Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
ISSN:
0003-1488
Publication Date:
01 Dec 2021
  • 1.

    Feldman EC, Nelson RW, Reusch C, et al. Hypercalcemia and primary hyperparathyroidism. In: Canine & Feline Endocrinology. 4th ed. Saunders; 2015:579–625.

    • Search Google Scholar
    • Export Citation
  • 2.

    Berger B, Feldman EC. Primary hyperparathyroidism in dogs: 21 cases (1976–1986). J Am Vet Med Assoc. 1987;191(3):350–356.

  • 3.

    Withrow SJ, Page R, Vail DM. Tumors of the endocrine system. In: Clinical Oncology. 5th ed. Elsevier; 2013:504–532.

  • 4.

    Gear RNA, Neiger R, Skelly BJS, Herrtage ME. Primary hyperparathyroidism in 29 dogs: diagnosis, treatment, outcome and associated renal failure. J Small Anim Pract. 2005;46(1):10–16.

    • Search Google Scholar
    • Export Citation
  • 5.

    Rasor L, Pollard R, Feldman EC. Retrospective evaluation of three treatment methods for primary hyperparathyroidism in dogs. J Am Anim Hosp Assoc. 2007;43(2):70–77.

    • Search Google Scholar
    • Export Citation
  • 6.

    Feldman EC. Disorders of the parathyroid glands. In: Textbook of Veterinary Internal Medicine. 7th ed. Saunders; 2010:1722–1742.

  • 7.

    Secrest S, Grimes J. Ultrasonographic size of the canine parathyroid gland may not correlate with histopathology. Vet Radiol Ultrasound. 2019;60:729–733.

    • Search Google Scholar
    • Export Citation
  • 8.

    Armstrong AJ, Hauptman JG, Stanley BJ, et al. Effect of prophylactic calcitriol administration on serum ionized calcium concentrations after parathyroidectomy: 78 cases (2005–2015). J Vet Intern Med. 2018;32(1):99–106.

    • Search Google Scholar
    • Export Citation
  • 9.

    Sawyer ES, Northrup NC, Schmiedt CW, et al. Outcome of 19 dogs with parathyroid carcinoma after surgical excision. Vet Comp Oncol. 2012;10(1):57–64.

    • Search Google Scholar
    • Export Citation
  • 10.

    Feldman EC, Hoar B, Pollard R, Nelson RW. Pretreatment clinical and laboratory findings in dogs with primary hyperparathyroidism: 210 cases (1987–2004). J Am Vet Med Assoc. 2005;227(5):756–761.

    • Search Google Scholar
    • Export Citation
  • 11.

    Ham K, Greenfield CL, Barger A, et al. Validation of a rapid parathyroid hormone assay and intraoperative measurement of parathyroid hormone in dogs with benign naturally occurring primary hyperparathyroidism. Vet Surg. 2009;38(1):122–132.

    • Search Google Scholar
    • Export Citation
  • 12.

    Kishi EN, Holmes SP, Abbott JR, Bacon NJ. Functional metastatic parathyroid adenocarcinoma in a dog. Can Vet J. 2014;55(4):383–388.

  • 13.

    Patnaik AK, MacEwen EG, Erlandson RA, Lieberman PH, Liu SK. Mediastinal parathyroid adenocarcinoma in a dog. Vet Pathol. 1978;15(1):55–63.

    • Search Google Scholar
    • Export Citation
  • 14.

    Sakals SA, Gillick MS, Kerr ME, Boston SE. Diagnosing the etiology of hypercalcemia in a dog: a case of primary hyperparathyroidism. Vet Pathol. 2010;47(3):579–581.

    • Search Google Scholar
    • Export Citation
  • 15.

    Torrance AG, Mb V, 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(2):86–89.

    • Search Google Scholar
    • Export Citation
  • 16.

    Hristova EN, Cecco S, Niemela JE, Rehak NN, Elin RJ. Analyzer-dependent differences in results for ionized calcium, ionized magnesium, sodium, and pH. Clin Chem. 1995;41(11):1649–1653.

    • Search Google Scholar
    • Export Citation
  • 17.

