Primary hyperparathyroidism with calcium oxalate urolithiasis in a dog and treatment by ultrasound-guided percutaneous ethanol injection
"Soren:, an eight year old male castrated Samoyed, presented to the Small Animal Medicine service at Cornell University after hypercalcemia, calcium oxalate crystalluria and urolithiasis was diagnosed by his referring veterinarian. On physical examination, pain was elicited on palpation of the urinary bladder and a small (3 mm.) nodule was palpated within the anus. Hypercalcemia, hypophosphatemia and elevated alkaline phosphatase were seen on a serum chemistry panel. Urinalysis revealed isosthenuria and calcium oxalate crystalluria. Cytologic evaluation of the anal mass indicated probable circumanal gland hyperplasia or adenoma. A 5 mm hypoechoic nodule was present at the cranial pole of the right thyroid gland on cervical ultrasound examination. Results of a parathyoid panel were consistent with primary hyperparathyroidism (marked elevation of ionized calcium with normal parathyroid hormone and parathormone related protein levels). Soren's owners elected to pursue ultrasound guided chemical ablation of the parathyroid nodule and cystotomy to remove the urinary bladder stones.