Perioperative characteristics, histological diagnosis, and outcome in cats undergoing surgical treatment of primary hyperparathyroidism

Ameet Singh, Michelle Giuffrida, Christopher B. Thomson, Jared Baum, Betty Kramek, Julius M. Liptak, Philip Hyndman, Brendon Ringwood, Daniel Smeak, Kathleen Ham, John Berg, Kelley Thieman-Mankin, Shauna L. Blois, Sarah E. Boston

Research output: Contribution to journalArticle

Abstract

Objective: To report perioperative characteristics, complications, histopathologic diagnosis and outcome in cats undergoing surgical treatment for primary hyperparathyroidism (PHPT). Study design: Multi-institutional, retrospective case series. Animals: Thirty-two client-owned cats. Methods: Medical records of cats treated with surgical removal of 1 or more parathyroid gland(s) with confirmed histopathologic evaluation were reviewed. Cats were divided into preoperative ionized calcium (iCa) groups corresponding to the 33rd, 67th, and 100th percentiles of the preoperative iCa results of the study population. Follow-up consisted of phone conversation with owners or primary veterinarian. Results: Ionized calcium was above reference range in all cats (median 1.8 mmol/L [interquartile range, 1.5–1.9]). Abnormal tissue was excised after cervical exploration in all cats. The most common histopathologic diagnoses were parathyroid adenoma in 20 of 32 (62.5%) cats and parathyroid carcinoma in 7 of 32 (21.9%) cats. At discharge, 6 of 32 (18.8%) cats had hypercalcemia, 5 of 32 (15.6%) had hypocalcemia, and 21 of 32 (65.6%) were normocalcemic. Preoperative iCa did not correlate with postoperative iCa. The median follow-up time was 332 days (range, 7–3156). Overall median survival time was 1109 days (95% CI, 856–1332). Survival time was not associated with preoperative iCa group, hypocalcemia at discharge, hypercalcemia at discharge, or diagnosis of carcinoma. Conclusion: In this cohort of cats, parathyroid adenoma was the most common cause of PHPT, and surgical treatment resulted in very good median survival time. Preoperative iCa was not predictive of postoperative hypocalcemia. Clinical significance: Surgical parathyroidectomy for treatment of PHPT in cats provides a favorable prognosis.

Original languageEnglish (US)
JournalVeterinary Surgery
DOIs
StateAccepted/In press - Jan 1 2019

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hyperparathyroidism
Primary Hyperparathyroidism
Cats
cats
Calcium
calcium
Parathyroid Neoplasms
hypocalcemia
Hypocalcemia
Therapeutics
hypercalcemia
adenoma
Hypercalcemia
carcinoma
parathyroid glands
Parathyroidectomy
Parathyroid Glands
Veterinarians
prognosis
Medical Records

ASJC Scopus subject areas

  • veterinary(all)

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Perioperative characteristics, histological diagnosis, and outcome in cats undergoing surgical treatment of primary hyperparathyroidism. / Singh, Ameet; Giuffrida, Michelle; Thomson, Christopher B.; Baum, Jared; Kramek, Betty; Liptak, Julius M.; Hyndman, Philip; Ringwood, Brendon; Smeak, Daniel; Ham, Kathleen; Berg, John; Thieman-Mankin, Kelley; Blois, Shauna L.; Boston, Sarah E.

In: Veterinary Surgery, 01.01.2019.

Research output: Contribution to journalArticle

Singh, A, Giuffrida, M, Thomson, CB, Baum, J, Kramek, B, Liptak, JM, Hyndman, P, Ringwood, B, Smeak, D, Ham, K, Berg, J, Thieman-Mankin, K, Blois, SL & Boston, SE 2019, 'Perioperative characteristics, histological diagnosis, and outcome in cats undergoing surgical treatment of primary hyperparathyroidism', Veterinary Surgery. https://doi.org/10.1111/vsu.13165
Singh, Ameet ; Giuffrida, Michelle ; Thomson, Christopher B. ; Baum, Jared ; Kramek, Betty ; Liptak, Julius M. ; Hyndman, Philip ; Ringwood, Brendon ; Smeak, Daniel ; Ham, Kathleen ; Berg, John ; Thieman-Mankin, Kelley ; Blois, Shauna L. ; Boston, Sarah E. / Perioperative characteristics, histological diagnosis, and outcome in cats undergoing surgical treatment of primary hyperparathyroidism. In: Veterinary Surgery. 2019.
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abstract = "Objective: To report perioperative characteristics, complications, histopathologic diagnosis and outcome in cats undergoing surgical treatment for primary hyperparathyroidism (PHPT). Study design: Multi-institutional, retrospective case series. Animals: Thirty-two client-owned cats. Methods: Medical records of cats treated with surgical removal of 1 or more parathyroid gland(s) with confirmed histopathologic evaluation were reviewed. Cats were divided into preoperative ionized calcium (iCa) groups corresponding to the 33rd, 67th, and 100th percentiles of the preoperative iCa results of the study population. Follow-up consisted of phone conversation with owners or primary veterinarian. Results: Ionized calcium was above reference range in all cats (median 1.8 mmol/L [interquartile range, 1.5–1.9]). Abnormal tissue was excised after cervical exploration in all cats. The most common histopathologic diagnoses were parathyroid adenoma in 20 of 32 (62.5{\%}) cats and parathyroid carcinoma in 7 of 32 (21.9{\%}) cats. At discharge, 6 of 32 (18.8{\%}) cats had hypercalcemia, 5 of 32 (15.6{\%}) had hypocalcemia, and 21 of 32 (65.6{\%}) were normocalcemic. Preoperative iCa did not correlate with postoperative iCa. The median follow-up time was 332 days (range, 7–3156). Overall median survival time was 1109 days (95{\%} CI, 856–1332). Survival time was not associated with preoperative iCa group, hypocalcemia at discharge, hypercalcemia at discharge, or diagnosis of carcinoma. Conclusion: In this cohort of cats, parathyroid adenoma was the most common cause of PHPT, and surgical treatment resulted in very good median survival time. Preoperative iCa was not predictive of postoperative hypocalcemia. Clinical significance: Surgical parathyroidectomy for treatment of PHPT in cats provides a favorable prognosis.",
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AU - Singh, Ameet

