Hypercalcemia associated with granulomatous disease in a cat.

A 6-year-old cat was examined because of recurrence of a draining mass involving skin and subcutaneous tissues of the caudoventral aspect of the abdomen. Previous treatment included administration of antimicrobial drugs and corticosteroids and surgical excision. Atypical mycobacteria were seen during cytologic examination of biopsy specimens of the mass; Nocardia sp was cultured. While hospitalized, the cat developed hypercalcemia and was found to have high serum calcitriol concentrations. Treatment consisted of administration of ciprofloxacin and trimethoprim-sulfadiazine because of the infection and administration of sodium chloride solution, furosemide, and calcitonin because of the hypercalcemia. The cat recovered.

Calcitriol and bone mass accumulation in females during puberty.

Adolescence is characterized by rapid skeletal development and high demands for bone minerals. Though the stimulative effect of calcitriol on intestinal calcium and phosphorus absorption is well understood, its effect on bone development is not completely clear. It may be directly involved in the facilitation of calcium economy during this critical phase of skeletal development. Therefore, we evaluated the serum concentrations of calcitriol in relation to skeletal development in a cross-sectional study of 178 healthy Caucasian females during different pubertal stages, extending from childhood to young adulthood. In addition, a subsample of 57 younger girls was followed for a 1-year period to evaluate the association among serum calcitriol, nutrition parameters (dietary calcium, phosphorus, and vitamin D), bone mass accumulation, and biochemical markers of bone turnover. The serum calcitriol concentration in a cross-sectional sample was the highest during pubertal growth spurt (sexual maturity index 3-4, age 11-13 years) (ANOVA; F = 2.4945; P = 0.0329). This correlated to the peak skeletal calcium accretion (g/year) and bone mass accumulation in total body and forearm. In a longitudinal sample, there was a positive association between annual change in TBBMC (P = 0.0255); TBBMD (P = 0.0168); proximal radius (1/3 distance from styloid process) BMC (P = 0.0096); BMD (P = 0.0541), and baseline calcitriol level in forward stepwise regression analyses. The results of the forward stepwise regression analyses with serum calcitriol as a dependent variable and different serum, urinary, and dietary parameters measured at baseline (age 11 years, n = 114) and after 1 year (age 12 years, n = 57) showed that osteocalcin was positively associated with calcitriol in both years; more so in a second year (P = 0.0514, P < 0.001, respectively). Dietary vitamin D and phosphorus showed negative association with serum calcitriol at age 11, and dietary Ca and P were selected at age 12. The results of this study show that calcitriol is a significant correlate of bone mass accumulation during pubertal growth, presumably in response to the high requirements for calcium during this critical phase of skeletal development.

Benefits of calcitriol therapy and serum phosphorus control in dogs and cats with chronic renal failure. Both are essential to prevent of suppress toxic hyperparathyroidism.