    DeVries SE, Feldman EC, Nelson RW, Kennedy PC. Primary parathyroid gland hyperplasia in dogs: six cases (1982–1991). J Am Vet Med Assoc. 1993;202(7):1132–1136.

    • Search Google Scholar
    • Export Citation
  • 18.

    Goldstein RE, Atwater DZ, Cazolli DM, Goldstein O, Wade CM, Lindblad-Toh K. Inheritance, mode of inheritance, and candidate genes for primary hyperparathyroidism in Keeshonden. J Vet Intern Med. 2007;21(1):199–203.

    • Search Google Scholar
    • Export Citation
  • 19.

    Arbaugh M, Smeak D, Monnet E. Evaluation of preoperative serum concentrations of ionized calcium and parathyroid hormone as predictors of hypocalcemia following parathyroidectomy in dogs with primary hyperparathyroidism: 17 cases (2001–2009). J Am Vet Med Assoc. 2012;241(2):233–236.

    • Search Google Scholar
    • Export Citation
  • 20.

    Shane E. Parathyroid Carcinoma. J Clin Endocrinol Metab. 2001;86(2):485–493.

  • 21.

    Wisner ER, Penninck D, Biller DS, Feldman EC, Drake C, Nyland TG. High-resolution parathyroid sonography. Vet Radiol Ultrasound. 1997;38(6):462–466.

    • Search Google Scholar
    • Export Citation
  • 22.

    Wisner ER, Nyland TG. Ultrasonography of the thyroid and parathyroid glands. Vet Clin North Am Small Anim Pract. 1998;28(4):973–991.

  • 23.

    Liles SR, Linder KE, Cain B, Pease AP. Ultrasonography of histologically normal parathyroid glands and thyroid lobules in normocalcemic dogs. Vet Radiol Ultrasound. 2010;51(4):447–452.

    • Search Google Scholar
    • Export Citation
  • 24.

    Halenka M, Karasek D, Frysak Z. Four ultrasound and clinical pictures of parathyroid carcinoma. Case Rep Endocrinol. 2012;2012:363690.

  • 25.

    Dear JD, Kass PH, Della Maggiore AM, Feldman EC. Association of hypercalcemia before treatment with hypocalcemia after treatment in dogs with primary hyperparathyroidism. J Vet Intern Med. 2017;31(2):349–354.

    • Search Google Scholar
    • Export Citation
  • 26.

    Milovancev M, Schmiedt CW. Preoperative factors associated with postoperative hypocalcemia in dogs with primary hyperparathyroidism that underwent parathyroidectomy: 62 cases (2004–2009). J Am Vet Med Assoc. 2013;242(4):507–515.

    • Search Google Scholar
    • Export Citation
  • 27.

    Rosol TJ, Meuten DJ. Tumors of the endocrine glands. In: Tumors in Domestic Animals. 5th ed. Wiley; 2020:766–834.

  • 28.

    Lee I-T, Sheu WH-H, Tu S-T, Kuo S-W, Pei D. Bisphosphonate pretreatment attenuates hungry bone syndrome postoperatively in subjects with primary hyperparathyroidism. J Bone Miner Metab. 2006;24(3):255–258.

    • Search Google Scholar
    • Export Citation
  • 29.

    Mittendorf EA, Merlino JI, McHenry CR. Post-parathyroidectomy hypocalcemia: incidence, risk factors, and management. Am Surg. 2004;70(2):114–119.

    • Search Google Scholar
    • Export Citation
  • 30.

    Headley CM. Hungry bone syndrome following parathyroidectomy. ANNA J. 1998;25(3):283–289.

  • 31.

    Kumar A, Ralston SH. Bisphosphonates prevent the hungry bone syndrome. Nephron. 1996;74(4):729.

  • 32.

    Hruska KA, Teitelbaum SL. Renal osteodystrophy. N Engl J Med. 1995;333(3):166–174.

  • 33.

    Okamoto T, Iihara M, Obara T, Tsukada T. Parathyroid carcinoma: etiology, diagnosis, and treatment. World J Surg. 2009;33(11):2343–2354.

    • Search Google Scholar
    • Export Citation
  • 34.

    Kameyama K, Takami H. Proposal for the histological classification of parathyroid carcinoma. Endocr Pathol. 2005;16(1):49–52.

