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Hypoparathyroidism: Management 1429.e1

Hypoparathyroidism: Management
VetBooks.ir

Confirmed hypocalcemia
and hyperphosphatemia

Decreased serum albumin and/or increased Normal serum albumin concentration and
blood urea nitrogen (BUN) and serum creatinine normal BUN and serum creatinine levels

• Investigate other causes of hypocalcemia
• Measure serum ionized calcium level
High-normal or Decreased or low-normal
increased PTH? serum parathyroid
hormone (PTH) level?
Yes
Yes
Patient is showing no signs or mild clinical signs
(e.g., intermittent muscle fasciculations) Initiate treatment for
hypoparathyroidism

Patient is showing severe clinical
signs referable to hypocalcemia
(e.g., tetany, hyperthermia)
• Calcitriol 0.01–0.02 mcg/kg orally q
24h; adjust long-term based
on response
• Calcium carbonate: 25 mg/kg elemental • Connect electrocardiographic (ECG) monitor
calcium (= 62.5 mg/kg calcium carbonate) Once stabilized and administer calcium gluconate 10%
orally q 24h injectable solution: 0.5-1.5 mL/kg IV slowly
• Dihydrotachysterol no longer available in (10-15 minutes) to effect,
USA (dose 0.01-0.02 mg/kg orally q 24h while monitoring for efficacy (visible
if available) in place of calcitriol reduction in clinical signs) and/or signs
of excess
(e.g., bradycardia or QT interval shortening
on ECG)
• Measure serum magnesium and
Recheck serum calcium twice supplement as necessary
weekly until in mid-normal range.

UPDATED AND EDITED BY: Leah A. Cohn, DVM, PhD, DACVIM
ORIGINALLY WRITTEN BY: Cary L. M. Bassett, DVM, DACVIM

Clinical Algorithms

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