Daily oral calcitriol at low doses is safe and effective in the control of renal secondary hyperparathyroidism in dogs and cats. Low doses of calcitriol are most effective when started early in uremia before the advanced stages of renal secondary hyperparathyroidism. At early stages calcitriol both diminishes PTH synthesis in the parathyroid cells present and prevents the hyperplasia that, if unchecked, results in the most extensive an difficult-to-control hyperparathyroidism. The salutary effects on the dog's or cat's sense of well being, appetite, activity, strength, and lifespan as reported by the veterinarians of our survey are attributed primarily to keeping PTH levels below a toxic threshold. Additionally, some of the benefits achieved by calcitriol are likely a direct consequence of calcitriol interacting with the vitamin D receptor in a wide variety of tissues throughout the body. Phosphorus restriction through a combination of diet and intestinal phosphate binders is important to allow calcitriol therapy to successfully lower PTH levels, but it likely has no direct effects that are independent of interactions involving calcitriol. Phosphorus restriction is also important to minimize chances for adverse tissue mineralization. Calcitriol therapy can be considered for treatment of chronic renal failure after serum phosphorus has been decreased to less than 6.0 mg/dL in patients in whom it was initially elevated. Calcitriol supplementation to dogs and cats with chronic renal failure makes good endocrinologic sense. Calcitriol deficits cause increased PTH and, as these two hormones are designed to maintain calcium and phosphorus homeostasis, the PTH increase is initially adaptive. One of the important effects of PTH is to stimulate additional calcitriol formation as a powerful means to raise blood calcium through increased calcium absorption from the diet. With too great an increase in PTH, however, its effects become harmful to many tissues due to the widespread distribution of the PTH receptor in many cell types that are likely normally responsive only to the paracrine PTH-related peptide that shares the PTH receptor. Exogenous supplemental calcitriol administration allows concentrations of calcitriol in the bloodstream to remain normal without the toxic consequences of excessive PTH secretion that would otherwise be provoked. Studies involving young dogs with subtotal nephrectomy may not parallel those on older dogs and cats with spontaneous chronic renal failure. In particular, higher doses are needed to effect PTH change in these young dogs than we have found necessary for older dogs and cats. Because survey participants agreed most strongly with the idea that their calcitriol-treated dogs and cats were living longer than comparably uremic animals they had treated previously, further studies to evaluate the ability of calcitriol to retard the progression of renal lesions and loss of excretory renal function seem warranted. Additional studies to document the beneficial effects of calcitriol on the many organs adversely affected by excess PTH during uremia are also needed because findings thoroughly documented and proven in humans and rats may not always extrapolate to dogs and cats.

Hypophosphatemic rickets in rheas (Rhea americana).

Rickets was diagnosed in 11 rheas from four flocks in Ohio. At necropsy, had pliable bones with prominent valgus or varus deformation of the femoral bone and/or the tibiotarsal bone, marked thickening of the metaphyseal plates, and frequent fractures. Histopathologically, bones of rachitic birds showed marked retention of cartilage core within the growth plate, mainly because of a significant lengthening of the hypertrophied zone of the growth plate in relationship to the remaining zones. Feed analysis showed that rachitic birds were fed diets having higher calcium/phosphorus (Ca/P) ratios (1.38-4.32) than that of the diet fed to nonrachitic birds from a different flock (0.65 Ca/P ratio). Serum analysis of blood from clinically rachitic birds from the affected flocks revealed a marked hypophosphatemia (3.0-4.7 mg/dl), mild hypocalcemia, and normal 25-(OH)-vitamin D concentrations as compared with values in nonrachitic birds, which had serum phosphorus concentrations of 8.5-8.7 mg/dl. These findings suggest that rickets in growing rheas was associated with marked hypophosphatemia and improper Ca/P ratios.

Humoral hypercalcemia of malignancy associated with ameloblastoma in a horse.

Humoral hypercalcemia of malignancy was evident in a horse that had a locally invasive ameloblastoma of the left hemimandible. Surgical removal of the neoplasm resulted in prompt return of serum calcium and parathyroid hormone concentrations to within reference limits. The tumor contained parathyroid hormone-related protein, as demonstrated by immunohistochemistry and western blot analysis. It is likely that production of this protein by the neoplasm was important in the pathogenesis of the hypercalcemia. The case represented a sporadic form of humoral hypercalcemia of malignancy attributable to an uncommon epithelial neoplasm, and indicated that humoral hypercalcemia of malignancy can develop with neoplasms in horses.

Comparative effects of calcitriol and parathyroid hormone on serum aluminum in vitamin D-depleted rabbits fed an aluminum-supplemented diet.

