypercalcemic Cats CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller Veterinary Medicine - July 2008 Veterinary Medicine - July 2008 - Veterinary Medicine - July 2008 (Page Cover1) Veterinary Medicine - July 2008 - Veterinary Medicine - July 2008 (Page Cover2) Veterinary Medicine - July 2008 - Veterinary Medicine - July 2008 (Page 347) Veterinary Medicine - July 2008 - Veterinary Medicine - July 2008 (Page 348) Veterinary Medicine - July 2008 - Contents (Page 349) Veterinary Medicine - July 2008 - Contents (Page 350) Veterinary Medicine - July 2008 - Contents (Page 351) Veterinary Medicine - July 2008 - Contents (Page 352) Veterinary Medicine - July 2008 - Contents (Page 353) Veterinary Medicine - July 2008 - Contents (Page 354) Veterinary Medicine - July 2008 - Contents (Page 355) Veterinary Medicine - July 2008 - Leading Off (Page 356) Veterinary Medicine - July 2008 - Leading Off (Page 357) Veterinary Medicine - July 2008 - Practical Matters (Page 358) Veterinary Medicine - July 2008 - Practical Matters (Page 359) Veterinary Medicine - July 2008 - Practical Matters (Page 360) Veterinary Medicine - July 2008 - Practical Matters (Page 361) Veterinary Medicine - July 2008 - Clarification (Page 362) Veterinary Medicine - July 2008 - Clarification (Page I1) Veterinary Medicine - July 2008 - Clarification (Page I2) Veterinary Medicine - July 2008 - Clarification (Page I3) Veterinary Medicine - July 2008 - Clarification (Page I4) Veterinary Medicine - July 2008 - Dental Corner (Page 363) Veterinary Medicine - July 2008 - Dental Corner (Page 364) Veterinary Medicine - July 2008 - Dental Corner (Page 365) Veterinary Medicine - July 2008 - Dental Corner (Page 366) Veterinary Medicine - July 2008 - Dental Corner (Page 367) Veterinary Medicine - July 2008 - Dental Corner (Page 368) Veterinary Medicine - July 2008 - Dental Corner (Page 369) Veterinary Medicine - July 2008 - Dental Corner (Page 370) Veterinary Medicine - July 2008 - Dental Corner (Page 371) Veterinary Medicine - July 2008 - Dental Corner (Page 372) Veterinary Medicine - July 2008 - Dental Corner (Page 373) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 374) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 375) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 376) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 377) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 378) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page V1) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page V2) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page V3) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page V4) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page V5) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page V6) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page V7) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page V8) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 379) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 380) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 381) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 382) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 383) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 384) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 385) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 386) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 387) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 388) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 389) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 390) Veterinary Medicine - July 2008 - The Diagnostic Approach to Hematuria (Page 391) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 392) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 393) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 394) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 395) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 396) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 397) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 398) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 399) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 400) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 401) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 402) Veterinary Medicine - July 2008 - Guidelines for Evaluating Hypercalcemic Cats (Page 403) Veterinary Medicine - July 2008 - Advertiser Index (Page 404) Veterinary Medicine - July 2008 - Marketplace/Classifieds (Page 405) Veterinary Medicine - July 2008 - Marketplace/Classifieds (Page 406) Veterinary Medicine - July 2008 - Marketplace/Classifieds (Page 407) Veterinary Medicine - July 2008 - Marketplace/Classifieds (Page 408) Veterinary Medicine - July 2008 - Marketplace/Classifieds (Page 409) Veterinary Medicine - July 2008 - Mind Over Miller (Page 410) Veterinary Medicine - July 2008 - Mind Over Miller (Page Cover3) Veterinary Medicine - July 2008 - Mind Over Miller (Page Cover4)
For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.