  • 35.

    Kiupel M, Capen C, Miller M, et al. Histological classification of tumors of the endocrine system of domestic animals. In: International Histological Classification of Tumors of Domestic Animals. Vol 12. Charles Louis Davis DVM Foundation; 2008:39–43.

    • Search Google Scholar
    • Export Citation
  • 36.

    Schantz A, Castleman B. Parathyroid carcinoma. A study of 70 cases. Cancer. 1973;31(3):600–605.

  • 37.

    Bondeson L, Sandelin K, Grimelius L. Histopathological variables and DNA cytometry in parathyroid carcinoma. Am J Surg Pathol. 1993;17(8):820–829.

    • Search Google Scholar
    • Export Citation
  • 38.

    Shane E, Bilezikian JP. Parathyroid carcinoma: a review of 62 patients. Endocr Rev. 1982;3(2):218–226.

  • 39.

    Juhlin CC, Nilsson I-L, Lagerstedt-Robinson K, et al. Parafibromin immunostainings of parathyroid tumors in clinical routine: a near-decade experience from a tertiary center. Mod Pathol. 2019;32(8):1082–1094.

    • Search Google Scholar
    • Export Citation
  • 40.

    Gardner DG. Recent advances in multiple endocrine neoplasia syndromes. Adv Intern Med. 1997;42:597–627.

  • 41.

    Lemos MC, Thakker RV. Multiple endocrine neoplasia type 1 (MEN1): analysis of 1336 mutations reported in the first decade following identification of the gene. Hum Mutat. 2008;29(1):22–32.

    • Search Google Scholar
    • Export Citation
  • 42.

    Marx SJ. Molecular genetics of multiple endocrine neoplasia types 1 and 2. Nat Rev Cancer. 2005;5(5):367–375.

  • 43.

    Posada-González M, Gómez-Ramírez J, Luque-Ramírez M, et al. Nonfunctional metastatic parathyroid carcinoma in the setting of multiple endocrine neoplasia type 2A syndrome. Surg Res Pract. 2014;2014:731481. doi: 10.1155/2014/731481

    • Search Google Scholar
    • Export Citation
  • 44.

    Thakker RV, De Groot L, Jameson JL. Multiple endocrine neoplasia type 1. In: Endocrinology. 6th ed. Elsevier; 2010:2719–2741.

  • 45.

    Thakker RV. Multiple endocrine neoplasiaapos;syndromes of the twentieth century. J Clin Endocrinol Metab. 1998;83(8):2617–2620.

  • 46.

    Jenkins PJ, Satta MA, Simmgen M, et al. Metastatic parathyroid carcinoma in the MEN2A syndrome. Clin Endocrinol (Oxf). 1997;47(6):747–751.

  • 47.

    Alfaro JJ, Lamas C, Estrada J, Lucas T. MEN-2A syndrome and pulmonary metastasis. Postgrad Med J. 2002;78(915): 51–52.

  • 48.

    von Dehn BJ, Nelson RW, Feldman EC, Griffery SM. Pheochromocytoma and hyperadrenocorticism in dogs: six cases (1982–1992). J Am Vet Med Assoc. 1995;207(3):322–324.

    • Search Google Scholar
    • Export Citation
  • 49.

    Bennett PF, Norman EJ. Mitotane (o,p′-DDD) resistance in a dog with pituitary-dependent hyperadrenocorticism and phaeochromocytoma. Aust Vet J.1998;76(2):101–103.

  • 50.

    Thuróczy J, van Sluijs FJ, Kooistra HS, et al. Multiple endocrine neoplasias in a dog: corticotrophic tumour, bilateral adrenocortical tumours, and pheochromocytoma. Vet Q. 1998;20(2):56–61.

    • Search Google Scholar
    • Export Citation
  • 51.

    Walker MC, Jones BR, Guildford WG, Burbidge HM, Alley MR. Multiple endocrine neoplasia type 1 in a crossbred dog. J Small Anim Pract. 2000;41(2):67–70.

    • Search Google Scholar
    • Export Citation
  • 52.

    Beatrice L, Boretti FS, Sieber-Ruckstuhl NS, et al. Concurrent endocrine neoplasias in dogs and cats: a retrospective study (2004–2014). Vet Rec. 2018;182(11):323.

