TABLE 4.
Clinical data for 138 cats with clinically significant ionized hypercalcemia presented to a referral center between 1st January 2009 and 1st January 2019 by diagnosis
| Variable | Diagnosis | P value | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Acute kidney injury | Chronic kidney disease/renal diet‐associated | Granulomatous | Iatrogenic | Idiopathic | Malignancy‐associated | Primary HyperPTH | Toxicity | Transient | ||
| Cases with each diagnosis | n = 31 | n = 20 | n = 4 | n = 13 | n = 24 | n = 24 | n = 5 | n = 5 | n = 12 | |
| First high iCa (mmol/L) | 1.53 (1.45‐1.62) | 1.43 (1.39‐1.50)a,b | 1.57 (1.46‐1.67) | 1.56 (1.44‐1.65) | 1.56 (1.43‐1.66) | 1.55 (1.48‐1.77)a | 1.76 (1.48‐1.87) | 1.76 (1.64‐2.07)b,c | 1.46 (1.42‐1.53)c | <.001 |
| Max iCa (mmol/L) | 1.53 (1.47‐1.62)c,d | 1.57 (1.48‐1.67) | 1.57 (1.46‐1.67) | 1.56 (1.48‐1.56) | 1.68 (1.57‐1.79)a,c | 1.55 (1.48‐1.84) | 1.76 (1.52‐1.87) | 1.91 (1.75‐2.07)b,d | 1.48 (1.42‐1.53)a,b | <.001 |
| Biochemistry performed | n = 27 |
n = 18 (TCa) n = 19 (Crea + PO4) |
n = 3 | n = 10 | n = 23 | n = 21 | n = 5 | n = 5 | n = 11 | |
| Serum total calcium (mg/dL) | 10.96 (9.96‐12.04)f,g | 11.26 (10.67‐12.45) | 13.6 | 10.66 (9.03‐12.07)d,e | 11.72 (10.80‐12.80) | 12.68 (11.50‐13.54)a | 15.32 (13.56‐16.96)b,d,f | 14.60 (13.64‐16.32)c,e,g | 9.84 (9.08‐10.24)a,b,c | <.001 |
| Total hypercalcemia | 11/27 (40.7%) | 9/18 (50%) | 2/3 (66.7%) | 3/10 (30%) | 15/23 (65.2%) | 15/21 (71.4%) | 5/5 (100%) | 5/5 (100%) | 1/11 (9.1%) | |
| Serum phosphate (mg/dL) | 5.77 (5.77‐7.94)a | 4.84 (3.81‐6.63) | 5.89 | 8.87 (5.19‐13.49)b | 4.50 (3.57‐4.74)a,b | 4.31 (3.80‐6.51) | 3.07 (2.70‐5.43) | 6.88 (5.63‐7.67) | 6.26 (5.05‐7.32) | <.010 |
| Serum creatinine (mg/dL) | 3.72 (3.02‐5.91)b,e,g | 2.57 (1.95‐4.58)a,d | 1.39 | 11.75 (2.50‐5.04)c,f,h | 1.71 (1.54‐2.10)g,h | 1.45 (1.20‐1.75)d,e,f | 1.88 (1.29‐2.50) | 1.34 (1.14‐2.51) | 1.22 (0.76‐1.47)a,b,c | <.001 |
Note: Significant differences within rows but between diagnoses are shown with superscript symbols (a‐g), all P < .05. Initial iCa, max iCa, serum total calcium, serum phosphate and serum creatinine concentrations reported as median (IQR). Insufficient data was available to calculate an interquartile range for serum total calcium, serum creatinine and serum phosphate concentrations for the granulomatous diagnosis. Reference range for total hypercalcemia was >11.2 mg/dL until August 2017, and >11.6 mg/dL from August 2017 until study end.
Abbreviations: Crea, serum creatinine; HyperPTH, hyperparathyroidism; iCa, ionized calcium; Max iCa, maximum ionized calcium; PO4, serum phosphate; TCa, total calcium.