Evaluation of presentation, treatment and outcome in dogs with granulomatous steatitis associated with hypercalcaemia: six cases (2019-2023).


Journal

The Journal of small animal practice
ISSN: 1748-5827
Titre abrégé: J Small Anim Pract
Pays: England
ID NLM: 0165053

Informations de publication

Date de publication:
07 Aug 2024
Historique:
revised: 18 04 2024
received: 19 02 2024
accepted: 26 06 2024
medline: 8 8 2024
pubmed: 8 8 2024
entrez: 8 8 2024
Statut: aheadofprint

Résumé

To report the presentation, treatment and outcome of dogs with granulomatous steatitis associated with total and ionised hypercalcaemia. Six dogs diagnosed with ionised and/or total hypercalcaemia and histologically diagnosed granulomatous steatitis were evaluated to determine the clinical signs, clinical findings, response to treatment and outcome. These cases were seen at different primary care and referral veterinary hospitals in the United Kingdom between 2019 and 2023. No alternative aetiology to explain the total and/or ionised hypercalcaemia or steatitis was identified. The most common presenting signs were lethargy, anorexia or hyporexia, vomiting and polyuria/polydipsia. Other clinical signs included weight loss, discomfort and panting. Five out of the six dogs responded to prednisolone. Four dogs were alive at the time of writing, one dog was lost to follow-up and one dog died 2 weeks post-diagnosis. It is well-established that granulomatous disease can cause hypercalcaemia. In this case series we found granulomatous steatitis associated with total and/or ionised hypercalcaemia. Dogs diagnosed with granulomatous steatitis should have ionised calcium measured, which may prompt further diagnostics and treatment options. Dogs with hypercalcaemia should be evaluated for evidence of steatitis where more common differentials have been excluded.

Identifiants

pubmed: 39113328
doi: 10.1111/jsap.13771
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Author(s). Journal of Small Animal Practice published by John Wiley & Sons Ltd on behalf of British Small Animal Veterinary Association.