Under normal circumstances, the body barriers effectively limit the entry and retention of dietary aluminum. However, both parathyroid hormone (PTH) and calcitriol (physiologically active hormonal form of vitamin D3) have been reported to produce elevation of serum aluminum in animals fed an aluminum-supplemented ration. To compare the effects of calcitriol with those of PTH with reference to their putative effect to enhance aluminum absorption, an experiment was designed wherein the serum levels of both PTH and calcitriol would be changing markedly during a short time-frame. To condition the rabbits used for this comparison, they were fed a vitamin D-free diet, which caused the level of calcitriol and its precursors to decline rapidly. The calcitriol deficit together with the ensuing lack of calcium absorption resulted in a state of secondary hyperparathyroidism. Vitamin D-depletion was shown to be complete by the high level of serum PTH and a low (unmeasurable) level of serum calcitriol. To enable comparison of PTH with calcitriol, exogenous calcitriol infusion (60 IU/day) was started by osmotic pump simultaneously with the beginning of an aluminum (aluminum lactate) supplemented diet. Aliquots were collected for both serum PTH and serum calcitriol at intervals during the 7 day study. A rising serum aluminum level was highly correlated with the rising serum calcitriol level in the rabbits (r = 0.903, p = 0.036) during the first 4 days of the infusion. The mean serum aluminum levels rose nearly 13 parts per billion (ppb) in the 7 day period. Declining serum PTH (due to feedback mechanisms of calcitriol suppressing PTH synthesis) showed a negative correlation of serum aluminum and serum PTH (r = -0.959, p = < 0.01) during the first 4 days of infusion. Control rabbits (vitamin-D depleted) fed aluminum-supplemented rations have shown only a minimal transient rise in serum aluminum level which returned to the pre-test level by the end of the week. To test for any effect of PTH on serum aluminum in the absence of calcitriol, five rabbits were implanted with osmotic pumps infusing PTH (mean 6.0 U/hr) and started on an aluminum supplemented diet. These rabbits, having previously been depleted of vitamin D were already in a state of nutritional secondary hyperparathyroidism as shown by their elevated pretest PTH levels. During the 7 day infusion, the serum aluminum rose only a mean of approximately 1 part per billion (ppb).(ABSTRACT TRUNCATED AT 400 WORDS)

Parathyroid hormone (PTH)-related protein, PTH, and 1,25-dihydroxyvitamin D in dogs with cancer-associated hypercalcemia.

Circulating N-terminal PTH-related protein (PTHrP), N-terminal PTH, and 1,25-dihydroxyvitamin D [1,25-(OH)2D] concentrations were measured in normal dogs and dogs with cancer-associated hypercalcemia (CAH), parathyroid adenomas, and miscellaneous tumors. PTHrP was undetectable (less than 1.8 pM) in normal dogs and increased in dogs with CAH due to adenocarcinomas derived from apocrine glands of the anal sac (44.9 +/- 27 pM), lymphoma (8.3 +/- 4.4 pM), and miscellaneous carcinomas (13.3 +/- 11.4 pM). The PTHrP concentration decreased in dogs with lymphoma and anal sac adenocarcinomas after successful treatment of CAH. The PTHrP concentration had a significant linear correlation with total serum calcium in dogs with anal sac adenocarcinomas and hypercalcemia, but not in dogs with lymphoma and hypercalcemia. Serum N-terminal PTH concentrations were usually in the normal range (12-34 pg/ml) for all groups of dogs except dogs with parathyroid adenomas (83 +/- 38 pg/ml). The serum PTH concentration increased after successful treatment of CAH. Serum 1,25-(OH)2D concentrations were decreased, normal, or increased in dogs with CAH, and 1,25-(OH)2D levels decreased after treatment of CAH. In summary, circulating concentrations of PTHrP are consistently increased in dogs with CAH, and PTHrP appears to play an important role in the induction of hypercalcemia.

Anemia of chronic renal failure in dogs.

