RESUMEN
Clinically relevant hypocalcemia is a well-documented complication of glucocorticoid administration in people with hypoparathyroidism. The current report describes the phenomenon in a dog. A 7 yr old neutered male Pomeranian was diagnosed with immune-mediated thrombocytopenia, immune-mediated hemolytic anemia, and primary hypoparathyroidism. This dog required long-term parenteral calcium gluconate to prevent clinical hypocalcemia despite appropriate doses of oral calcitriol and calcium carbonate. This is the first description of clinically significant presumptive glucocorticoid induced hypocalcemia in a dog with primary hypoparathyroidism.
Asunto(s)
Anemia Hemolítica/veterinaria , Enfermedades de los Perros/inducido químicamente , Glucocorticoides/efectos adversos , Hipocalcemia/veterinaria , Hipoparatiroidismo/veterinaria , Trombocitopenia/veterinaria , Anemia Hemolítica/tratamiento farmacológico , Anemia Hemolítica/inmunología , Animales , Calcitriol/administración & dosificación , Calcitriol/uso terapéutico , Carbonato de Calcio/administración & dosificación , Carbonato de Calcio/uso terapéutico , Gluconato de Calcio/administración & dosificación , Gluconato de Calcio/uso terapéutico , Hormonas y Agentes Reguladores de Calcio/administración & dosificación , Hormonas y Agentes Reguladores de Calcio/uso terapéutico , Suplementos Dietéticos , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Perros/inmunología , Perros , Esquema de Medicación , Glucocorticoides/administración & dosificación , Hipocalcemia/inducido químicamente , Hipocalcemia/prevención & control , Hipoparatiroidismo/tratamiento farmacológico , Hipoparatiroidismo/inmunología , Masculino , Trombocitopenia/tratamiento farmacológico , Trombocitopenia/inmunologíaRESUMEN
Lymphangiectasia is one of the causes of protein-losing enteropathy in dogs and characteristic ultrasonographic small intestinal lesions have been previously described. The purpose of this study was to determine whether corn oil administered orally (COAO) would result in increased conspicuity of these characteristic small intestinal ultrasonographic lesions in dogs with lymphangiectasia. Affected dogs were included if they underwent corn oil administered orally and had a surgical full-thickness intestinal biopsy diagnosis of lymphangiectasia. Control dogs had normal clinical examination and standard laboratory test findings. Ultrasound images of duodenum, jejunum, and ileum were obtained prior to and 30, 60, 90, and 120 min after corn oil administered orally for all dogs. Parameters recorded for each ultrasound study were intestinal wall thickness, mucosal echogenicity, and presence or absence of hyperechoic mucosal striations (HMS) and a parallel hyperechoic mucosal line (PHML). Nine affected and five controls dogs were included in the study. Seven of the nine dogs with lymphangiectasia had hyperechoic mucosal striations prior to corn oil administered orally. Jejunal hyperechoic mucosal striations were significantly associated with lymphangiectasia at multiple time points (P < 0.05) and were best identified in dogs with lymphangiectasia 60 or 90 min after corn oil administered orally. Increased mucosal echogenicity was observed in all dogs at multiple time points after corn oil administered orally. A parallel hyperechoic mucosal line was present in the jejunum in 4/5 healthy and 6/9 dogs with lymphangiectasia at one or more time points after corn oil administered orally. Findings indicated that corn oil administered orally improves conspicuity of characteristic ultrasonographic lesions in dogs with lymphangiectasia, however some of these lesions may also be present in healthy dogs that recently received a fatty meal.