What should I do if my cat has idiopathic hypercalcemia?
As you know, treatment for idiopathic hypercalcemia in cat is currently empiric, since the cause of the disorder remains unknown. I generally start with a change in diet as a first step in treatment (1), since normocalcemia is sometimes restored after a change to a different diet.
Is there a cure for normocalcemia in cats?
However, even in cats that show an initial response to dietary intervention, the duration of normocalcemia may be short-lived and the hypercalcemia can relapse. In these cats, I then turn to medical therapy (i.e., glucocorticoids or bisphosphonates) to help control the hypercalcemia.
How often should I give my Cat alendronate?
Like you, I start with an initial oral dose of 10 mg per week, and then gradually increase the dose based on ionized calcium concentrations monitored at 4-6 week intervals (4). This treatment protocol will restore normocalcemia in over two-thirds of the hypercalcemic cats treated with an average weekly dose of 15 mg (4).
When to treat high calcium levels in CKD cats?
High calcium levels are more common in CKD cats than low calcium levels, but it is not always essential to treat hypercalcaemia. High calcium levels are not normally a problem unless: if calcium multiplied by phosphorus is higher than 60-70 in US values or 5 in international values.
Why is feline idiopathic hypercalcemia an increasing problem?
Feline Idiopathic Hypercalcemia is an increasing problem rather than just an increasing recognition of an old problem. It is not understood what causes it or why it is becoming prevalent. Many experts believe that acidifying, magnesium-restricted diets lead to IHC in genetically predisposed cats, perhaps due to the calcium resorption from bones.
What to do for a cat with ionized hypercalcemia?
If no response is detected after a month or two on this restricted calcium diet, alternative medical therapies (e.g., glucocorticoids, alendronate) should be considered. In cats with idiopathic hypercalcemia, clinical signs and the associated degree of ionized hypercalcemia are usually mild, at least at diagnosis.
Are there canned diets for cats with idiopathic hypercalcemia?
Canned diets developed to prevent calcium oxalate urolithiasis (e.g., Royal Canin Urinary SO, Purina UR Urinary St/Ox, Iams Urinary-O Plus Moderate pH/O, Hill’s c/d) may be beneficial in the treatment of cats with idiopathic hypercalcemia (5,6).
However, even in cats that show an initial response to dietary intervention, the duration of normocalcemia may be short-lived and the hypercalcemia can relapse. In these cats, I then turn to medical therapy (i.e., glucocorticoids or bisphosphonates) to help control the hypercalcemia.