Seventeen dogs with chronic renal failure (CRF) were studied to evaluate the incidence, type, and etiology of anemia in CRF. A nonregenerative, normochromic, normocytic anemia was seen in 12 of 17 dogs (70.6%). There was a direct correlation between the degree of anemia and the extent of CRF as assessed by serum creatinine concentrations (P = .0386, r = .50923). Erythrocyte concentrations of 2,3-diphosphoglycerate (DPG) were significantly increased in anemic animals and showed a close correlation to the degree of anemia. The high DPG concentrations may compensate for the anemia by decreasing the hemoglobin-oxygen affinity and thereby facilitating tissue oxygenation at low hematocrits. Serum concentrations of erythropoietin (Epo) were in the low to normal range, despite mild to moderate anemia, documenting a deficiency of Epo in dogs with CRF. The nonregenerative nature of the anemia supports impaired hematopoiesis as a significant etiologic factor. Other factors, such as increases in serum parathyroid hormone and phosphorus, were not found to correlate significantly with the degree of anemia, although there were significant differences between their concentrations in anemic compared with non-anemic dogs. There was no change in erythrocyte osmotic fragility with uremia. The documentation of a nonregenerative, normochromic, normocytic anemia, with failure of an appropriate increase in Epo production, supports the therapeutic use of Epo in the management of the anemia seen in CRF in the dog.

Nephrocalcinosis caused by hyperparathyroidism in progression of renal failure: treatment with calcitriol.

Nephrocalcinosis is accepted to contribute to the progression of renal failure. We have reviewed evidence that nephrocalcinosis is caused directly by the excess parathyroid hormone produced in renal disease. Evidence that hyperparathyroidism in uremic patients results from calcitriol deficiency and the mechanisms by which this comes about have been discussed. We have shown that renal secondary hyperparathyroidism can be eliminated or substantially reduced without increasing blood calcium using a low-dosage regimen of calcitriol. Decreasing PTH concentrations to or near normal alleviates this hormone's toxicity to many organs, including the kidneys. Potential benefits for the uremic patient include an increase in the quality and length of life. Calcitriol treatment provides a powerful means to reduce PTH concentration in uremic patients that may not be achieved with other methods. Further prospective clinical studies of uremic dogs and cats are warranted to document preservation of renal function and histology during calcitriol treatments.

Effects of mithramycin on calcium metabolism and bone in dogs.

Mithramycin (0.1 mg/kg) was administered intravenously to eight Beagle dogs on days 0 and 7 to determine its effects on calcium and phosphorus metabolism, serum parathyroid hormone concentration, osteoclastic bone resorption, and serum biochemical and hematologic parameters. Ionized calcium concentration was paradoxically increased on day 1 and decreased on day 8 in association with an increased serum parathyroid hormone concentration. Serum phosphorus concentration was decreased on days 1 and 2. Osteoclastic bone resorption in iliac cancellous bone was significantly decreased on day 8. There were mild increases in serum alkaline phosphatase (days 1, 2, 4, 8, 9), aspartate aminotransferase (day 9), and gammaglutamyl transpeptidase (days 7, 9) activities. Platelet numbers were increased on days 7 through 13, and packed red blood cell volumes were mildly decreased. This investigation demonstrates that two doses of mithramycin can be administered safely to dogs and may inhibit bone resorption in diseases associated with increased osteoclastic bone resorption, such as humoral hypercalcemia of malignancy.

Evaluation of urine and serum metabolites in miniature schnauzers with calcium oxalate urolithiasis.

