scott@vtx-cpd.com

Replying to Alice L 16/08/2023 - 18:16

Hello Alice.

I hope you are well! I will make sure we cove this in the session tomorrow night!

Thanks again for the great question.

Scott 🙂

Replying to Laura Jones 02/08/2023 - 15:25

Hey Laura.

Really interesting topic indeed, thank you so much for sharing.

Scott 🙂

Replying to Dan T. 03/08/2023 - 20:00

Hey Dan.

This is really interesting, thank you for sharing.

It was good to touch on this in the live session too, it is such an interesting topic.

Thank you again for all of the brilliant contribution.

Scott 🙂

Replying to Harry S. 03/08/2023 - 10:59

Hey Harry.

I hope you are well. Great to see you here and thank you so much for your contribution!

I am a bit jealous deep down, I truly wish I understood fluid therapy like you did!

Your brilliance is noted and appreciated.

Thanks again.

Scott 🙂

Replying to Janette B. 01/08/2023 - 16:04

Hello Janette!

We are so honoured that your are involved with this course! Thank you so much for being a part of it. I know the delegates will learn a lot from you, I certainly have over the years!

Thank you again.

Scott 🙂

Replying to Francesca Lamb 24/07/2023 - 16:36

Fran!!! This is gold star stuff… what a brilliant response! Thank you for the time and consideration!

Differential diagnoses for hypercalcemia included granulomatous disease, neoplasia, hypervitaminosis D, renal disease, primary hyperparathyroidism, idiopathic hypercalcaemia, osteolysis or hypoadrenocorticism. Weight loss could be caused by hyporexia, maldigestion, malabsorption, chronic infection or inflammation, renal or hepatic disease, neoplasia, cardiac or – less likely – endocrine disease, including hyperthyroidism (the cat was relatively young for this), diabetes mellitus (polyuria, polydipsia and polyphagia would be expected) or hypoadrenocorticism (rare in cats); underfeeding, poor-quality diet and oral disease had been excluded. Harsh lung sounds could indicate pneumonia, primary or metastatic neoplasia or – less likely – idiopathic pulmonary fibrosis, pulmonary oedema or contusions. Hyporexia is a non-specific clinical sign; in the absence of oral/nasal disease or environmental stress, hyporexia could indicate systemic disease, nausea or pain.

Haematology, serum biochemistry (including thyroxine) and urine analysis were unremarkable, except for hypercalcaemia (ionised calcium [iCa] 1.75 mmol/l [RI 1.1–1.35 mmol/l]). Ionised hypercalcaemia was confirmed with a repeated blood sample, and there was no haemolysis or lipolysis. Feline immunodeficiency virus antibody and feline leukaemia virus antigen were negative, and blood pressure was normal.

Further investigations of hypercalcaemia included plasma parathyroid hormone concentration (<10 pg/ml [RI <40 pg/ml]; not supporting hyperparathyroidism), plasma parathyroid hormone-related protein (<0.1 pmol/ml [RI <0.5 pmol/ml]; not supporting neoplasia, although there are other mechanisms by which neoplasia could result in hypercalcaemia), 25-hydroxyvitamin D (95 nmol/l [RI 127–335 nmol/l]; not supporting most types of hypervitaminosis D) and serum toxoplasma IgG and IgM titres (<50 and <20 [RI <50 and <20, respectively]). Abdominal ultrasound and radiographs were unremarkable. Thoracic radiographs (Figure 2) revealed a diffuse, interstitial–alveolar pattern, most marked on the caudal lung lobes. Differential diagnoses included infectious pneumonia (bacterial, parasitic, protozoal, viral or fungal), primary or metastatic neoplasia or, less likely, idiopathic pulmonary fibrosis. The spine and vertebrae were carefully examined in all radiographs for the presence of osteolytic lesions, and none were found.

What would your next steps be?

Have a great week!

Scott 🙂