    • Search Google Scholar
    • Export Citation
  • 53.

    Peterson ME, Randolph JF, Zaki FA, Heath H III. Multiple endocrine neoplasia in a dog. J Am Vet Med Assoc. 1982;180(12):1476–1478.

  • 54.

    Wright KN, Breitschwerdt EB, Feldman JM, Berry CR, Meuten GJ, Spodnick GJ. Diagnostic and therapeutic considerations in a hypercalcemic dog with multiple endocrine neoplasia. J Am Anim Hosp Assoc. 1995;31(2):156–162.

    • Search Google Scholar
    • Export Citation
  • 55.

    Kiupel M, Mueller PB, Ramos Vara J, Irizarry A, Lin TL. Multiple endocrine neoplasia in a dog. J Comp Pathol. 2000;123(2–3):210–217.

    • Search Google Scholar
    • Export Citation
  • 56.

    Proverbio D, Spada E, Perego R, et al. Potential variant of multiple endocrine neoplasia in a dog. J Am Anim Hosp Assoc. 2012;48(2):132–138.

  • 57.

    Hoenerhoff M, Kiupel M. Concurrent gastrinoma and somatostatinoma in a 10-year-old Portuguese water dog. J Comp Pathol. 2004;130(4):313–318.

    • Search Google Scholar
    • Export Citation
  • 58.

    Feldman EC, Nelson RW. Canine thyroid tumors and hyperthyroidism. In: Canine and Feline Endocrinology and Reproduction. 3rd ed. Saunders; 2004:220–249.

    • Search Google Scholar
    • Export Citation
  • 59.

    Cetani F, Pardi E, Marcocci C. Parathyroid carcinoma. Front Horm Res. 2019;51:63–76.

  • 60.

    Long CD, Goldstein RE, Hornof WJ, Feldman EC, Nyland TG. Percutaneous ultrasound-guided chemical parathyroid ablation for treatment of primary hyperparathyroidism in dogs. J Am Vet Med Assoc. 1999;215(2):217–221.

    • Search Google Scholar
    • Export Citation
  • 61.

    Pollard RE, Long CD, Nelson RW, Hornof WJ, Feldman EC. Percutaneous ultrasonographically guided radiofrequency heat ablation for treatment of primary hyperparathyroidism in dogs. J Am Vet Med Assoc. 2001;218(7):1106–1110.

    • Search Google Scholar
    • Export Citation
  • 62.

    Guttin T, Knox VW, Diroff JS. Outcomes for dogs with primary hyperparathyroidism following treatment with percutaneous ultrasound-guided ethanol ablation of presumed functional parathyroid nodules: 27 cases (2008–2011). J Am Vet Med Assoc. 2015;247(7):771–777.

    • Search Google Scholar
    • Export Citation

Incidence, survival time, and surgical treatment of parathyroid carcinomas in dogs: 100 cases (2010–2019)

Andrea K. Erickson DVM1, Penny J. Regier DVM, MS1, Meghan M. Watt BS1, Kathleen M. Ham DVM, MS3, Sarah J. Marvel DVM, MS5, Mandy L. Wallace DVM, MS6, Sara A. Colopy DVM, PhD7, Valery F. Scharf DVM, MS8, Junxian Zheng BS8, Danielle R. Dugat DVM, MS9, Julia P. Sumner BVSc10, James Howard DVM, MS4, Owen T. Skinner BVSc11, Megan A. Mickelson DVM12, Kelley M. Thieman-Mankin DVM, MS13, and James C. Colee MS2
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  • 1 From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine.
  • | 2 From the Statistics Division, Institute of Food and Agricultural Sciences.
  • | 3 From the University of Florida, Gainesville, FL 32610; Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824.
  • | 4 From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 5 From the Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.
  • | 6 From the Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.
  • | 7 From the Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI 53706.
  • | 8 From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607.
  • | 9 From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74074.
  • | 10 From the Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.
  • | 11 From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211.
  • | 12 From the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50010.
  • | 13 From the Department of Clinical Studies, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843.
DOI:
https://doi.org/10.2460/javma.20.06.0335
Volume/Issue:
Volume 259: Issue 11
Online Publication Date:
01 Nov 2021
Restricted access
Reprints and Permissions Purchase Article

Abstract

OBJECTIVE

To evaluate outcomes of dogs with parathyroid carcinoma (PTC) treated by surgical excision and to describe the incidence of postoperative hypocalcemia, degree of hypocalcemia, duration of hospitalization, duration of calcium supplementation, and survival time

ANIMALS

100 client-owned dogs with PTC admitted to academic, referral veterinary institutions.