To evaluate underlying causes of calcium oxalate urolithiasis, 24-hour excretion of urine metabolites was measured in 6 Miniature Schnauzers that formed calcium oxalate (CaOx) uroliths during periods when they were fed a standard diet and during periods when food was withheld. Serum concentrations of parathyroid hormone and 1,25-dihydroxyvitamin D also were evaluated. Serum calcium concentrations were normal in all 6 affected Miniature Schnauzers; however, during diet consumption, mean 24-hour urinary excretion of calcium was significantly (P = 0.025) higher than calcium excretion when food was withheld. In 1 dog, urinary calcium excretion was lower during the period of food consumption, compared with the period when food was withheld. Compared with clinically normal Beagles, Miniature Schnauzers that formed CaOx uroliths excreted significantly greater quantities of calcium when food was consumed (P = 0.0004) and when food was withheld (P = 0.001). Miniature Schnauzers that formed CaOx uroliths excreted significantly less oxalate than clinically normal Beagles during fed (P = 0.028) and nonfed (P = 0.004) conditions. Affected Miniature Schnauzers also excreted abnormally high quantities of uric acid. Excretion of citrate was not different between Miniature Schnauzers with CaOx urolithiasis and clinically normal Beagles. In 5 of 6 Miniature Schnauzers with CaOx urolithiasis, concentrations of serum parathyroid hormone were similar to values from age- and gender-matched Miniature Schnauzers without uroliths. The concentration of serum parathyroid hormone in 1 dog was greater than 4 times the mean concentration of clinically normal Miniature Schnauzers. Mean serum concentrations of 1,25-dihydroxyvitamin D in Miniature Schnauzers with calcium oxalate urolithiasis were similar to concentrations of clinically normal Miniature Schnauzers.

Effect of calcitriol infusions on serum aluminum in vitamin D-depleted rabbits fed an aluminum-supplemented ration.

Three dosages of calcitriol (10, 30 and 60 IU/day) were given to rabbits by subcutaneously implanted osmotic pumps. The purpose was to compare the dosages with regard to their putative effect in elevating serum aluminum levels by mechanisms such as enhancing intestinal absorption, diminishing renal excretion, or others. To establish uniform levels of endogenous calcitriol and its precursors, all rabbits had been depleted of vitamin D. The depletion was demonstrated by their serum calcidiol and calcitriol levels declining to unmeasurable levels, following the regimen of a vitamin D-free diet. The 8 rabbits were then placed on an aluminum-supplemented (aluminum lactate) ration. The amount of feed (and aluminum) consumed was determined at daily intervals. Serum aluminum levels were determined at intervals during the 7 days on this regimen. In a second test, the same 8 rabbits received the same regimen but in addition were infused with 10, 30 or 60 IU calcitriol per day. It was found that the aluminum-fed rabbits receiving 60 IU/day and 30 IU/day calcitriol infusions showed statistically significantly elevated serum aluminum levels as compared to their levels without calcitriol (p = 0.0208 and p = 0.434, respectively). Rabbits receiving pumps delivering 10 IU/day while receiving the aluminum-supplemented ration showed no rise in serum aluminum with time or treatment during the 7 day study. Likewise rabbits receiving aluminum-supplemented rations without calcitriol showed only an early minimal rise in mean serum aluminum which returned to the pre-test level by the end of a week in spite of continued consumption of aluminum-supplemented rations.

Age-related differences in phosphonoformate-induced bone toxicity in cats.

Phosphonoformate (PFA), a monophosphonate pyrophosphate analog, caused plasma biochemical and bone histomorphologic abnormalities in cats given 1,000 mg/kg/day as a continuous intravenous infusion for 14 days. Plasma biochemical alterations observed in young cats (10 weeks old) treated with PFA included increased calcium and decreased phosphorus, alkaline phosphatase, and calcitriol. Young cats treated with PFA developed rickets-like lesions characterized by widened growth plates, increased osteoid, and failure of mineralization. In addition, area of mineralized trabecular bone was decreased. Osteoclast size was increased whereas osteoclast perimeter and number were unaffected in young PFA-treated cats. Plasma alkaline phosphatase was decreased in adult cats (greater than or equal to 1 year old) treated with PFA but changes in calcium, calcitriol, and immunoreactive parathyroid hormone were highly variable and not significantly different. Adult cats treated with PFA exhibited osteomalacia characterized by increased osteoid area, perimeter, and width with failure of mineralization. In addition, static resorption indices were increased in PFA-treated adult cats but area of mineralized trabecular bone was not decreased. The monophosphonate PFA inhibited bone mineralization in young and adult cats similar to bisphosphonate treatment in other species. Because PFA is currently in phase I trials for use in AIDS, results of this study suggest a need to evaluate patients treated with PFA for metabolic bone disease.

