PMID- 32303315
OWN - NLM
STAT- MEDLINE
DCOM- 20210122
LR  - 20210122
IS  - 0737-0806 (Print)
IS  - 0737-0806 (Linking)
VI  - 88
DP  - 2020 May
TI  - Primary Hyperparathyroidism Associated With Atypical Headshaking Behavior in a 
      Warmblood Gelding.
PG  - 102840
LID - S0737-0806(19)30589-1 [pii]
LID - 10.1016/j.jevs.2019.102840 [doi]
AB  - A 14-year-old Zweibrucker Warmblood gelding was presented for evaluation of 
      lethargy and headshaking. The horse had a history of bouts of lameness in 
      different limbs and back problems. It also had many mild colic episodes in the 
      past. Results of repeat laboratory tests had shown persistent hypercalcemia 
      (4.8 mmol/L; reference interval [RI]: 2.0-3.2 mmol/L) for 1.5 years and later on 
      hypophosphatemia (0.4 mmol/L; RI: 0.5-1.3 mmol/L) and mild hypermagnesemia 
      (1.0 mmol/L; RI: 0.5-0.9 mmol/L). Parathyroid hormone (PTH) concentration was 
      within the RI. Other causes of hypercalcemia, such as renal failure, vitamin D 
      toxicosis, and granulomatous disease, and nutritional secondary 
      hyperparathyroidism were ruled out. Furthermore, there was no evidence of 
      neoplastic disease. Parathyroid hormone-related protein was measured but 
      inconclusive. A diagnosis of primary hyperparathyroidism was established on the 
      basis of hypercalcemia, hypophosphatemia, low fractional excretion of calcium, 
      and high fractional excretion of phosphorus in combination with a PTH secretion 
      refractory to high calcium levels. Because of the bad prognosis, the owner 
      decided to euthanize the horse. Results of postmortem examination were 
      unremarkable. Hypercalcemia should always be considered abnormal, and further 
      examinations need to be performed to proof hypercalcemia and subsequently find 
      the cause. The main differential diagnoses are renal insufficiency and humoral 
      hypercalcemia of malignancy, but also rare diseases, such as hyperparathyroidism, 
      have to be taken into account.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Schwarz, Bianca
AU  - Schwarz B
AD  - Pferdeinternist Dr. Bianca C. Schwarz, DipECEIM, Saarlouis, Germany. Electronic 
      address: schwarz@pferdeinternist.de.
FAU - Klang, Andrea
AU  - Klang A
AD  - Department of Pathobiology, Institute of Pathology, University of Veterinary 
      Medicine, Vienna, Austria.
FAU - Schwendenwein, Ilse
AU  - Schwendenwein I
AD  - Clinical Pathology Platform, Department for Pathobiology, University of 
      Veterinary Medicine, Vienna, Austria.
LA  - eng
PT  - Case Reports
DEP - 20191112
PL  - United States
TA  - J Equine Vet Sci
JT  - Journal of equine veterinary science
JID - 8216840
RN  - 0 (Parathyroid Hormone)
SB  - IM
MH  - Animals
MH  - *Colic/veterinary
MH  - *Horse Diseases/diagnosis
MH  - Horses
MH  - *Hypercalcemia/diagnosis/veterinary
MH  - *Hyperparathyroidism, Primary/complications/veterinary
MH  - *Hyperparathyroidism, Secondary/veterinary
MH  - Male
MH  - Parathyroid Hormone
OTO - NOTNLM
OT  - Calcium
OT  - Headshaking
OT  - Horse
OT  - Hypercalcemia
OT  - Parathyroid hormone
EDAT- 2020/04/19 06:00
MHDA- 2021/01/23 06:00
CRDT- 2020/04/19 06:00
PHST- 2019/07/14 00:00 [received]
PHST- 2019/10/31 00:00 [revised]
PHST- 2019/11/08 00:00 [accepted]
PHST- 2020/04/19 06:00 [entrez]
PHST- 2020/04/19 06:00 [pubmed]
PHST- 2021/01/23 06:00 [medline]
AID - S0737-0806(19)30589-1 [pii]
AID - 10.1016/j.jevs.2019.102840 [doi]
PST - ppublish
SO  - J Equine Vet Sci. 2020 May;88:102840. doi: 10.1016/j.jevs.2019.102840. Epub 2019 
      Nov 12.