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Diagnosis and treatment of confirmed and suspected primary hyperparathyroidism in equids: 17 cases (1999–2016)
Author(s) -
Gorenberg E. B.,
Johnson A. L.,
Magdesian K. G.,
Bertin F.R.,
Costa L. R. R.,
Theelen M. J. P.,
DurwardAkhurst S. A.,
Cruz Villagrán C.,
Carslake H.,
Frank N.,
Tomlinson J. E.
Publication year - 2020
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/evj.13120
Subject(s) - medicine , primary hyperparathyroidism , scintigraphy , adenoma , parathyroid adenoma , hyperparathyroidism , retrospective cohort study , parathyroid hormone , thyroid , horse , radiology , surgery , paleontology , biology , calcium
Summary Background Primary hyperparathyroidism is uncommon in equids. Objectives To describe the diagnostic findings and efficacy of treatment in equids with primary hyperparathyroidism. Study design 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 ( PTH rP) 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. Main limitations 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.