Effects of dietary acidification and potassium depletion on acid-base balance, mineral metabolism and renal function in adult cats.

Effects of dietary potassium restriction, with or without dietary acidification, on acid-base balance, mineral metabolism and renal function were evaluated in 12 adult cats. Six cats were fed a potassium-restricted diet (0.2% potassium) for 8 wk, and six cats were fed the same potassium-restricted diet plus a dietary acidifier (0.8% NH4Cl) for 8 wk. Both groups of cats were then fed the same diet supplemented with potassium gluconate (0.7% dietary potassium) for an additional 4 wk. Renal function was evaluated before treatment and again at 8 and 12 wk. Serum potassium concentration declined in all cats by wk 1 and was also lower in NH4Cl-treated cats at 2, 3, 6 and 8 wk than in control cats. Metabolic acidosis developed in both groups of cats. Dietary balance studies indicated negative potassium balance in NH4Cl-treated cats. Glomerular filtration rate declined significantly in NH4Cl-treated cats after 8 wk but was unchanged in control cats. From the results of this study, we conclude that adding a dietary acidifier to a potassium-restricted diet worsens hypokalemia, possibly by affecting gastrointestinal potassium handling, and induces severe metabolic acidosis and renal dysfunction in adult cats.

The effects of uremia and dietary phosphorus on the bone of rats.

In order to evaluate the effects of uremia and low levels of dietary phosphorus on bone, male Sprague-Dawley rats weighing 320 +/- 20 g (12 weeks old) were subjected to either a two-step, subtotal nephrectomy or sham-operation (SO), and then fed a custom diet with either normal calcium (0.5%) and normal phosphorus (0.3%) (NCNP), or normal calcium and low phosphorus (0.03%). When compared to the NCNP SO group after seven days, only uremic rats fed low phosphorus diets developed osteomalacia characterized by an increase in the osteoid thickness, surface and volume, a prolonged osteoid maturation time, and a decreased bone formation rate. No other groups developed these changes. This osteomalacia was also associated with hypophosphatemia, a reduced serum PTH and an elevation in the serum 1,25(OH)2D3. It was concluded that while neither this degree of uremia nor the low phosphorus diets alone had any significant effect, the combination of uremia and low dietary phosphorus resulted in the initiation of osteomalacia. This animal model should prove useful in investigations dealing with the influence of uremia on the mineralization process.

The effect of chronic dietary acidification using ammonium chloride on acid-base and mineral metabolism in the adult cat.

Adult cats with normal renal function were fed a nutritionally balanced, vitamin A-replete, experimental dry diet with or without ammonium chloride (NH4Cl) for 6 mo to study the effects of chronic dietary acidification on acid-base parameters and the metabolism of selected minerals. Dietary balance studies were performed monthly. Blood and urine samples were collected monthly to evaluate acid-base parameters, plasma parathyroid hormone (PTH) and 1.25-dihydroxycholecalciferol levels. Ammonium chloride-treated cats had significantly lower blood and urinary pH, and lower blood bicarbonate concentrations. Treated cats also had higher blood ionized calcium concentrations, hypercalciuria and lower intestinal calcium absorption relative to baseline (prior to feeding the experimental diet) and to control cats. This resulted in the development of lower calcium balance in the first several months. PTH levels were unaffected by dietary acidification; however, 1.25-dihydroxycholecalciferol levels were significantly decreased in treated cats. Treated cats had negative potassium balance during 5 mo of dietary acidification. Magnesium, sodium, and phosphorus balances were lower, but positive, in treated cats compared to control cats. Cats consuming the NH4Cl-supplemented diet had increased chloride balance. Thus, chronic dietary acidification with 1.5% NH4Cl produced chronic metabolic acidosis and lower or negative, calcium and potassium balance.

