Hypercalcemia

TL;DR. Hipercalcemia adalah kadar kalsium darah yang berbahaya tinggi yang tanpa pengobatan dapat merusak ginjal, jantung, dan sistem saraf.

Hipercalcemia memengaruhi anjing dan kucing dan membutuhkan diagnosis dini.

Apa itu?

Kalsium mengatur saraf, otot (termasuk jantung), pembekuan, dan tulang. Kelebihan disebut hipercalcemia dan sering menandai penyakit dasar. Risiko ginjal dan saraf.

"The consequences of hypercalcemia can be severe and affect multiple body systems including the central nervous syst"

Penyebab dan faktor risiko

Neoplasma (limfoma, adenokarsinoma kantung anal), hiperparatiroidisme primer, penyakit ginjal, toksisitas vitamin D, Addison, idiopatik pada kucing. Risiko: Keeshond, Siamese cats.

Tanda

Polidipsia/poliuria, dehidrasi, anoreksia, letargi, muntah; kadang konstipasi, tremor, aritmia; jarang kejang.

Haus dan urine meningkat adalah tanda awal klasik.

"Bradycardia may be detected on physical examination, and electrocardiographic (ECG) monitoring may reveal a prolonged PR interval, widened QRS complex, shortened QT interval, shortened or absent ST segment, and a widened T wave. Bradyarrhythmias may progress to complete heart block, asystole, and cardiac arrest in severely affected animals."

Diagnosis

Kalsium terionisasi [EMAS], kalsium total, PTH/PTHrP, urine dan fungsi ginjal.

"Prolonged hypercalcemia, especially in conjunction with concurrent high-normal to increased serum phosphorus concentration, can also cause nephrocalcinosis and exacerbate renal insufficiency and azotemia. Determining whether the renal failure is primary or secondary in a dog with hypercalcemia, hyperphosphatemia, and azotemia poses an interesting diagnostic challenge..."

Kalsium terionisasi adalah standar emas.

Pengobatan

Penyebab plus dukungan jika tanda berat atau nilai sangat tinggi.

"Medical therapy should be directed at eradicating the underlying cause of the hypercalcemia. Supportive therapy to decrease the serum calcium concentration to less toxic levels is indicated if clinical signs are severe, if serum calcium concentration is greater than 17 mg/dL (dog) or 16 mg/dL (cat), if serum ionized calcium is greater than 1. 8 mmol/L (dog) or 1. 7 mmol/L (cat)..."

Sodium Chloride IV; Furosemide setelah hidrasi; Glucocorticoids; berat: Calcitonin Salmon.

Prognosis

Tergantung penyebab. Paratiroid jinak dioperasi: sering sangat baik. Kanker agresif: waspada.

Pencegahan

Hindari toksin vitamin D; tes darah pada ras berisiko.

Kapan menghubungi dokter hewan

Lebih haus/urine: kunjungan. Darurat: kejang, kelemahan ekstrem, muntah tak terkendali, bradikardia, kolaps.

Untuk ras tertentu

Keeshond: hiperparatiroidisme primer herediter. Siamese: risiko hipercalcemia lebih tinggi.

Sumber

• Small Animal Critical Care Medicine, 2nd Edition, pages 313, 314.
• Internal Medicine, 5th Edition, pages 920, 922.

My highlights & notes

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