scott@vtx-cpd.com

Hello pal!

Thank you so much for your brilliant session. I wondered if you have any experience of using the MILA Tunneler for the retrograde placement of MILA Length-Adjustable Esophagostomy Tubes?

I have never used these before, but they are using them at my new job and are really cool!

Scott 🙂

Replying to Esther H. 12/07/2024 - 10:44

I do!

I use Chia seeds a lot in cats. I have popped a whole new post on regarding the topic. I am actually moving away from alendronate completely due to possible side effects:

“Hello everyone,

I wanted to share some insights from a recent study on the management of feline idiopathic ionised hypercalcaemia and ionised hypercalcaemia associated with chronic kidney disease. This study evaluates the efficacy of alendronate combined with standard treatment compared to standard treatment alone.

Study Overview:

Objectives:

To characterise the signalment, clinicopathologic data, complications, and the association between treatment and outcome in cats with idiopathic or chronic kidney disease-associated ionised hypercalcaemia.
To compare the outcome between cats managed with alendronate and standard treatment versus standard treatment alone.
Materials and Methods:

This retrospective cohort multicentre study reviewed medical records of cats diagnosed with idiopathic or chronic kidney disease-associated ionised hypercalcaemia.
Cats treated with alendronate and standard treatment were assigned to the alendronate group, while those treated with standard treatment alone were assigned to the control group.
Standard treatment included dietary modification, monitoring of ionised calcium concentrations, and managing complications secondary to hypercalcaemia.
The follow-up period was 6 months.

Results:

A total of 29 cats were enrolled in the study: 9 in the control group and 20 in the alendronate group.
Both groups showed a significant reduction in serum ionised calcium between the baseline and the follow-up visit. However, the reduction did not differ significantly between the two groups (mean change in ionised calcium concentration: -0.18 for the alendronate group and -0.17 for the control group).
Suspected bisphosphate-related osteonecrosis of the jaw was reported in one cat receiving alendronate.

Clinical Significance:

The study observed similar reductions in serum ionised calcium concentration in cats treated with diet alone and in those treated with diet and alendronate.

These results should be interpreted with caution as the study was underpowered for meaningful statistical comparison.
Cats receiving alendronate should be monitored for adverse reactions, including osteonecrosis of the jaw.
Additionally, it has been relatively well documented that using chia seeds can be a really effective non-pharmacological intervention for the management of hypercalcaemia, and this is certainly something that I would do very routinely. Generally speaking, I will now avoid alendronate in the management of idiopathic hypercalcaemia in cats. I am much more likely to turn to diet, chia seeds, or even prednisolone or steroids as management options rather than using alendronate.

Case Reports: Managing Feline Idiopathic Hypercalcemia With Chia Seeds (Salvia hispanica L.): A Case Series

Abstract:

Background: This case series describes the use of chia seeds (Salvia hispanica L.) as a non-pharmacological solution in managing feline idiopathic hypercalcaemia when dietary change alone fails.

Case Summary: Over a 2-year period, three female spayed, middle-aged, Domestic Shorthair cats were diagnosed with idiopathic hypercalcaemia. Initial management with various high-moisture pet foods did not result in normocalcemia. Supplementing the diet with chia seeds (2 g/cat/day) for 4 weeks resulted in normalization of ionized calcium concentration in all cats.

Conclusion: Chia seeds supplementation could be a useful tool in managing feline idiopathic hypercalcaemia.

Additionally, another paper highlights the potential complications associated with long-term bisphosphonate treatment:

Medication‐related osteonecrosis of the jaw after long‐term bisphosphonate treatment in a cat

Abstract:

Background: A 12‐year‐old, neutered female, domestic medium hair cat was evaluated for a nonhealing oral mucosal ulceration. The cat had a history of idiopathic hypercalcemia that had been treated with a bisphosphonate for 41 months. Oral examination identified exposed maxillary bone adjacent to a previous extraction site. Histopathology of the exposed bone and associated mucosa was most consistent with medication‐related osteonecrosis of the jaw. Treatment involved both medical and surgical interventions. Oral mucosal healing occurred after 6 months of treatment.

For more details, you can access the full studies here:

Assessment of alendronate and dietary treatment in the management of feline idiopathic ionised hypercalcaemia and ionised hypercalcaemia associated with chronic kidney disease: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13755

Managing Feline Idiopathic Hypercalcemia With Chia Seeds (Salvia hispanica L.): A Case Series: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7387619/

Medication‐related osteonecrosis of the jaw after long‐term bisphosphonate treatment in a cat: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6430911/

I would love to hear your thoughts and experiences in managing feline hypercalcaemia. Have you found alendronate or chia seeds to be effective in your practice, and have you encountered any notable side effects?

Best regards,

Scott”