Serum calcitriol and parathyroid hormone levels following prolonged infusion of calcitriol in vitamin D replete and depleted rabbits.

The objectives of this study are (1) to determine if serum calcitriol levels resulting from calcitriol infusion by subcutaneously implanted osmotic pumps are in proportion to dose, (2) to determine if such serum levels remain steady during the "pump-life" and (3) to determine if these increased calcitriol levels have an effect on serum parathyroid hormone (PTH) levels. A general objective of the study is to define a model whereby agents (calcitriol, and parathyroid hormone) suspected of enhancing absorption of metals other than calcium from the gastrointestinal tract could be evaluated individually by the levels of these hormones present in serum at a series of intervals during calcitriol infusion by osmotic pump. Calcitriol was infused into rabbits by subcutaneously implanted osmotic pumps at 3 different dosages (30, 60, and 100 IU/day) for 7 days and one dose (60 IU/day) for a 28 day period. The serum calcitriol levels initially rose markedly in all experimental rabbits in proportion to infused dosage and peaked at 3 days. The quantitative relationship between infused calcitriol and serum calcitriol at 3-5 days showed a correlation coefficient of 0.977 (P less than 0.005) for rabbits receiving the 7 day pumps with the 3 different dosages. There was subsequent decline of serum calcitriol which continued for the remainder of the pump-life, suggesting acceleration of degradation mechanisms. There was a sharp reduction in serum parathyroid hormone (PTH) levels 3-5 days after starting the calcitriol infusion, which was interpreted to result from direct suppression of PTH synthesis by calcitriol and/or the feedback effect of enhanced intestinal calcium absorption. Rabbits which had been depleted of vitamin D prior to implantation of the 28 day osmotic pumps showed a similar pattern of serum calcitriol and PTH. Multiple analyses within a single rabbit showed a reciprocal relationship between the serum calcitriol and PTH during the 28 days. There was a statistically significant negative correlation between these parameters (r = 0.635, P less than 0.05). The data indicate that despite a constant rate of infusion of calcitriol by osmotic pump, the levels of serum calcitriol and parathyroid hormone do not remain constant, but rather undergo marked changes. These findings demonstrate the necessity of monitoring blood levels, even in studies in which animals receive a constant infusion of calcitriol.

Hypercalcemia in dogs with lymphosarcoma. Biochemical, ultrastructural, and histomorphometric investigations.

Dogs with lymphosarcoma and hypercalcemia had decreased trabecular bone volume and increased osteoclastic osteolysis, whereas dogs with lymphosarcoma that were normocalcemic did not have increased bone resorption. Increased osteoclastic resorption was present only in bone from hypercalcemic dogs that contained neoplastic tissue but not in bone free of tumors, suggesting that the factor(s) responsible for stimulating bone resorption were elaborated locally by the tumor tissue. Hypercalcemic dogs with lymphosarcoma had decreased concentrations of plasma immunoreactive parathyroid hormone and serum 1,25-(OH)2D compared with normocalcemic dogs with lymphosarcoma and control dogs with and without other neoplasms. Immunoreactive parathyroid hormone was not detected in lymphosarcoma tissue. The plasma concentration of 13,14-dihydro-15-keto-prostaglandin E2 (PGE2M) was increased approximately 2-fold in hypercalcemic dogs with lymphosarcoma as compared with other groups. Urine excretion of calcium, phosphorus, and hydroxyproline were increased in hypercalcemic dogs with lymphosarcoma. Ultrastructurally, lymphosarcomas were composed of tumor cells with large nuclei and a paucity of cytoplasmic organelles. Light and electron microscopic examination of parathyroid glands revealed inactive or atrophic chief cells in dogs with lymphosarcoma and hypercalcemia. The increased osteoclastic bone resorption in hypercalcemic dogs with lymphosarcoma was not mediated by increased circulating levels of immunoreactive parathyroid hormone and 1,25-(OH)2D but was dependent upon infiltration of bone marrow by neoplastic cells and, presumably, the local production of a bone resorption-stimulating factor.

