Hypoparathyroidism in Dogs

 

Hypoparathyroidism is characterized by an absolute or relative deficiency of parathyroid hormone in the blood. The parathyroid hormone regulates calcium and phosphorus levels in the blood, normally increasing blood calcium levels by causing calcium to be reabsorbed from the bone. Low levels of parathyroid hormone secretion will therefore lead to low levels of calcium in the blood, a condition called hypocalcemia.

 

The parathyroid glands are small, hormone-secreting glands that are located on or near the thyroid glands, which are in turn located at the front of the neck, in alignment with the larynx and trachea.

 

In dogs, there is a predilection for hypoparathyroidism in toy poodles, miniature schnauzers, German shepherd dogs, Labrador retrievers, and terrier breeds. The average age of diagnosis is 4.8 years, with a range of six weeks to 13 years. There also appears to be a gender difference, as females tend to be diagnosed in higher numbers.

 

Symptoms

 

• Seizures
• Tense abdomen
• Wobbly, incoordinated, or drunken appearing movement (ataxia)
• Stiff gait
• Fever
• Facial rubbing
• Muscle trembling, twitching, or involuntary contractions of muscles
• Growling
• Panting
• Cataracts
• Weakness
• Increased urination and increased thirst
• Vomiting
• Lack of appetite

 

Causes

 

Hypoparathyroidism is most commonly of unknown cause, or is the result of an immune-mediated inflammation of the parathyroid gland.

 

Diagnosis

 

Your veterinarian will perform a thorough physical exam on your dog, taking into account the background history of symptoms that you are able to provide. Standard testing, including a complete blood profile will be conducted, as well as a chemical blood profile, a complete blood count, a urinalysis and an electrolyte panel. The results of these tests will usually return normal in the case of hypoparathyroidism, however, they are important in discounting any other underlying disorders.

 

 

Because there are several possible causes for the symptoms described here, your veterinarian will most likely use differential diagnosis. This process is guided by deeper inspection of the apparent outward symptoms, ruling out each of the more common causes until the correct disorder is settled upon and can be treated appropriately. The main problems associated with hypoparathyroidism that must be differentiated from other disease processes are seizures, weakness, muscle trembling, and twitching.

 

Some of the causes that will need to be ruled out are heart related diseases, metabolic diseases, such as hypoglycemia (low blood sugar) or hepatoencephalopathy (liver disease that affects the brain's functioning). Neurological causes that will need to be ruled out are inflammatory diseases, tumors, or epilepsy.

 

An exploration of the cervical section of the throat may reveal that the parathyroid glands are absent or have atrophied (wasted).

 

Treatment

 

Your dog may need to be hospitalized initially for medical management of low levels of calcium in the blood, at least until the clinical signs are controlled. Other treatment will be dependent on whether any other underlying conditions have been diagnosed.

 

Emergency treatment is usually only needed for certain patients, such as those with primary hypoparathyroidism, or hypoparathyroidism that is secondary to procedures that have been used to correct excessive levels of thyroid hormone or excessive levels of parathyroid hormone -- that is, procedures that have been medically used to lower the amount of parathyroid hormone in the blood, and have resulted in levels of parathyroid hormone that are now too low.

 

If your dog has been diagnosed with hypocalcemia, low calcium levels in the blood, your doctor will prescribe long-term treatment for the condition. Vitamin D will be needed indefinitely, with the dosage amount determined by your veterinarian, based on your dog's needs. Calcium supplements can be given by mouth, again, with the type and dose of calcium supplement directed by your veterinarian

 

Living and Management

 

Both low levels of calcium in the blood and excessive levels of calcium in the blood are concerns that will need to be managed over the long-term. Initially, your veterinarian will want to see your dog frequently in order to follow your dog's progress and to make changes to care as needed. Once serum calcium is stable and normal, your veterinarian will assess serum calcium concentration monthly for six months, and then every two to four months.