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.


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A. A 10-year-old intact female American bulldog presenting with pronounced peripheral lymphadenopathy, eventually diagnosed as diffuse large T-cell lymphoma on histologic examination. Markedly enlarged superficial cervical (prescapular) and mandibular lymph nodes are easily visible.

B & C. Lateral and ventrodorsal thoracic radiographs of a 6-year-old spayed female boxer presenting with dyspnea, polyuria, and polydipsia. Severe hypercalcemia (20.4 mg/dl) and azotemia were noted on the serum chemistry profile. Note the pleural effusion and a large soft tissue opacity in the cranial mediastinum displacing the lungs caudodorsally.

D & E. Lateral and ventrodorsal thoracic radiographs of the same dog five weeks after a standard combination chemotherapy protocol was initiated. Dyspnea and hypercalcemia rapidly resolved after supportive therapy and cytotoxic chemotherapy were initiated.

F & G. Cytologic preparations of fine-needle aspirates from cranial mediastinal masses in two different dogs. Figure F shows a monomorphic population of intermediate to large lymphocytes, with large nuclei, prominent nucleoli (arrowheads), and an open chromatin pattern, consistent with lymphoma (Wright's-Giemsa, 1,000x). Figure G shows a mixed population of small and intermediate lymphocytes, with occasional mast cells (arrowheads), suggestive of thymoma despite the absence of epithelial cells on this sample (Wright's-Giemsa, 400x). (Photomicrographs courtesy of Dr. Laura D. Garrett.)


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