AU - Giuffrida, Michelle

AU - Thomson, Christopher B.

AU - Baum, Jared

AU - Kramek, Betty

AU - Liptak, Julius M.

AU - Hyndman, Philip

AU - Ringwood, Brendon

AU - Smeak, Daniel

AU - Ham, Kathleen

AU - Berg, John

AU - Thieman-Mankin, Kelley

AU - Blois, Shauna L.

AU - Boston, Sarah E.

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N2 - Objective: To report perioperative characteristics, complications, histopathologic diagnosis and outcome in cats undergoing surgical treatment for primary hyperparathyroidism (PHPT). Study design: Multi-institutional, retrospective case series. Animals: Thirty-two client-owned cats. Methods: Medical records of cats treated with surgical removal of 1 or more parathyroid gland(s) with confirmed histopathologic evaluation were reviewed. Cats were divided into preoperative ionized calcium (iCa) groups corresponding to the 33rd, 67th, and 100th percentiles of the preoperative iCa results of the study population. Follow-up consisted of phone conversation with owners or primary veterinarian. Results: Ionized calcium was above reference range in all cats (median 1.8 mmol/L [interquartile range, 1.5–1.9]). Abnormal tissue was excised after cervical exploration in all cats. The most common histopathologic diagnoses were parathyroid adenoma in 20 of 32 (62.5%) cats and parathyroid carcinoma in 7 of 32 (21.9%) cats. At discharge, 6 of 32 (18.8%) cats had hypercalcemia, 5 of 32 (15.6%) had hypocalcemia, and 21 of 32 (65.6%) were normocalcemic. Preoperative iCa did not correlate with postoperative iCa. The median follow-up time was 332 days (range, 7–3156). Overall median survival time was 1109 days (95% CI, 856–1332). Survival time was not associated with preoperative iCa group, hypocalcemia at discharge, hypercalcemia at discharge, or diagnosis of carcinoma. Conclusion: In this cohort of cats, parathyroid adenoma was the most common cause of PHPT, and surgical treatment resulted in very good median survival time. Preoperative iCa was not predictive of postoperative hypocalcemia. Clinical significance: Surgical parathyroidectomy for treatment of PHPT in cats provides a favorable prognosis.

AB - Objective: To report perioperative characteristics, complications, histopathologic diagnosis and outcome in cats undergoing surgical treatment for primary hyperparathyroidism (PHPT). Study design: Multi-institutional, retrospective case series. Animals: Thirty-two client-owned cats. Methods: Medical records of cats treated with surgical removal of 1 or more parathyroid gland(s) with confirmed histopathologic evaluation were reviewed. Cats were divided into preoperative ionized calcium (iCa) groups corresponding to the 33rd, 67th, and 100th percentiles of the preoperative iCa results of the study population. Follow-up consisted of phone conversation with owners or primary veterinarian. Results: Ionized calcium was above reference range in all cats (median 1.8 mmol/L [interquartile range, 1.5–1.9]). Abnormal tissue was excised after cervical exploration in all cats. The most common histopathologic diagnoses were parathyroid adenoma in 20 of 32 (62.5%) cats and parathyroid carcinoma in 7 of 32 (21.9%) cats. At discharge, 6 of 32 (18.8%) cats had hypercalcemia, 5 of 32 (15.6%) had hypocalcemia, and 21 of 32 (65.6%) were normocalcemic. Preoperative iCa did not correlate with postoperative iCa. The median follow-up time was 332 days (range, 7–3156). Overall median survival time was 1109 days (95% CI, 856–1332). Survival time was not associated with preoperative iCa group, hypocalcemia at discharge, hypercalcemia at discharge, or diagnosis of carcinoma. Conclusion: In this cohort of cats, parathyroid adenoma was the most common cause of PHPT, and surgical treatment resulted in very good median survival time. Preoperative iCa was not predictive of postoperative hypocalcemia. Clinical significance: Surgical parathyroidectomy for treatment of PHPT in cats provides a favorable prognosis.

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