PROGNOSIS
The prognosis for naturally occurring primary hypoparathyroidism depends on the dedication of the owner to manage the patient
and the vigilance of the veterinarian to monitor the patient's status.1,3 In uncomplicated cases with appropriate care, the prognosis can be excellent.1,3 Normal life expectancy is reported by some authors.1,3 Others state that quality and length of life have yet to be determined.2
Conclusion
Owner awareness is essential for early detection of the clinical signs of both hypocalcemia and hypercalcemia. Patients with
primary hypoparathyroidism present with clinical signs consistent with hypocalcemia that are indistinguishable from other
causes of hypocalcemia. The most common presenting complaints are tetany, seizures, and behavioral changes. Evaluation of
a complete biochemical profile and serum pth concentration in combination with a serum ionized calcium concentration is essential
to confirm the diagnosis of primary hypoparathyroidism.
Initial treatment consists of intravenous calcium salts. After initial stabilization, the patient may be transitioned to an
oral vitamin D analogue, which will need to be administered for the rest of its life, and oral calcium supplementation, at
least temporarily. Regularly measuring total serum calcium concentration and monitoring the patient for clinical signs of
hypocalcemia or hypercalcemia are paramount. The frequency of these evaluations will decrease from weekly to monthly, or less,
as the patient's condition stabilizes. With the proper care, primary hypoparathyroidism has a good to excellent prognosis.
Beth L. McElravy, DVM
Jill D. Brunker, DVM, DACVIM
Department of Small Animal Internal Medicine
College of Veterinary Medicine
Oklahoma State University
Stillwater, OK 74078
REFERENCES
1. Feldman EC, Nelson RW. Hypocalcemia and primary hypoparathyroidism. In: Canine and feline endocrinology and reproduction. 3rd ed. Philadelphia, Pa: Elsevier Science, 2004;716-742.
2. Chew DJ, Nagode LA. Treatment of hypoparathyroidism. In: Bonagura JD, ed. Kirk's current veterinary therapy XIII small animal practice. Philadelphia, Pa: WB Saunders Co, 2000;340-345.
3. Feldman EC. Disorders of the parathyroid glands. In: Ettinger SJ, Feldman EC, eds. Textbook of veterinary internal medicine: diseases of the dog and cat. 6th ed. St. Louis, Mo: Elsevier Saunders, 2005;1508-1535.
4. Bruyette DS, Feldman EC. Primary hypoparathyroidism in the dog. J Vet Intern Med 1988;2:7-14.
5. Bassett JR. Hypocalcemia and hyperphosphatemia due to primary hypoparathyroidism in a six-month-old kitten. J Am Anim Hosp Assoc 1998;34:503-507.
6. Waters CB, Scott-Moncrieff JCR. Hypocalcemia in cats. Compend Cont Educ Vet Pract 1992;14:497-507.
7. Torrance AG, Nachreiner R. Intact parathyroid hormone assay and total calcium concentration in the diagnosis of disorders
of calcium metabolism in dogs. J Vet Intern Med 1989;3:86-89.
8. Barber PJ. Disorders of the parathyroid glands. J Feline Med Surg 2004;6:259-269.
9. Sherding RG, Meuten DJ, Chew DJ, et al. Primary hypoparathyroidism in the dog. J Am Vet Med Assoc 1980;176:439-444.
10. Dhupa N, Proulx J. Hypocalcemia and hypomagnesemia. Vet Clin North Am Small Anim Pract 1998;28:587-608.
11. Greco DS. Endocrine emergencies. Part II. Adrenal, thyroid, and parathyroid disorders. Compend Cont Educ Vet Pract 1997;19:27-39.
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