Treatment of primary hyperparathyroidism in a Miniature Horse using chemical ablation of abnormal parathyroid tissue localized by 3-phase computed tomography.
Abstract: A 15-year-old Miniature Horse mare with persistently increased plasma calcium (total and ionized) and serum parathyroid hormone concentrations was presented for suspected primary hyperparathyroidism. Ultrasonography of the thyroid region identified an enlarged heterogeneous mass axial to the right thyroid lobe suggestive of an enlarged parathyroid gland, which was further confirmed using sestamibi nuclear scintigraphy and 3-phase computed tomography. Percutaneous ultrasound-guided ethanol ablation of the mass, a method not previously described in the horse, was performed under general anesthesia resulting in rapid normalization of plasma ionized calcium and serum parathyroid hormone concentrations. Ablation of abnormal parathyroid gland tissue may be a suitable alternative to surgical resection in certain cases of primary hyperparathyroidism in the horse.
© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Publication Date: 2022-02-12 PubMed ID: 35150016PubMed Central: PMC8965272DOI: 10.1111/jvim.16390Google Scholar: Lookup
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Summary
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The research is about successfully treating a 15-year-old Miniature Horse mare suffering from primary hyperparathyroidism using a method that involves chemical ablation of abnormal parathyroid tissue. This method has not previously been used in horses.
Diagnosis of Primary Hyperparathyroidism
- The miniature horse was suspected to have primary hyperparathyroidism. It was consistently showing increased plasma calcium and serum parathyroid hormone concentrations.
- To confirm the condition, the researchers used a combination of methods. Initial ultrasonography of the thyroid region revealed a large heterogeneous mass adjacent to the right thyroid lobe indicative of an enlarged parathyroid gland.
- Furthermore, nuclear scintigraphy using sestamibi and 3-phase computed tomography was applied to confirm the diagnosis. These imaging processes effectively localized the abnormal parathyroid tissue.
Use of Percutaneous Ultrasound-Guided Ethanol Ablation
- Once the diagnosis was confirmed, the research team conducted percutaneous ultrasound-guided ethanol ablation of the mass. This involved using ultrasound imaging to guide a needle to the mass, and then injecting ethanol to destroy or ablate the problematic tissue.
- This procedure was performed under general anesthesia and has not been previously described in the horse. Despite its novelty in this particular case, the procedure resulted in a swift normalization of both plasma ionized calcium and serum parathyroid hormone levels within the horse.
Summary and Potential Applications
- The successful treatment suggests that ablation of abnormal parathyroid glands could be an effective alternative to surgical removal in cases of primary hyperparathyroidism in horses. This is particularly relevant for cases where surgery may present higher risks or infeasible.
- Through this case study, the researchers have demonstrated that chemical ablation of abnormal parathyroid tissue could be a potentially valuable treatment option to consider in veterinary medicine, particularly for equine patients.
Cite This Article
APA
Colmer SF, Wulster K, Johnson AL, Levine DG, Underwood C, Watkins TW, Van Eps AW.
(2022).
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, 36(2), 798-804.
https://doi.org/10.1111/jvim.16390 Publication
Researcher Affiliations
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
- Department of Medical Imaging, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
MeSH Terms
- Adenoma / veterinary
- Animals
- Female
- Horse Diseases / diagnostic imaging
- Horse Diseases / surgery
- Horses
- Hyperparathyroidism, Primary / veterinary
- Parathyroid Glands / diagnostic imaging
- Parathyroid Glands / surgery
- Parathyroid Hormone
- Parathyroid Neoplasms / diagnostic imaging
- Parathyroid Neoplasms / surgery
- Parathyroid Neoplasms / veterinary
- Technetium Tc 99m Sestamibi
- Tomography, X-Ray Computed / veterinary
- Ultrasonography
Conflict of Interest Statement
Authors declare no conflict of interest.
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