Evaluation of total and ionized calcium status in dogs with blastomycosis: 38 cases (1997–2006)

Laura J. Crews Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

Search for other papers by Laura J. Crews in
Current site
Google Scholar
PubMed Close
 DVM, MS
,
Leslie C. Sharkey Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

Search for other papers by Leslie C. Sharkey in
Current site
Google Scholar
PubMed Close
 DVM, PhD, DACVP
,
Daniel A. Feeney Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

Search for other papers by Daniel A. Feeney in
Current site
Google Scholar
PubMed Close
 DVM, MS, DACVR
,
Carl R. Jessen Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

Search for other papers by Carl R. Jessen in
Current site
Google Scholar
PubMed Close
 DVM, PhD, DACVR
, and
Tammy Ruska Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

Search for other papers by Tammy Ruska in
Current site
Google Scholar
PubMed Close
DOI:
https://doi.org/10.2460/javma.231.10.1545
Volume/Issue:
Volume 231: Issue 10
Online Publication Date:
15 Nov 2007
Restricted access
Sign In Reprints and Permissions Purchase Article

Abstract

Objective—To determine blood ionized calcium (iCa) and serum total calcium (tCa) concentrations in dogs with blastomycosis and to evaluate whether serum tCa concentration, albumin-adjusted serum calcium concentration (AdjCa-Alb), and total protein–adjusted serum calcium concentration (AdjCa-TP) accurately predict iCa status.

Design—Retrospective case series.

Animals—38 client-owned dogs with a cytologic diagnosis of blastomycosis.

Procedures—Dogs were classified as hypocalcemic, normocalcemic, or hypercalcemic on the basis of blood iCa concentration, serum tCa concentration, AdjCa-Alb, and AdjCa-TP; classification on the basis of serum tCa concentration, AdjCa-Alb, and AdjCa-TP was compared with blood iCa concentration.

Results—Except for 2 hypercalcemic dogs, all dogs had blood iCa concentrations within the reference interval. Use of serum tCa concentration overestimated hypocalcemia in 57.9% (22/38) of dogs and underestimated hypercalcemia in 1 dog. Use of AdjCa-Alb correctly reclassified all dogs as normocalcemic that were classified as hypocalcemic on the basis of serum tCa concentration, but failed to predict hypercalcemia in 1 dog. Use of AdjCa-TP correctly reclassified all but 2 dogs as normocalcemic that were classified as hypocalcemic on the basis of serum tCa concentration, and failed to predict hypercalcemia in 1 dog. No correlation was found between blood iCa concentration and serum concentrations of tCa, total protein, and albumin; AdjCa-Alb; or AdjCa-TP.

Conclusions and Clinical Relevance—High blood iCa concentration was uncommon in dogs with blastomycosis. Hypoalbuminemia contributed to a low serum tCa concentration despite a blood iCa concentration within reference limits. The use of serum tCa concentration, AdjCa-Alb, and AdjCa-TP may fail to identify a small number of dogs with high blood iCa concentrations.

Abstract

Objective—To determine blood ionized calcium (iCa) and serum total calcium (tCa) concentrations in dogs with blastomycosis and to evaluate whether serum tCa concentration, albumin-adjusted serum calcium concentration (AdjCa-Alb), and total protein–adjusted serum calcium concentration (AdjCa-TP) accurately predict iCa status.

Design—Retrospective case series.

Animals—38 client-owned dogs with a cytologic diagnosis of blastomycosis.

Procedures—Dogs were classified as hypocalcemic, normocalcemic, or hypercalcemic on the basis of blood iCa concentration, serum tCa concentration, AdjCa-Alb, and AdjCa-TP; classification on the basis of serum tCa concentration, AdjCa-Alb, and AdjCa-TP was compared with blood iCa concentration.

Results—Except for 2 hypercalcemic dogs, all dogs had blood iCa concentrations within the reference interval. Use of serum tCa concentration overestimated hypocalcemia in 57.9% (22/38) of dogs and underestimated hypercalcemia in 1 dog. Use of AdjCa-Alb correctly reclassified all dogs as normocalcemic that were classified as hypocalcemic on the basis of serum tCa concentration, but failed to predict hypercalcemia in 1 dog. Use of AdjCa-TP correctly reclassified all but 2 dogs as normocalcemic that were classified as hypocalcemic on the basis of serum tCa concentration, and failed to predict hypercalcemia in 1 dog. No correlation was found between blood iCa concentration and serum concentrations of tCa, total protein, and albumin; AdjCa-Alb; or AdjCa-TP.

