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Abstract Background Hypocalcemia is a relatively common complication after parathyroidectomy for treatment of primary hyperparathyroidism. Objectives To retrospectively evaluate clinical variables in dogs with primary hyperparathyroidism to determine whether or not an association exists between pre-surgical variables and the development of post-surgical hypocalcemia. Animals One hundred three dogs diagnosed with primary hyperparathyroidism and treated by parathyroidectomy in seven referral hospitals between 2010 and 2021. Material and Methods Data collected from medical records included signalment, physical examination findings, concurrent illnesses, ongoing medications, and clinicopathologic test results (including serum ALP activity, iCa, plasma phosphate and PTH concentrations). Dogs were assigned into groups based on lowest iCa post-surgery: Group1 ≥ 1.1 mmol/L, Group2 < 1.1 mmol/L. The Mann–Whitney U test assessed associations between several variables of interest and the occurrence of post-surgery hypocalcemia. ROC analyses were performed to identify variables that had the potential to predict the development of hypocalcemia after surgery. Results The median plasma PTH concentration pre-surgery in dogs which developed hypocalcemia after surgery was significantly higher (232 pg/mL {[IQR] 108–421}) than in dogs which did not develop hypocalcemia after surgery (81.5 pg/mL {IQR 58.5–145.0}; p < 0.001). Plasma PTH concentration had a fair to good ability to predict the development of post-surgery hypocalcemia, with AUC being 0.78 [95% confidence interval 0.67–0.89]. Using a cut-off of ≥ 75 pg/mL, pre-surgery plasma PTH concentration had a sensitivity of 96.6% and specificity of 42.3% for the development of post-surgery hypocalcemia. Dogs that developed hypocalcemia after surgery were older and had lower body weights. Conclusion Pre-surgery plasma PTH concentrations might be helpful in predicting those dogs at risk of developing hypocalcemia after parathyroidectomy.

Abstract Background Development of hypocalcemia after treatment of hyperparathyroidism results in increased costs and risk of poorer outcomes. Previous studies have shown conflicting data about predictors of hypocalcemia after these procedures. Hypothesis/Objectives The objective of this study was to investigate whether ionized calcium (iCa) concentrations before treatment are predictive of hypocalcemia or its clinical signs after surgical removal or heat ablation in dogs with primary hyperparathyroidism. Animals Fifty-four dogs with primary hyperparathyroidism (29 female, 25 male; 49 retrospective, 5 prospective). Methods Dogs were enrolled if they met the inclusion criteria: persistent hypercalcemia (iCa >1.41 mmol/L) due to primary hyperparathyroidism and absence of preemptive calcitriol treatment. All dogs were treated with parathyroidectomy (n = 37) or percutaneous ultrasound-guided heat ablation (n = 17). After treatment, iCa was monitored twice daily until plateau or intervention. Results There was a moderate correlation between before-treatment hypercalcemia and after-treatment hypocalcemia. The prospective study was terminated due to ethical concerns given findings in the retrospective section. All dogs were placed into groups according to their pretreatment iCa: 1.46–1.61 mmol/L, 1.62–1.71 mmol/L, iCa 1.72–1.81 mmol/L, or >1.81 mmol/L. After treatment, the mean lowest iCa for each group, respectively, was 1.19, 1.18, 1.13, and 1.01 mmol/L. There was a significant association between higher group and proportion of dogs with iCa <1.00 mmol/L (P = .014). Conclusions and Clinical Importance This study demonstrates a moderate correlation between iCa concentration before treatment and hypocalcemia after treatment. Dogs with higher initial iCa concentrations should be treated to prevent rapid decline and development of clinical hypocalcemia.

This report describes a canine case of severe hypocalcaemia following the surgical removal of a thyroid lobe and the ipsilateral parathyroid glands for thyroid carcinoma. After initial stabilisation with intravenous calcium gluconate, the dog was initially managed with a commercial diet, and subsequently with a homemade diet, which provided 3.72 and 3.30 g/1,000 kcal ME of calcium, 376 and 295 IU of vitamin D3, and 2.48 and 1.50 g/1,000 kcal metabolisable energy (ME) of phosphorus, respectively. Both nutritional plans were supplemented with calcium carbonate (200 mg/day) and calcitriol (9.84 IU/day) to maintain normocalcaemia. A tailored, homemade diet was formulated to address the onset of hyporexia. The patient maintained stable serum calcium, phosphorus, and total 25(OH) vitamin D concentrations over a mid-term follow-up period of 6 months.

Hypoparathyroidism is a relatively rare human and veterinary disease characterized by deficient or absent production of parathyroid hormone (PTH). PTH is known as a classical regulator of calcium and phosphorus homeostasis. Nevertheless, the hormone also appears to modulate immune functions. For example, increased CD4:CD8 T-cell ratios and elevated interleukin (IL)-6 and IL-17A levels were observed in patients with hyperparathyroidism, whereas gene expression of tumor necrosis factor-α (TNF-α) and granulocyte macrophage-colony stimulating factor (GM-CSF) was decreased in patients with chronic postsurgical hypoparathyroidism. Various immune cell populations are affected differently. So, there is a need for validated animal models for the further characterization of this disease for identifying targeted immune-modulatory therapies. In addition to genetically modified mouse models of hypoparathyroidism, there are surgical rodent models. Parathyroidectomy (PTX) can be well performed in rats—for pharmacological and associated osteoimmunological research and bone mechanical studies, a large animal model could be preferable, however. A major drawback for successfully performing total PTX in large animal species (pigs and sheep) is the presence of accessory glands, thus demanding to develop new approaches for real-time detection of all parathyroid tissues.