Hypercalcemia

TL;DR. Hipercalcemia ialah tahap kalsium darah yang berbahaya tinggi yang boleh merosakkan buah pinggang, jantung dan sistem saraf tanpa rawatan.

Hipercalcemia menjejaskan anjing dan kucing dan memerlukan diagnosis awal.

Apakah itu?

Kalsium mengawal saraf, otot (termasuk jantung), pembekuan dan tulang. Lebihan dipanggil hipercalcemia dan sering tanda penyakit asas. Risiko buah pinggang dan saraf.

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

Punca dan faktor risiko

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

Tanda

Polidipsia/poliuria, dehidrasi, anoreksia, letargi, muntah; kadang sembelit, gegaran, aritmia; jarang sawan.

Lebih dahaga dan air kencing ialah 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 terion [EMAS], kalsium total, PTH/PTHrP, air kencing dan fungsi buah pinggang.

"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 terion ialah ujian rujukan.

Rawatan

Punca plus sokongan jika tanda teruk 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 selepas hidrasi; Glucocorticoids; teruk: Calcitonin Salmon.

Prognosis

Bergantung pada punca. Paratiroid jinak dibedah: sering cemerlang. Kanser agresif: berwaspada.

Pencegahan

Elak toksin vitamin D; ujian darah pada baka berisiko.

Bila hubungi doktor haiwan

Lebih dahaga/air kencing: temujanji. Kecemasan: sawan, kelemahan melampau, muntah tidak terkawal, bradikardia, rebah.

Untuk baka tertentu

Keeshond: hiperparatiroidisme primer keturunan. 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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