Références

Adams, J.S., Singer, F.R., Gacad, M.A., Sharma, O.P., Hayes, M.J., Vouros, P. et al. (1985) Isolation and structural identification of 1,25‐dihydroxyvitamin D3 produced by cultured alveolar macrophages in sarcoidosis. Journal of Clinical Endocrinology and Metabolism, 60, 960–966.
Barker, E. (2023) How to… approach hypercalcaemia in dogs. BSAVA Companion, 2023, 10–15.
Boag, A.K., Murphy, K.F. & Connolly, D.J. (2005) Hypercalcaemia associated with angiostrongylus vasorum in three dogs. The Journal of Small Amimal Practice, 46, 79–84.
Cheng, S.P., Liu, C.L., Liu, T.P., Hsu, Y.C. & Lee, J.J. (2014) Association between parathyroid hormone levels and inflammatory markers among US adults. Mediators of Inflammation, 2014, 709024.
Coady, M., Fletcher, D.J. & Goggs, R. (2019) Severity of ionized hypercalcemia and hypocalcemia is associated with etiology in dogs and cats. Frontiers in Veterinary Science, 6, 276.
Contreary, C.L., Outerbridge, C.A., Affolter, V.K., Kass, P.H. & White, S.D. (2015) Canine sterile nodular panniculitis: a retrospective study of 39 dogs. Veterinary Dermatology, 26, 451–458, e104–455.
Crews, L.J., Sharkey, L.C., Feeney, D.A., Jessen, C.R. & Ruska, T. (2007) Evaluation of total and ionized calcium status in dogs with blastomycosis: 38 cases (1997‐2006). Journal of the American Veterinary Medical Association, 231, 1545–1549.
Doerr, K.A., Outerbridge, C.A., White, S.D., Kass, P.H., Shiraki, R., Lam, A.T. et al. (2013) Calcinosis cutis in dogs: histopathological and clinical analysis of 46 cases. Veterinary Dermatology, 24, 355–361, e78–9.
Elliott, J., Dobson, J.M., Dunn, J.K., Herrtage, M.E. & Jackson, K.F. (1991) Hypercalcaemia in the dog: a study of 40 cases. Journal of Small Animal Practice, 32, 564–571.
Fierer, J., Burton, D.W., Haghighi, P. & Deftos, L.J. (2012) Hypercalcemia in disseminated coccidioidomycosis: expression of parathyroid hormone‐related peptide is characteristic of granulomatous inflammation. Clinical Infectious Diseases, 55, e61–e66.
Fradkin, J., Braniecki, A., Craig, T., Ramiro‐Ibanez, F., Rogers, K. & Zoran, D. (2001) Elevated parathyroid hormone‐related protein and hypercalcemia in two dogs with schistosomiasis. Journal of the American Animal Hospital Association, 37, 349–355.
Frank, L., Brandt, S. & Wabitsch, M. (2022) Subcutaneous fat necrosis in newborns: a systematic literature review of case reports and model of pathophysiology. Molecular and Cellular Pediatrics, 9, 18.
Gear, R.N., Bacon, N.J., Langley‐Hobbs, S., Watson, P.J., Woodger, N. & Herrtage, M.E. (2006) Panniculitis, polyarthritis and osteomyelitis associated with pancreatic neoplasia in two dogs. The Journal of Small Amimal Practice, 47, 400–404.
German, A.J., Foster, A.P., Holden, D., Hotston Moore, A., Day, M.J. & Hall, E.J. (2003) Sterile nodular panniculitis and pansteatitis in three weimaraners. The Journal of Small Amimal Practice, 44, 449–455.
Groth, E.M., Chew, D.J., Lulich, J.P., Tommet, M., Rendahl, A.K., Husbands, B.D. et al. (2020) Determination of a serum total calcium concentration threshold for accurate prediction of ionized hypercalcemia in dogs with and without hyperphosphatemia. Journal of Veterinary Internal Medicine, 34, 74–82.
Hughes, D., Goldschmidt, M.H., Washabau, R.J. & Kueppers, F. (1996) Serum alpha 1‐antitrypsin concentration in dogs with panniculitis. Journal of the American Veterinary Medical Association, 209, 1582–1584.
IRIS Canine GN Study Group Standard Therapy Subgroup, Brown, S., Elliott, J., Francey, T., Polzin, D. & Vaden, S. (2013) Consensus recommendations for standard therapy of glomerular disease in dogs. Journal of Veterinary Internal Medicine, 27(Supplement 1), S27–S43.
Kim, H.J., Kang, M.H., Kim, J.H., Kim, D. & Park, H.M. (2011) Sterile panniculitis in dogs: new diagnostic findings and alternative treatments. Veterinary Dermatology, 22, 352–359.
Latic, N. & Erben, R.G. (2021) FGF23 and vitamin D metabolism. JBMR Plus, 5, e10558.
Lem, K., Fosgate, G., Norby, B. & Steiner, J. (2008) Associations between dietary factors and pancreatitis in dogs. Journal of the American Veterinary Medical Association, 233, 1425–1431.
McLellan, G.J. & Bedford, P.G. (2012) Oral vitamin E absorption in English cocker spaniels with familial vitamin E deficiency and retinal pigment epithelial dystrophy. Veterinary Ophthalmology, 15(Supplement 2), 48–56.
Mellanby, R.J., Stell, A., Baines, E., Chantrey, J.C. & Herrtage, M.E. (2003) Panniculitis associated with pancreatitis in a cocker spaniel. The Journal of Small Amimal Practice, 44, 24–28.
Mellanby, R.J., Mellor, P., Villiers, E.J., Herrtage, M.E., Halsall, D., O'Rahilly, S. et al. (2006) Hypercalcaemia associated with granulomatous lymphadenitis and elevated 1,25 dihydroxyvitamin D concentration in a dog. The Journal of Small Amimal Practice, 47, 207–212.
