High calcium results on labs

Hi All,

Nugget was diagnosed about 11 days ago. We have had a fairly steady stream of good BG values. However, all 3 of the vets I saw were extremely concerned about her high calcium result on both sets of labs run.

The first vet went to far as to say "yupp, for sure your cat is diabetic and she might also have cancer".
As such, I burst into tears in the hallway at work (I'm a teacher) and this nagging thought has been in the back of my head this whole time.

Another vet said it could be idiopathic, that we need to run labs to check it again. She also said there is the possibility of the diabetes just throwing her out of wack. She felt a small nodule on Nugget's thyroid as well, but her thyroid values came back normal.

The third vet said not to worry about it just yet, but yes, there is a possibility that it could be cancer, and that would mean a myriad of diagnostic tests to figure it out.

Prior to her diabetes diagnosis Nugget was always a healthy cat. She was never sick, she lost weight from the time we adopted her (13 pounds to just under 10 pounds over 4 years), she loves to play, her teeth are in good shape, she is a snuggle muffin and very loving.

Has anyone else gotten a high calcium reading on a lab after being diagnosed with diabetes? I am not sure how often labs need to be repeated, and if this is something to tackle aggressively or not.

 

The lab guru here is @Marje and Gracie . She might be able to give you good info.

 

That’s a pretty high calcium. Anything over 10.5 is of concern.

The serum high calcium would not likely be caused by diabetes although a cat who is drinking and peeing a lot might have transient high calcium.

Hypercalcemia is better diagnosed with an ionized calcium test. It is more reflective of whether Hypercalcemia exists or not as it measures the amount of free calcium in the blood and is not affected by the albumin (her albumin is normal but high albumin...often due to dehydration...can cause increased serum calcium).

Causes of Hypercalcemia include:

• Hyperparathyroidism (this is different than hyperthyroid).......overactivity of the parathyroid gland. This is relatively rare in cats but when it is seen, it’s “usually” in conjunction with chronic kidney disease (CKD). Of course, with cats, one never assumes it can be caused only by CKD.
• Overdose of vitamin D
• Ingesting rat poison
• Cancer
• Idiopathic meaning no one knows.

If Nugget was mine, I’d get her right back in for an ionized calcium test at the least and possibly a PTH test to see if there is any significance to the elevated serum calcium and whether she has parathyroidism, respectively.

Your vet should also give her fluids and migh5 want you to give subq fluids. We have another member who has a civvie with Hypercalcemia and he’s been on Fosamax, which has helped. He also is non diabetic but has hypoglycemia.

Has she had fluids lately or is she drinking a ton of water? Her urine specific gravity is low. It can vary during the day so before stressing about it, you could take in the very first free catch sample of the day and have your vet check the USG with a refractometer to see if she is able to concentrate her urine. Can you please check her IDEXX lab report from 2/28 and see if it has a value for SDMA? Her hematocrit is also lower than it should be.

Pls let me know if you have questions.

 

My shop cat had routine bw and next day her labs indicate hypokalemia and CKD stage 4
I was losing her--she is only 12 (not my diabetic)
long story and will get to what may help you--
I am wondering of you are using epakitin?
https://www.amazon.com/Epakitin-EPA...e=UTF8&qid=1520830806&sr=8-1&keywords=epaktin
Many use it as a phos binder but is also increases calcium (thank you @tiffmaxee )
I ALMOST got it but thankfully my friend from the forum urged me to to
I supplemented with NOW brand-she is normal calcium now as her was low-

prayers for you and kitty ---so stressful...
Hi @Marje and Gracie

 

so sorry my kitty is hypokalemia

 

Hi sweetie...sorry to hear about this kitty.

Hypokalemia is low potassium. You mean hypocalcemia, yes? I’m glad it helped her!

Hope your boys are well.

 

Yes--I always get it confused--I added the MSM from.... https://www.theholistichorse.com/shop/animal-products/cats/su-per-msm-ultra-pure-powder-2/

I can't explain it but she is doing great--Elise has been my shoulder .....she was the one who said NOOOOOOO to epakitan. (thank goodness)

boys are good -thanks!
your cutie??

 

I’m also not a fan of epakitin. I’m glad the boys are well. Liv and Tobey are Super.....thanks!