Conclusions and Clinical Relevance—High blood iCa concentration was uncommon in dogs with blastomycosis. Hypoalbuminemia contributed to a low serum tCa concentration despite a blood iCa concentration within reference limits. The use of serum tCa concentration, AdjCa-Alb, and AdjCa-TP may fail to identify a small number of dogs with high blood iCa concentrations.

Contributor Notes

Address correspondence to Dr. Sharkey.
Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
Publication Date:
15 Nov 2007
  • 1.

    Stockham SL, Scott MA. Calcium, phosphorus, magnesium, and their regulatory hormones. In: Stockham SL, Scott MA, eds. Fundamentals of veterinary clinical pathology. Ames, Iowa: Iowa State Press, 2002;401–432.

    • Search Google Scholar
    • Export Citation
  • 2.

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

    • Search Google Scholar
    • Export Citation
  • 3.

    Legendre AM. Blastomycosis. In: Greene CE, ed. Infectious diseases of the dog and cat. 3rd ed. St Louis: Saunders Elsevier, 2006;569–576.

    • Search Google Scholar
    • Export Citation
  • 4.

    Legendre AM, Walker M & Buyukmihci N, et al. Canine blastomycosis: a review of 47 clinical cases. J Am Vet Med Assoc 1981;178:1163–1168.

  • 5.

    Arceneaux KA, Taboada J, Hosgood G. Blastomycosis in dogs: 115 cases (1980–1995). J Am Vet Med Assoc 1998;213:658–663.

  • 6.

    Dow SW, Legendre AM & Stiff M, et al. Hypercalcemia associated with blastomycosis in dogs. J Am Vet Med Assoc 1986;188:706–709.

  • 7.

    Schenck PA, Chew DJ. Determination of calcium fractionation in dogs with chronic renal failure. Am J Vet Res 2003;64:1181–1184.

  • 8.

    Fettman MJ. Fluid and electrolyte metabolism. In: Thrall MA, ed. Veterinary hematology and clinical chemistry. Philadelphia: Lippincott Williams & Wilkins, 2004;329–353.

    • Search Google Scholar
    • Export Citation
  • 9.

    Ferguson DC, Hoenig M. Endocrine system. In: Latimer KS, Mahaffey EA, Prasse KW, eds. Duncan and Prasse's veterinary laboratory medicine: clinical pathology. 4th ed. Ames, Iowa: Iowa State Press, 2003;270–303.

    • Search Google Scholar
    • Export Citation
  • 10.

    Schenck PA, Chew DJ. Prediction of serum ionized calcium concentration by use of serum total calcium concentration in dogs. Am J Vet Res 2005;66:1330–1336.

    • Search Google Scholar
    • Export Citation
  • 11.

    Kogika MM, Lustoza MD & Notomi MK, et al. Serum ionized calcium in dogs with chronic renal failure and metabolic acidosis. Vet Clin Pathol 2006;35:441–445.

    • Search Google Scholar
    • Export Citation
  • 12.

    Crews LJ, Feeney DA & Jessen CR, et al. Radiographic findings in dogs with pulmonary blastomycosis: 125 cases (1989–2006). J Am Vet Med Assoc 2007;in press.

    • Search Google Scholar
    • Export Citation
  • 13.

    Crews LJ, Feeney DA & Jessen CR, et al. Utility of diagnostic tests for medical treatment of pulmonary blastomycosis in dogs: 125 cases (1989–2006). J Am Vet Med Assoc 2007;in press.

    • Search Google Scholar
    • Export Citation
  • 14.

    Caldwell JW, Arsura EL & Kilgore WB, et al. Hypercalcemia in patients with disseminated coccidioidomycosis. Am J Med Sci 2004;327:15–18.

  • 15.

    Sharma OP. Hypercalcemia in granulomatous disorders: a clinical review. Curr Opin Pulm Med 2000;6:442–447.

  • 16.

    Mellanby RJ, Mellor P & Villiers EJ, et al. Hypercalcemia associated with granulomatous lymphadenitis and elevated 1,25-dihydroxyvitamin D concentration in a dog. J Small Anim Pract 2006;47:207–212.

    • Search Google Scholar
    • Export Citation

Advertisement