American Association of Feline Practitioners

Veterinary professionals passionate about the care of cats

Idiopathic Hypercalcemia in Cats – What You May Not Know

Idiopathic Hypercalcemia in Cats – What You May Not Know


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The importance of ionized calcium (iCa) for its biological activity and why measuring iCa is superior to measurement of total calcium will be introduced. Increases in iCa often occur earlier in chronic disease than will occur for total calcium which allows an earlier diagnosis to be made. Though ionized calcium can be estimated at times, actual measurement is more accurate and is the gold standard. The differential diagnoses for hypercalcemia in the cat will focus on idiopathic hypercalcemia (IHC) as most common, followed by malignancy, primary hyperparathyroidism, and hypervitaminosis D. The accurate diagnosis of IHC will be illustrated first and then followed by how to use diet and bisphosphonates (alendronate) to restore normocalcemia. 

At the end of this seminar, the attendee should be able to:

  • Explain to a client how measurement of ionized calcium can be more clinically helpful than evaluation of total calcium on a routine biochemical panel
  • Contrast how measurement of iCa can generate different results depending on sample handling and between in-house or send-out to a reference laboratory
  • Diagnose the cause of hypercalcemia as arising from IHC, malignancy, hyperparathyroidism, or hypervitaminosis D
  • Develop a treatment and monitoring plan using diet for IHC in cats
  • Develop a treatment and monitoring plan using alendronate for IHC in cats

Speaker Bio

Dennis J. Chew, DVM, DACVIM

Dr. Chew is a 1972 graduate of the College of Veterinary Medicine at Michigan State University. He did a one-year internship at South Weymouth Veterinary Associates and a two-year residency in internal medicine and nephrology at the Animal Medical Center in New York City. He became a Diplomate of the American College of Veterinary Internal Medicine in 1977. Dr. Chew was an attending veterinarian at The Ohio State University College of Veterinary Medicine Teaching Hospital for 36 years and is now Professor Emeritus. Most of his work in clinics, research, and publications involves urology/nephrology in small animals. He has special interest in disorders of calcium metabolism, chronic kidney disease and vitamin D metabolite dynamics, idiopathic/interstitial cystitis of cats, and diagnostic urinary endoscopy. He has been the author of over 100 peer-reviewed publications and 2 editions of the Manual of Nephrology and Urology in Small Animals.


RACE Credits 

This program 20-804536 is approved by the AAVSB RACE to offer a total of 1.00 CE Credits (1.00 max) being available to any one veterinarian: and/or 1.00 Veterinary Technician CE Credits (1.00 max). This RACE approval is for the subject matter categorie(s) of: Scientific using the delivery method(s) of: Non-Interactive Distance. This approval is valid in jurisdictions which recognize AAVSB RACE; however, participants are responsible for ascertaining each board's CE requirements.


Disclosure Statement

This webinar is sponsored by Zoetis. Speakers are expected to disclose conflict of interests whenever a conflict arises relating to the topics of this educational webinar.

Dr. Chew is an independent contractor with Zoetis and Antech and serves on the Advisory Board for Nestle-Purina. Dr. Chew also delivers Urinary CE content for VCA.