My cat is in ER with high calcium. Do I need all these expensive tests?

According to the PetHealth network, testing involves: Complete blood count to look at the white and red blood cells and platelets Chemistry panel to look at the kidney and liver function Electrolytes to look at the calcium, phosphorous, and salt balance (e.g., sodium, potassium, etc.) Urinalysis to look for the presence of an underlying infection, crystals, or appropriate urine concentration Urine culture to rule out an underlying urinary tract infection Feline leukemia (FELV) and feline immunodeficiency virus (FIV) X-rays to rule out underlying cancer, bladder stones, or evidence of mineralization of tissue (secondary to hypercalcemia) Ultrasound to rule out underlying cancer, bladder stones, or inappropriate mineralization Parathyroid hormone (PTH) and PTH-rP concentration (parathyroid hormone related protein) levels. With hyperparathyroidism, the PTH levels are typically normal to high. With hypercalcemia of malignancy, PTH-rP concentrations are typically elevated. With idiopathic hypercalcemia in cats, PTH levels and PTH-rP levels are typically low. This can be expensive, but necessary to get to the cause. I would speak to Sammy's vet to discuss what tests should be done first. Best of luck.

Hi there and thank you for using Petco Pet Education Center, formerly Petcoach to address your concern. The further testing may help with determining what the primary cause is so that treatment can be administered that will help with the condition. However, if you do not want to put Kai through a major surgery or chemotherapy, the further diagnostics that have been recommended would then be more for your own knowledge so you know what the cause is. You could also keep Kai comfortable and start her on liver supplements without doing the further diagnostics and hope for the best. If you are determined to find out what the problem is, then I would proceed with the recommended testing that the veterinarian discussed with you. I hope this helps guide you in the right direction. Please let me know if you have any other questions or concerns and I would be more than happy to help you further. Please take the time to mark this question as helpful or not as it helps us to improve on the quality of our answers to other pet owners. Thank you kindly!

Hi and thanks for your request. Neoplasia, chronic renal failure (CRF), and idiopathic hypercalcemia are common causes of elevation of Calcium levels. The approach to this problem with elevated Ca++ I would recommend is: - repeat the blood test and analyze the ionised Ca++ (which can give you a reliable information about the calcium levels). At the same time I would recommend to perform a urine analysis and determine the SDMA value on the blood which can be an early indicator of renal failure; - If then this is a true elevation (Ionised Ca++ elevated) I would recommend to perform x rays of the chest and an abdominal ultrasound. This is to rule out any possibility of a tumor, especially lymphoma which is a common reason for this problem. - Based on these results you can then either treat appropriately or look for other uncommon causes like Hyperparathyroidsm (HP), Vitamin D toxicosis, granulomatous diseases such as Actinomycosis and Criptococcosis, and Hypoadrenocorticism. Regarding the ear discharge, these are typical signs of an infection and antibiotics ear drops are often resolutive. Hope this answer was helpful, and at least gave you an idea of the next steps necessary in these cases, but please do not hesitate to contact us again on the forum or by requesting a consultation if you have any more questions or to discuss it any further. If this answer was helpful please let us know, this will be used to improve our service!

Hi there and thank you for using Petco Pet Education Center, formerly Petcoach to address your concern. Based on these lab results, I would suspect renal disease. BUN, Amylase, magnesium and CPK all can become altered with renal impairment. The weight loss may be due to muscle wastage due to chronic renal disease or something else may be going on. I would consider having Tigger's urine specific gravity checked and also send out an SDMA test to see if the kidney's are the main problem. At 14.5 years of age, renal disease would be high on my list of causes of these symptoms. Other problems such as cancer and inflammatory diseases may be the cause of the symptoms as well. I would recommend having your vet pursue additional testing to get more of a definitive answer on whether or not the kidneys are impaired and if not, coming up with further recommendations on diagnostics and treatment. I hope this helps guide you in the right direction. Please let me know if you have any other questions or concerns and I would be more than happy to help you further.

High calcium is not very commonly found in cats on well-balanced cat foods. Potential causes for hypercalcemia in cats include lab error or lipemic blood sample, cancer, kidney failure, bone disease, hyperthyroidism, toxic exposure, supplements, among a few others. I would recommend that you follow-up with your vet about these possible concerns. The vet may recommend additional testing, including an ionized Calcium level, which more accurately evaluates the calcium in the body than total calcium on most in-house blood panels.

I would recommend the bloodwork if possible. Many of the symptoms your describe could be due to hyperthyroidism which can often be managed with diet or medication. Renal disease diabetes are also concerns. Speak with your vet to determine what they suspect is most likely and find out if it is possible to test for one thing at a time instead of running a full panel at once. The vet will suggest the best options but often if you explain financial constraints we can work with owners. If unable to do the diagnostic testing then euthanasia is a reasonable option to prevent her from suffering. Thanks for using Petco Pet Education Center, formerly Petcoach

Unfortunately high calcium levels often do point to a cancerous condition such as lymphoma. And cats are particularly prone to lymphoma. Here is some good information on feline lymphona: http://download.skyscape.com/download/ota/5mvetcf5/documents/pdf/lymphoma-cats.pdf And here is information on hyperparathyroidism: http://download.skyscape.com/download/ota/5mvetcf5/documents/pdf/hyperparathyroidism.pdf If you have any specific question feel free to ask. Sometimes high calcium levels may be idiopathic, ie the cause is unknown. Your vet likely will also send blood in for ionized calcium which will help determine the cause.