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Equine veterinary journal2019; 52(1); 83-90; doi: 10.1111/evj.13120

Diagnosis and treatment of confirmed and suspected primary hyperparathyroidism in equids: 17 cases (1999-2016).

Abstract: Primary hyperparathyroidism is uncommon in equids. Objective: To describe the diagnostic findings and efficacy of treatment in equids with primary hyperparathyroidism. Methods: Retrospective case series describing 16 horses and one mule. Methods: Cases were identified by retrospective review of records at Cornell University and via an ACVIM listserv query. Inclusion criteria were an equid with hypercalcemia, normal renal function and high parathyroid hormone (PTH) or histopathological diagnosis of a parathyroid adenoma. Equids with normal PTH and PTH-related protein (PTHrP) in the face of hypercalcemia were included as suspect cases. Results: The most common presenting complaints were weight loss (12/17) and hypercalcemia (10/17). PTH was above reference range in 12/17 cases. Suspected parathyroid tumours were localised in 12/14 equids imaged using ultrasonography alone (2/3), technetium 99m Tc sestamibi scintigraphy alone (1/1) or both modalities (9/10). Three horses did not have imaging performed. Surgical exploration successfully excised tumours in six of 10 cases. Five were located at the thoracic inlet, and surgery resulted in complete cure. One tumour was excised from the thyroid lobe, and the horse remained hypercalcemic. Four other cases explored surgically, four treated medically and three that were not treated also remained hypercalcemic. Conclusions: The small study size prohibited statistical analysis. Conclusions: Parathyroid adenomas in equids can be successfully localised with ultrasonography and scintigraphy. Surgical excision appears more likely to be successful for single gland disease at the thoracic inlet.
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Publication Date: 2019-05-10 PubMed ID: 30980730DOI: 10.1111/evj.13120Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article is focused on the diagnosis and treatment methods used for primary hyperparathyroidism in horses and a mule, detailing their effectiveness on 17 cases that were observed over a period from 1999 to 2016.

Objective and Methodology

  • The primary aim of this study is to outline the findings made during diagnosis and assess the effectiveness of treatments administered to horses diagnosed with primary hyperparathyroidism.
  • A retrospective case series was used for the study consisting of 16 horses and one mule.
  • The research employed a two-way method to identify cases. First, past records of Cornell University were thoroughly reviewed. Secondly, an ACVIM (American College of Veterinary Internal Medicine) listserv query was executed.
  • The criteria for including a subject in the research was any horse with hypercalcemia, or an abnormal level of calcium in the blood, normal renal or kidney function, and an elevated Parathyroid hormone (PTH), or a histopathological diagnosis of a parathyroid adenoma, a noncancerous (benign) tumor of the parathyroid gland.
  • For suspect cases, horses with normal PTH and PTH-related protein (PTHrP) levels amidst hypercalcemia were also included.

Results

  • The most frequently observed symptoms of the disease among the studied subjects were weight loss (12/17 cases) and higher levels of calcium in the blood (10/17 cases).
  • PTH levels were discovered to be outside the reference range in 12 out of 17 cases.
  • Imaging methods like ultrasonography and technetium 99m Tc sestamibi scintigraphy were able to satisfactorily locate suspected parathyroid tumors in 12 out of 14 equids.
  • Successful surgical removal of tumors was reported in 6 out of 10 cases. In these successful surgeries, the adenomas were located at the thoracic inlet except in one case, where the adenoma was located in the thyroid lobe.
  • The case with the thyroid lobe tumor continued to display hypercalcemia even post surgery. The same symptom continued to occur in four other cases which underwent surgery, four cases treated medically and three cases which were not treated.

Conclusion

  • Even though the small sample size of the study disallowed any statistical analysis, the findings indicated that parathyroid adenomas in horses can be successfully localized using ultrasonography and scintigraphy.
  • In addition, surgical removal appears to be successful for single gland disease especially when the tumor is located at the thoracic inlet.

Cite This Article

APA
Gorenberg EB, Johnson AL, Magdesian KG, Bertin FR, Costa LRR, Theelen MJP, Durward-Akhurst SA, Cruz Villagrán C, Carslake H, Frank N, Tomlinson JE. (2019). Diagnosis and treatment of confirmed and suspected primary hyperparathyroidism in equids: 17 cases (1999-2016). Equine Vet J, 52(1), 83-90. https://doi.org/10.1111/evj.13120

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 52
Issue: 1
Pages: 83-90

Researcher Affiliations

Gorenberg, E B
  • Cornell University College of Veterinary Medicine, Ithaca, New York, USA.
Johnson, A L
  • New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA.
Magdesian, K G
  • University of California Davis Veterinary Medical Teaching Hospital, Davis, California, USA.
Bertin, F-R
  • The University of Queensland School of Veterinary Science, Gatton, Queensland, Australia.
Costa, L R R
  • University of California Davis Veterinary Medical Teaching Hospital, Davis, California, USA.
Theelen, M J P
  • Department of Equine Sciences, Utrecht University, Utrecht, The Netherlands.
Durward-Akhurst, S A
  • Department of Veterinary Population Medicine, University of Minnesota, St Paul, Minnesota, USA.
Cruz Villagrán, C
  • The University of Adelaide, Roseworthy, South Australia, Australia.
Carslake, H
  • School of Veterinary Science, University of Liverpool, Philip Leverhulme Equine Hospital, Cheshire, UK.
Frank, N
  • Tufts Cummings School of Veterinary Medicine, North Grafton, Massachusetts, USA.
Tomlinson, J E
  • Baker Institute for Animal Health, Cornell University College of Veterinary Medicine, Ithaca, New York, USA.

MeSH Terms

  • Adenoma / diagnosis
  • Adenoma / surgery
  • Adenoma / veterinary
  • Animals
  • Calcium / blood
  • Equidae
  • Hyperparathyroidism / diagnosis
  • Hyperparathyroidism / surgery
  • Hyperparathyroidism / veterinary
  • Parathyroid Neoplasms / diagnosis
  • Parathyroid Neoplasms / surgery
  • Parathyroid Neoplasms / veterinary
  • Retrospective Studies

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Citations

This article has been cited 2 times.
  1. Townsend KS, Johnson PJ, Donnelly LL, LaCarrubba AM, Lattimer JC, Havis B, Springer NL, Kim DY. Concurrent chronic lymphocytic leukemia and primary hyperparathyroidism in a mule. J Vet Intern Med 2023 May-Jun;37(3):1250-1255.
    doi: 10.1111/jvim.16714pubmed: 37118906google scholar: lookup
  2. Colmer SF, Wulster K, Johnson AL, Levine DG, Underwood C, Watkins TW, Van Eps AW. Treatment of primary hyperparathyroidism in a Miniature Horse using chemical ablation of abnormal parathyroid tissue localized by 3-phase computed tomography. J Vet Intern Med 2022 Mar;36(2):798-804.
    doi: 10.1111/jvim.16390pubmed: 35150016google scholar: lookup
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