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33 Cards in this Set
- Front
- Back
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Four common causes of hypercalcemia
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LSA
Addisons Primary hyperparathyroid CRF |
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What are 3 more uncommon causes of hypercalcemia
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apocrine gland carcinoma
multiple myeloma vitamin D toxicosis |
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What cells produce PTH?
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Chief cells
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The cuase of excessive PTH is usually a (type of tumor)
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solitary parathyroid adenoma
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How dose parathyroid hormone related protein cause hypercalcemia?
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secretion of parathyroid hormone related protein activates osteoclasts and PTH is suppressed
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How do animals get PU secondary to hypercalcemia?
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Hypercalceia interfers with the renal mechanisms for reabsroption of sodium and cannot respond to ADH
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What is seen on Chemistries for classical primary hyperparthyroidism
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hypercalcemia
hypophosphatemia hyperphostaturia |
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List the caners that commonly cause hypercalcemia (4):
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apocrine gland carcinoma of anal glands
mammary gland adenocarcinoma vaginal sarcoma multiple myeloma |
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What type of calcium is the biologically active component? What serves as the storage pool for the active component?
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ionized (free calcium)
protein bound |
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The formula for corrected calcium
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= total calcium - albumin +3.5
Dosent' work in cats |
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Inital TX for hypercalcemia (while hospitilized)
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TX underlying cause
IV fluids - 0.9% NaCL furosemide sodium bicarb glucocorticoids - only when neoplasia R/O |
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Pathophysiology of phospherous during hyperparathyroidsim
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PTH induced inhibition of phospherous from kidneys resulting in excessive loss.
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If see hypophysphatemia - what are two DDX
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primary hyperparathyroidism
hypercalcemia of malignancy |
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How dose saline help with high calcium
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competes with Ca in kidneys and cuases it to be excreted
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How dose furosemide help with hypercalcemia?
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inhibits calcium absoption from the loop of Henle
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How do glucocorticoids help with hypercalcemia (3)?
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Reducing bone resorption of caldium
decreasing intestinal absorption increasing renal clerance |
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What is the mechanism on how CRF causes hypercalcemia?
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high phosperous -> low iCa -> decrease calcitriol from kidneys-> lower Ca -> stimulate PTH production
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What is calcitriol?
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hormone produced by kidneys
calcium to be absorbed by: intestines & kidneys |
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For SX correction, what mg/dL would be high risk for post-op hypocalcemia?
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15 mg/dL
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What levels should post op calcium be around?
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8-9.5 m/gL
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How soon after hyperparathyroidism SX can hypocalcemia occur?
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12 hours
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If Calcium is above 15 mg/dL prior to SX correction of hyperparathyroidism, what TX should be started?
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Vit D +/- calcium therapy prior to SX
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What is the DDx for hypercalcemia in cats?
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ideopathic
Neoplastic - LSA, SCC CRF Addisons PHPTH |
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Is a cat's parathyroid mass palpable? Dogs?
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yes
no |
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What happens in the body to increase Ca if the parathyroid stops working
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mobilization of Ca and P from bone
renal retention of Ca and excretion of P absorbing Ca from intestine |
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Nervous system becomes_ with low calcium
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excitable
increases membrane permability |
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What calcium levels cause tetany?
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6.5 mg/dL
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C/S with hypoparathyroidism
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"always tense"
rubbing/pawing at face focal muscle twitching generalized tremmors |
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Diagnosis of primary hypoparathyroidism
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undetectable PTH
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Emergency TX for hypocalcemia
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calcium gluconate 10% over 10-30 min
Monitor ECG |
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Once emergency tetany has been controlled, what maintenance TX can e used?
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calcium gluconate SQ
oral vitamin D |
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Maintenance at home TX for hypocalcemia?
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Vit D therapy (dihydrotachysterol)
oral calcium - calcium carbonate |
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Cause of hypoparathyroidism?
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ideopathic
immune medicated cats -itatrogenic - thyroid SX |
