Primary hyperparathyroidism in dogs is the second most common cause of pathologic hypercalcemia in dogs. Dogs affected with this disease are likely to develop significant and life threatening renal disease if they are left untreated. Blood chemistry values along with imaging studies and combining these with pertinent historical data and presenting clinical signs are used to rule out the other causes of hypercalcemia. Definitive diagnosis then includes measuring serum PTH and ionized calcium concentrations. The treatment options available currently are several and include surgery or ablation techniques. This paper will discuss the diagnosis of and treatments for hyperparathyroidism, as well as, the genetics associated with this disease in Keeshonden.