Abstract Background: Primary hypoparathyroidism (PH) is an endocrine disorder characterized by decreased production and/or release of parathyroid hormone (PTH). Dogs and cats are rarely affected, and typical clinical signs include an abrupt onset of neurological and neuromuscular signs. The diagnosis is based on the history, clinical signs, and laboratory findings of hypocalcaemia, as well as the exclusion of other causes of tetany. Treatment involves stabilization of serum calcium with specific therapy. This study aimed to report three cases of PH: two canine cases and the first feline case in Brazil.
Cases: 1) A 8-year-old male Yorkshire terrier was brought to the clinic with a history of tetanic crisis. The owner reported that the animal had been previously diagnosed with epilepsy and since treated with phenobarbital. The physical examination revealed hyperthermia, tachypnea, tachycardia, salivation, and ataxia with hyperextension of the anterior and posterior limbs. Emergency treatment included intravenous (IV) administration of calcium gluconate, and the animal showed clinical improvement within an hour. Overall, the complete blood count was within the normal range, but the calcium and PTH levels were below the normal ranges. Therefore, PH was confirmed. Calcium carbonate and vitamin D3 supplementation were prescribed, and the treatment with phenobarbital was suspended. During the following year, the dog suffered three episodes of hypocalcaemia, even with appropriate administration of medication by the owner. In the last crisis, the animal died, probably because of acute renal failure (ARF). 2) A 7-year-old male Pinscher was presented for veterinary care with a history of 15 days of tetanic and seizure crises. The physical examination revealed hyperthermia, seizure activity, and hyperextension of the anterior and posterior limbs. Levels of total calcium and PTH were below the normal ranges. The animal showed clinical improvement with IV administration of calcium gluconate. Therefore, PH was diagnosed from the clinical signs, response to emergency treatment, and values of calcium and PTH. Calcium carbonate and vitamin D3 supplementation were prescribed. The owner had trouble purchasing calcitriol, and the animal died before the follow-up appointment. 3) A 14-year-old female mixed-breed cat was brought to the clinic with a history of anorexia and vomiting. From the results of the complete blood count, serum biochemistry, and electrocardiogram, the cat was diagnosed initially with hypertrophic cardiomyopathy with hepatic lipidosis due to prolonged anorexia. However, the serum ionized calcium and PTH levels were below normal ranges. Thus, on the basis of the clinical symptoms and serum calcium and PTH levels, the animal was diagnosed with PH. Treatment consisted of ongoing supplementation with vitamin D3 and calcium carbonate, and the existing treatment for heart disease was continued. The treatment did not result in any clinical improvement, and the animal was euthanized.
Discussion: The two dogs presented with the classic symptoms reported in the literature. However, the cat with the same pathology had different clinical signs. In the three cases, the diagnosis was confirmed according to the procedure described in the literature, ie, clinical symptoms, serum calcium and PTH levels below normal ranges, and response to treatment. The stabilization of the serum calcium concentration with calcium and vitamin D3 supplementation corroborates the literature. None of the study patients survived: the first dog probably died because of ARF due to excessive crises; the second dog died because of the advanced stage of the disease and the difficulty in purchasing the drugs prescribed; the cat was euthanized because it did not show any response to treatment, perhaps because it had more than one disease concurrently.