Hypercalcemia in a 10-Year-Old Female Spayed Miniature Schnauzer
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The patient, a 10-year-old female spayed Miniature Schnauzer dog, was referred to the Cornell University Hospital for Animals for hypercalcemia and a four-day history of anorexia, vomiting, lethargy, weakness, and wobbly gait. On rectal exam, a firm, non-expressible, 6 cm in diameter right anal sac mass was palpated. Initial laboratory data was suggestive of renal failure. The anal gland mass was aspirated, and cytology revealed the definitive diagnosis of apocrine gland adenocarcinoma of the anal sac. Imaging revealed evidence of local and distant cancer metastasis. Palliative treatment was elected, and pamidronate, prednisone, and fluid diuresis were used to decrease the patient’s serum calcium levels. The patient remained severely azotemic, despite aggressive fluid therapy. Serum calcium levels rapidly declined, until the patient became dangerously hypercalcemic, developed clinical signs of hypocalcemia, and required calcium supplementation.
Neoplasia is the number one cause of canine hypercalcemia. This case report offers a review of calcium homeostasis, paraneoplastic hypercalcemia in the context of anal sac apocrine gland adenocarcinoma, and the medical management of calcium imbalances.