Introduction
- Definition :
- Low total serum calcium concentration< 8 mg/dl.
- Low ionized serum calcium concentration < 1.25 mmol/L.
- Calcium is important for many intra and extracellular functions. Required for bone formation, muscle contraction, nerve conduction, neuromuscular transmission, enzymatic reactions, blood coagulation, maintenance of vascular tone, regulation of hormones (PTH, calcitonin, vitamin D), cell growth and division.
- Total calcium is composed of 50% ionized calcium (iCa), 40% protein bound calcium (pCa) and 10% complexed calcium. iCa is the biologically active fraction.
- Calcium regulation is a complex process involving parathyroid hormone ( PTH), vitamin D metabolites and calcitonin.
- Clinical signs are usually present when serum tCa is less than 6 mg/dL or iCa is less than 0.8 mmol/L.
Diagnosis
Clinical signs
- See client history.
Diagnosis
Differential diagnosis
- Primary hypoparathyroidism.
- Secondary hypoparathyroidism.
- Secondary to thyroidectomy and parathyroid damage.
- Puerperal tetany (eclampsia).
- Renal failure.
- Ethylene glycol toxicity.
- Acute pancreatitis.
- Intestinal malabsorption.
- Nutritional secondary hyperparathyroidism.
Sequelae
Expected response to treatment
- After administration of the calcium bolus it may take up to 30-60 minutes for the clinical signs to resolve especially panting, behavioral changes and restlessness.
Sources
Publications
Refereed papers
- Recent references from PubMed.
Other sources of information
- Small Animals Critical Care Medicine. (2008) Eds D C Silverstein and K Hopper. Saunders Elsevier, S Louis Missouri
- Fluid, Electrolytes and acid-base Disorders in Small Animal Practice. (2006) Eds S P DiBartola, Saunders Elsevier , St Louis Missouri.
- The Veterinary ICU Book. (2002) Eds W E Wingfield and M R Raffee. Teton New Media, Jackson Hole, WY.