PROCEDURES

In a retrospective multi-institutional study, medical records of dogs undergoing surgical excision of PTC between 2010 to 2019 were reviewed. Signalment, relevant medical history, clinical signs, clinicopathologic testing, imaging, surgical findings, intraoperative complications, histologic examination, and survival time were recorded.

RESULTS

100 dogs with PTC were included, and 96 dogs had clinical or incidental hypercalcemia. Common clinical signs included polyuria (44%), polydipsia (43%), hind limb paresis (22%), lethargy (21%), and hyporexia (20%). Cervical ultrasonography detected a parathyroid nodule in 91 of 91 dogs, with a single nodule in 70.3% (64/91), 2 nodules in 25.3% (23/91), and ≥ 3 nodules in 4 (4/91)% of dogs. Hypercalcemia resolved in 89 of 96 dogs within 7 days after surgery. Thirty-four percent of dogs developed hypocalcemia, on the basis of individual analyzer ranges, within 1 week after surgery. One dog had metastatic PTC to the prescapular lymph node, and 3 dogs were euthanized for refractory postoperative hypocalcemia. Estimated 1-, 2-, and 3-year survival rates were 84%, 65%, and 51% respectively, with a median survival time of 2 years.

CONCLUSIONS AND CLINICAL RELEVANCE

Excision of PTC results in resolution of hypercalcemia and excellent long-term tumor control. Surgical excision of PTC is recommended because of resolution of hypercalcemia and a good long-term prognosis. Future prospective studies and long-term follow-up are needed to further assess primary tumor recurrence, metastasis, and incidence of postoperative hypocalcemia.

Abstract

OBJECTIVE

To evaluate outcomes of dogs with parathyroid carcinoma (PTC) treated by surgical excision and to describe the incidence of postoperative hypocalcemia, degree of hypocalcemia, duration of hospitalization, duration of calcium supplementation, and survival time

ANIMALS

100 client-owned dogs with PTC admitted to academic, referral veterinary institutions.

PROCEDURES

In a retrospective multi-institutional study, medical records of dogs undergoing surgical excision of PTC between 2010 to 2019 were reviewed. Signalment, relevant medical history, clinical signs, clinicopathologic testing, imaging, surgical findings, intraoperative complications, histologic examination, and survival time were recorded.

RESULTS

100 dogs with PTC were included, and 96 dogs had clinical or incidental hypercalcemia. Common clinical signs included polyuria (44%), polydipsia (43%), hind limb paresis (22%), lethargy (21%), and hyporexia (20%). Cervical ultrasonography detected a parathyroid nodule in 91 of 91 dogs, with a single nodule in 70.3% (64/91), 2 nodules in 25.3% (23/91), and ≥ 3 nodules in 4 (4/91)% of dogs. Hypercalcemia resolved in 89 of 96 dogs within 7 days after surgery. Thirty-four percent of dogs developed hypocalcemia, on the basis of individual analyzer ranges, within 1 week after surgery. One dog had metastatic PTC to the prescapular lymph node, and 3 dogs were euthanized for refractory postoperative hypocalcemia. Estimated 1-, 2-, and 3-year survival rates were 84%, 65%, and 51% respectively, with a median survival time of 2 years.

CONCLUSIONS AND CLINICAL RELEVANCE

Excision of PTC results in resolution of hypercalcemia and excellent long-term tumor control. Surgical excision of PTC is recommended because of resolution of hypercalcemia and a good long-term prognosis. Future prospective studies and long-term follow-up are needed to further assess primary tumor recurrence, metastasis, and incidence of postoperative hypocalcemia.

Contributor Notes

Address correspondence to Dr. Regier (pregier@ufl.edu).