Hypercalcemia in dogs with adenocarcinoma derived from apocrine glands of the anal sac. Biochemical and histomorphometric investigations.

Hypercalcemia, hypercalciuria, and hyperphosphaturia were present in female dogs with adenocarcinomas derived from apocrine glands of the anal sac (CA). Remission of hypercalcemia accompanied tumor excision in all six dogs undergoing surgery, whereas tumor recurrence or growth of metastases was associated with a return of hypercalcemia. Preoperatively, the plasma concentrations of immunoreactive parathyroid hormone in all dogs were undetectable or in the low normal range. Plasma concentrations of 13,14-dihydro-15-keto-prostaglandin E2 (PGE2M) and serum 1,25-dihydroxyvitamin D were not significantly different from control dogs. Urinary cyclic AMP and hydroxyproline were increased in dogs with CA. No immunoreactive parathyroid hormone was detected in extracts from tumor tissue, and parathyroid glands from dogs with CA had ultrastructural characteristics of secretory inactivity. Lumbar vertebrae from hypercalcemic dogs had decreased trabecular bone volume and increased osteoclastic bone resorption compared with age-matched control dogs. After tumor excision, serum total calcium returned to the normal range, whereas immunoreactive parathyroid hormone increased 2- to 20-fold and 1,25-dihydroxyvitamin D decreased 2- to 8-fold. Postoperative hypocalcemia was not observed. These results indicate that CA produces a hypercalcemic factor other than immunoreactive parathyroid hormone or prostaglandin E2 that increases osteoclastic osteolysis distant from the tumor and results in hypercalcemia, hypercalciuria, and hyperphosphaturia.

Origin an importance of increased alkaline phosphatase activity in peritoneal fluids of horses with colic.

The origin of increased alkaline phosphatase (ALP) activity in peritoneal fluid (PF) of horses with clinical signs of abdominal pain was investigated to determine the usefulness of measuring ALP in PF in the diagnosis of small intestinal injury. The ALP isoenzymes in PF from 10 clinically normal horses and from 50 horses with clinical signs of acute abdominal pain were analyzed for their sensitivities to inhibition by L-phenylalanine, L-homoarginine, and levamisole and to inactivation by heat (56 C, 15 minutes). The enzymes also were discriminated by their patterns of migration during polyacrylamide gel disc electrophoresis. Of 50 horses with colic, 20 had ALP activity in PF at least 3 times the upper limit of normal. Of these 20 horses, 10 had marked increases of ALP activity in PF ranging from 10 to 150 times the mean value of activity as determined in the 10 normal horses. In the 50 horses with colic, ALP values in serum were within the normal range. In 19 of the 20 sick horses, the ALP in PF had properties different from small intestinal ALP. Of the 10 PF samples with markedly increased ALP activity, 9 had a group of properties that were unique for granulocytic ALP. The clinical diagnoses for the 10 horses with markedly increased ALP activity in PF included thromboembolic colic (4 horses), colonic torsion (2 horses), small intestinal volvulus (2 horses), peritonitis (1 horse), and salmonellosis (1 horse). Properties of the enzyme in the 10 PF samples with moderately increased ALP activity were compatible with a granulocytic origin, but insufficient enzyme concentration precluded electrophoretic confirmation of the source. The PF from 1 horse had a mixture of ALP isoenzymes derived from granulocytes and small intestinal mucosa. Of the 50 horses with colic, 6 had severe small intestinal disease without increased ALP activity in PF. Apparently, increased ALP activity in PF cannot be used as a reliable indicator of small intestinal injury in horses, because the ALP is predominantly granulocytic in origin.