Treating paraneoplastic hypercalcemia in dogs and cats - Veterinary Medicine
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Treating paraneoplastic hypercalcemia in dogs and cats
Various tumor-related factors may lead to elevated calcium concentrations that can greatly contribute to a cancer patient's morbidity. Here's how to help alleviate the suffering associated with this common paraneoplastic syndrome.


Other diagnostic tests may be needed to confirm a diagnosis of mediastinal lymphoma, such as thoracic ultrasonography with fine-needle aspiration or Tru-Cut biopsies of the suspect mass. Cytologic or histologic confirmation may differentiate lymphoma from thymoma, another tumor occasionally associated with paraneoplastic hypercalcemia in dogs and cats (Figures F & G). Abdominal radiography, abdominal ultrasonography, and bone marrow aspiration and cytology are recommended in cases of hypercalcemia of unknown origin and suspected lymphoid tumors. Humoral hypercalcemia of malignancy with normal PTHrP concentrations may be identified in some lymphoma cases and may occur because PTHrP can be sporadically released by the tumor or because some lymphoma cells possess 1 alpha-hydroxylase activities that lead to a syndrome of dysregulated 1,25-dihydroxycholecalciferol (calcitriol) formation, although this mechanism of paraneoplastic hypercalcemia has been rarely reported in companion animals.9,15-19


1. Barthez PY, Davis CR, Pool RR, et al. Multiple metaphyseal involvement of a thymic lymphoma associated with hypercalcemia in a puppy. J Am Anim Hosp Assoc 1995;31:82-85.

2. Wilkerson MJ, Dolce K, Koopman T, et al. Lineage differentiation of canine lymphoma/leukemias and aberrant expression of CD molecules. Vet Immunol Immunopathol 2005;106:179-196.

3. Garrett LD, Thamm DH, Chun R, et al. Evaluation of a 6-month chemotherapy protocol with no maintenance therapy for dogs with lymphoma. J Vet Intern Med 2002;16:704-709.

4. Chun R, Garrett LD, Vail DM. Evaluation of a high-dose chemotherapy protocol with no maintenance therapy for dogs with lymphoma. J Vet Intern Med 2000;14:120-124.

5. Greenlee PG, Filippa DA, Quimby FW, et al. Lymphomas in dogs. A morphologic, immunologic, and clinical study. Cancer 1990;66:480-490.

6. Sarmiento UM, Valli VE. Lymphocyte 5'-nucleotidase activities in normal dogs and in dogs with malignant lymphoma. Vet Immunol Immunopathol 1986;13:281-288.

7. Ruslander DA, Gebhard DH, Tompkins MB, et al. Immunophenotypic characterization of canine lymphoproliferative disorders. In Vivo 1997;11:169-172.

8. Weir EC, Norrdin RW, Matus RE, et al. Humoral hypercalcemia of malignancy in canine lymphosarcoma. Endocrinology 1988;122;602-608.

9. Rosol TJ, Nagode LA, Couto CG, et al. Parathyroid hormone (PTH)-related protein, PTH, and 1,25-dihydroxyvitamin D in dogs with cancer-associated hypercalcemia. Endocrinology 1992;131:1157-1164.

10. Clines GA, Guise TA. Hypercalcaemia of malignancy and basic research on mechanisms responsible for osteolytic and osteoblastic metastasis to bone. Endocr Relat Cancer 2005;12:549-583.

11. Schenck PA, Chew DJ, Nagode LA, et al. Disorders of calcium: hypercalcemia and hypocalcemia. In: DiBartola S, ed. Fluid, electrolyte, and acid-base disorders in small animal practice. 3rd Ed. St. Louis, Mo: Elsevier, 2006;122-194.

12. Feldman EC, Nelson RW. Canine and feline endocrinology and reproduction. 3rd ed. St. Louis, Mo: Saunders, 2004;660-715.

13. Fournel-Fleury C, Ponce F, Felman P, et al. Canine T-cell lymphomas: a morphological, immunological, and clinical study of 46 new cases. Vet Pathol 2002;39:92-109.

14. Grone A, Werkmeister JR, Steinmeyer CL, et al. Parathyroid hormone-related protein in normal and neoplastic canine tissues: immunohistochemical localization and biochemical extraction. Vet Pathol 1994;31:308-315.


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