Mellor, P.J., Fetz, K., Maggi, R.G., Haugland, S., Dunning, M., Villiers, E.J. et al. (2006) Alphal‐proteinase inhibitor deficiency and Bartonella infection in association with panniculitis, polyarthritis, and meningitis in a dog. Journal of Veterinary Internal Medicine, 20, 1023–1028.
Messinger, J.S., Windham, W.R. & Ward, C.R. (2009) Ionized hypercalcemia in dogs: a retrospective study of 109 cases (1998‐2003). Journal of Veterinary Internal Medicine, 23, 514–519.
Miller, W.H., Campbell, K.L., Griffin, C.E., Kirk, R., Muller, G.H. & Scott, D.W. (2013) Miscellaneous skin diseases. In: Muller & Kirk's small animal dermatology, 7th edition. St. Louis, MO: Elsevier Mosby.
O'Halloran, C., Barker, E.N., Hope, J.C. & Gunn‐Moore, D. (2024) Canine tuberculosis: a review of 18 new UK cases and 565 historical cases. The Veterinary Journal, 304, 106089.
O'Kell, A.L., Inteeworn, N., Diaz, S.F., Saunders, G.K. & Panciera, D.L. (2010) Canine sterile nodular panniculitis: a retrospective study of 14 cases. Journal of Veterinary Internal Medicine, 24, 278–284.
Parker, V.J., Harjes, L.M., Dembek, K., Young, G.S., Chew, D.J. & Toribio, R.E. (2017) Association of vitamin D metabolites with parathyroid hormone, fibroblast growth factor‐23, calcium, and phosphorus in dogs with various stages of chronic kidney disease. Journal of Veterinary Internal Medicine, 31, 791–798.
Paterson, S. (1994) Panniculitis associated with pancreatic necrosis in a dog. Journal of Small Animal Practice, 35, 116–118.
Paterson, S. (1995) Sterile idiopathic pedal panniculitis in the German shepherd dog – clinical presentation and response to treatment of four cases. The Journal of Small Amimal Practice, 36, 498–501.
Portales‐Castillo, I. & Simic, P. (2022) PTH, FGF‐23, klotho and vitamin D as regulators of calcium and phosphorus: genetics, epigenetics and beyond. Frontiers in Endocrinology (Lausanne), 13, 992666.
Reichel, H., Koeffler, H.P. & Norman, A.W. (1987) Synthesis in vitro of 1,25‐dihydroxyvitamin D3 and 24,25‐dihydroxyvitamin D3 by interferon‐gamma‐stimulated normal human bone marrow and alveolar macrophages. Journal of Biological Chemistry, 262, 10931–10937.
Rodriguez, M. (2020) FGF23: is it another biomarker for phosphate‐calcium metabolism? Advances in Therapy, 37, 73–79.
Rose, L.J., Dunn, M.E., Allegret, V. & Bedard, C. (2011) Effect of prednisone administration on coagulation variables in healthy beagle dogs. Veterinary Clinical Pathology, 40, 426–434.
Schissler, J. (2019) Sterile pyogranulomatous dermatitis and panniculitis. Veterinary Clinics of North America: Small Animal Practice, 49, 27–36.
Shanley, K.J. & Miller, W.H. (1985) Panniculitis in the dog: a report of five cases. Journal of the American Animal Hospital Association, 21, 545–550.
Tebben, P.J., Singh, R.J. & Kumar, R. (2016) Vitamin D‐mediated hypercalcemia: mechanisms, diagnosis, and treatment. Endocrinology Reviews, 37, 521–547.
Tidholm, A., Karlsson, I. & Wallius, B. (1996) Feline pansteatitis: a report of five cases. Acta Veterinaria Scandinavica, 37, 213–217.
Tinawi, M. (2021) Disorders of calcium metabolism: hypocalcemia and hypercalcemia. Cureus, 13, e12420.
Tornqvist‐Johnsen, C., Schnabel, T., Gow, A.G., Del‐Pozo, J., Milne, E., Macklin, V. et al. (2020) Investigation of the relationship between ionised and total calcium in dogs with ionised hypercalcaemia. The Journal of Small Amimal Practice, 61, 247–252.
Valverde, R., Rosales, B., Frutos, J.O.‐d., Luis Rodríguez‐Peralto, J. & Ortiz‐Romero, L. (2008) Alpha‐1‐antitrypsin deficiency panniculitis. Journal Dermatologic Clinics, 26, 447–451.
Weiss, D.J. & Rashid, J. (1998) The sepsis‐coagulant axis: a review. Journal of Veterinary Internal Medicine, 12, 317–324.
Xenoulis, P.G., Levinski, M.D., Suchodolski, J.S. & Steiner, J.M. (2011) Serum triglyceride concentrations in miniature schnauzers with and without a history of probable pancreatitis. Journal of Veterinary Internal Medicine, 25, 20–25.

Auteurs

H Reyes-Hughes (H)

Langford Vets, Small Animal Referral Hospital, University of Bristol, Langford, UK.

A Bivand (A)

Hayle Veterinary Surgery, Cornwall, UK.

C Waters (C)

Castle Veterinary Group, Launceston, UK.

P Valiente (P)

North Downs Specialist Referrals, Bletchingley Surrey, UK.

F Adam (F)

North Downs Specialist Referrals, Bletchingley Surrey, UK.

S Rapastella (S)

Davies Veterinary Specialists, Hertfordshire, UK.

E N Barker (EN)

Langford Vets, Small Animal Referral Hospital, University of Bristol, Langford, UK.
Bristol Veterinary School, University of Bristol, Langford, UK.

Classifications MeSH