Percutaneous ultrasound-guided chemical parathyroid ablation for treatment of primary hyperparathyroidism in dogs

Craig D. Long From the Veterinary Medical Teaching Hospital (Long, Goldstein) and the Departments of Surgery and Radiological Sciences (Hornof, Nyland) and Medicine and Epidemiology (Feldman), School of Veterinary Medicine, University of California, Davis, CA 95616-8745.

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Richard E. Goldstein From the Veterinary Medical Teaching Hospital (Long, Goldstein) and the Departments of Surgery and Radiological Sciences (Hornof, Nyland) and Medicine and Epidemiology (Feldman), School of Veterinary Medicine, University of California, Davis, CA 95616-8745.

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William J. Hornof From the Veterinary Medical Teaching Hospital (Long, Goldstein) and the Departments of Surgery and Radiological Sciences (Hornof, Nyland) and Medicine and Epidemiology (Feldman), School of Veterinary Medicine, University of California, Davis, CA 95616-8745.

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Edward C. Feldman From the Veterinary Medical Teaching Hospital (Long, Goldstein) and the Departments of Surgery and Radiological Sciences (Hornof, Nyland) and Medicine and Epidemiology (Feldman), School of Veterinary Medicine, University of California, Davis, CA 95616-8745.

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Thomas G. Nyland From the Veterinary Medical Teaching Hospital (Long, Goldstein) and the Departments of Surgery and Radiological Sciences (Hornof, Nyland) and Medicine and Epidemiology (Feldman), School of Veterinary Medicine, University of California, Davis, CA 95616-8745.

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Objective

To evaluate the efficacy, feasibility, and safety of ultrasound-guided chemical ablation of parathyroid masses in dogs with primary hyperparathyroidism.

Design

Prospective clinical trial.

Animals

8 dogs.

Procedure

In all dogs, a solitary parathyroid mass was evident ultrasonographically. Dogs were anesthetized with propofol, and a 27-gauge needle was directed into the parathyroid mass under ultrasound guidance. Ethanol (96%) was injected into the mass until there was evidence of diffusion of fluid throughout the mass. Serum total calcium, ionized calcium, phosphorus, and parathyroid hormone (PTH) concentrations were monitored daily for 5 to 7 days after the ablation procedure and again 1, 3, and 6 months after the procedure. Dogs were also monitored for adverse effects. Follow-up ultrasonography was performed 5 days and 1 month after the ablation procedure.

Results

One injection was required in 7 dogs, and 2 injections were required in 1. Serum total and ionized calcium concentrations were within reference ranges within 24 hours after treatment in 7 dogs and within 5 days in 1 dog. Serum PTH concentration decreased and serum phosphorus concentration increased within 24 hours after treatment in all 8 dogs. Transient hypocalcemia developed in 4 dogs during the first 5 days after treatment, but only 1 dog required treatment for hypocalcemic tetany. Hypercalcemia recurred in 1 dog 1 month after the procedure and surgical removal of the parathyroid mass was required. Other adverse effects were not reported.

Conclusions and Clinical Relevance

Ultrasound-guided chemical ablation of parathyroid masses is a safe and effective alternative to surgery for dogs with primary hyperparathyroidism. (J Am Vet Med Assoc 1999;215:217–221)

Objective

To evaluate the efficacy, feasibility, and safety of ultrasound-guided chemical ablation of parathyroid masses in dogs with primary hyperparathyroidism.

Design

Prospective clinical trial.

Animals

8 dogs.

Procedure

In all dogs, a solitary parathyroid mass was evident ultrasonographically. Dogs were anesthetized with propofol, and a 27-gauge needle was directed into the parathyroid mass under ultrasound guidance. Ethanol (96%) was injected into the mass until there was evidence of diffusion of fluid throughout the mass. Serum total calcium, ionized calcium, phosphorus, and parathyroid hormone (PTH) concentrations were monitored daily for 5 to 7 days after the ablation procedure and again 1, 3, and 6 months after the procedure. Dogs were also monitored for adverse effects. Follow-up ultrasonography was performed 5 days and 1 month after the ablation procedure.

Results

One injection was required in 7 dogs, and 2 injections were required in 1. Serum total and ionized calcium concentrations were within reference ranges within 24 hours after treatment in 7 dogs and within 5 days in 1 dog. Serum PTH concentration decreased and serum phosphorus concentration increased within 24 hours after treatment in all 8 dogs. Transient hypocalcemia developed in 4 dogs during the first 5 days after treatment, but only 1 dog required treatment for hypocalcemic tetany. Hypercalcemia recurred in 1 dog 1 month after the procedure and surgical removal of the parathyroid mass was required. Other adverse effects were not reported.

Conclusions and Clinical Relevance

Ultrasound-guided chemical ablation of parathyroid masses is a safe and effective alternative to surgery for dogs with primary hyperparathyroidism. (J Am Vet Med Assoc 1999;215:217–221)

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