Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases

Abstract Background Limited information is available concerning treatment of ionized hypercalcemia in cats. Hypothesis/Objectives Describe clinical findings in a cohort of cats with persistent ionized hypercalcemia and evaluate long‐term tolerance and efficacy of alendronate in these patients. Anima...

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Main Authors: Maxime Kurtz, Loïc Desquilbet, Justine Maire, Fiona Da Riz, Morgane Canonne‐Guibert, Ghita Benchekroun, Christelle Maurey
Format: Article
Language:English
Published: Wiley 2022-11-01
Series:Journal of Veterinary Internal Medicine
Subjects:
Online Access:https://doi.org/10.1111/jvim.16508
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author Maxime Kurtz
Loïc Desquilbet
Justine Maire
Fiona Da Riz
Morgane Canonne‐Guibert
Ghita Benchekroun
Christelle Maurey
author_facet Maxime Kurtz
Loïc Desquilbet
Justine Maire
Fiona Da Riz
Morgane Canonne‐Guibert
Ghita Benchekroun
Christelle Maurey
author_sort Maxime Kurtz
collection DOAJ
description Abstract Background Limited information is available concerning treatment of ionized hypercalcemia in cats. Hypothesis/Objectives Describe clinical findings in a cohort of cats with persistent ionized hypercalcemia and evaluate long‐term tolerance and efficacy of alendronate in these patients. Animals Twenty cats with persistent ionized hypercalcemia of undetermined origin, presented for routine or referral consultation at the teaching hospital of Maisons‐Alfort (France). Methods Medical records were retrospectively reviewed. Cats were divided into Group 1 (cats that received alendronate as well as other treatments, n = 11) and Group 2 (cats that did not receive alendronate, n = 9). Survival analysis (Kaplan‐Meier method, log‐rank test, and Cox proportional hazard models) was conducted to compare time to selected outcomes. Results Azotemia was present in 15 cats (75%). Alendronate treatment was administered and well tolerated during the entire follow‐up period (median, 9.5 months; interquartile range [IQR], 6.3; 27) in all cats from Group 1, except in 1 cat that developed severe hypophosphatemia, prompting treatment discontinuation. Univariate analysis determined that alendronate treatment was significantly associated with shorter time to reach a 15% decrease in ionized calcium concentration (iCa) from baseline during follow‐up (119 days vs median not reached, P = .02). This association was no longer significant after adjustment for age and initial iCa. Conclusions and Clinical Importance Alendronate overall was well tolerated with chronic use in this cohort, and can be considered a treatment option for persistent ionized hypercalcemia in cats.
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spelling doaj.art-6b3fdb6b310e4ae0a0bf8dfc0aa2dce92022-12-26T07:32:23ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762022-11-013661921193010.1111/jvim.16508Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 casesMaxime Kurtz0Loïc Desquilbet1Justine Maire2Fiona Da Riz3Morgane Canonne‐Guibert4Ghita Benchekroun5Christelle Maurey6Department of Internal Medicine Ecole Nationale Vétérinaire d'Alfort Maisons‐Alfort FranceDepartment of Clinical Epidemiology and Biostatistics Ecole Nationale Vétérinaire d'Alfort Maisons‐Alfort FranceDepartment of Internal Medicine Ecole Nationale Vétérinaire d'Alfort Maisons‐Alfort FranceDepartment of Internal Medicine Ecole Nationale Vétérinaire d'Alfort Maisons‐Alfort FranceDepartment of Internal Medicine Ecole Nationale Vétérinaire d'Alfort Maisons‐Alfort FranceDepartment of Internal Medicine Ecole Nationale Vétérinaire d'Alfort Maisons‐Alfort FranceDepartment of Internal Medicine Ecole Nationale Vétérinaire d'Alfort Maisons‐Alfort FranceAbstract Background Limited information is available concerning treatment of ionized hypercalcemia in cats. Hypothesis/Objectives Describe clinical findings in a cohort of cats with persistent ionized hypercalcemia and evaluate long‐term tolerance and efficacy of alendronate in these patients. Animals Twenty cats with persistent ionized hypercalcemia of undetermined origin, presented for routine or referral consultation at the teaching hospital of Maisons‐Alfort (France). Methods Medical records were retrospectively reviewed. Cats were divided into Group 1 (cats that received alendronate as well as other treatments, n = 11) and Group 2 (cats that did not receive alendronate, n = 9). Survival analysis (Kaplan‐Meier method, log‐rank test, and Cox proportional hazard models) was conducted to compare time to selected outcomes. Results Azotemia was present in 15 cats (75%). Alendronate treatment was administered and well tolerated during the entire follow‐up period (median, 9.5 months; interquartile range [IQR], 6.3; 27) in all cats from Group 1, except in 1 cat that developed severe hypophosphatemia, prompting treatment discontinuation. Univariate analysis determined that alendronate treatment was significantly associated with shorter time to reach a 15% decrease in ionized calcium concentration (iCa) from baseline during follow‐up (119 days vs median not reached, P = .02). This association was no longer significant after adjustment for age and initial iCa. Conclusions and Clinical Importance Alendronate overall was well tolerated with chronic use in this cohort, and can be considered a treatment option for persistent ionized hypercalcemia in cats.https://doi.org/10.1111/jvim.16508bisphosphonatescalciumchronic kidney diseaseurolithiasis
spellingShingle Maxime Kurtz
Loïc Desquilbet
Justine Maire
Fiona Da Riz
Morgane Canonne‐Guibert
Ghita Benchekroun
Christelle Maurey
Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases
Journal of Veterinary Internal Medicine
bisphosphonates
calcium
chronic kidney disease
urolithiasis
title Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases
title_full Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases
title_fullStr Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases
title_full_unstemmed Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases
title_short Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases
title_sort alendronate treatment in cats with persistent ionized hypercalcemia a retrospective cohort study of 20 cases
topic bisphosphonates
calcium
chronic kidney disease
urolithiasis
url https://doi.org/10.1111/jvim.16508
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