64 Hypocalcaemia INTRODUCTION Clinical signs of hypocalcaemia reflect calcium’s importance to the electrical stability of excitable tissue. Spasms, cramp and tetany are commonly observed. Handling and excitement typically induce or worsen the signs. Onset is sudden and dramatic and may follow a period of non-specific illness comprising lameness, stiffness, pain, nervousness, panting, lethargy, weakness, inappetance and fever. Total serum calcium may not reflect the low ionized calcium and the latter should always be specifically checked. The neuromuscular signs may be episodic despite a persistent hypocalcaemia. Diagnosis: ionized serum calcium <1.0 mmol/l. The muscle spasms are often painful (cramp). Rigid abdominal muscles and pain induced by palpation of the spinal epaxial muscles may be confused with spinal pain from IVDD, discospondylitis, etc. Pancreatitis may be an equally erroneous conclusion. A stiff, stilted hunched gait, with fasciculation and trembling occurs (Fig. 64.1). Figure 64.1 Hypocalcaemic muscle pain. Arched back, low neck carriage, wide hindlimb stance. Ear and facial twitching may occur. Elevated third eyelids are reported in the cat. Intense facial rubbing occurs in cats and is seen in over 50% of dogs. Intense biting or licking of the paws is another manifestation of what may be a paraesthesia. Humans report numbness and tingling of the fingers, feet and the perioral area. Seizures are commonly reported, and witnessed at the veterinary practice, while those caused by idiopathic epilepsy or intracranial lesions have usually resolved before the animal is presented. Muffled heart sounds, weak pulses and paroxysmal tachyarrhythmias are commonly detected on physical examination. SIGNALMENT A 5-year-old neutered female terrier dog. CASE PRESENTING SIGNS Neck pain. CASE HISTORY The dog had been quiet and depressed for months and was inappetant. Vomiting had been intermittent. Painful episodes had occurred in the week prior to presentation. NSAID administration had not improved the dog’s condition. The dog had been referred for treatment of suspected IUD disease. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Metabolic encephalopathy: hepatic encephalopathy Meningioma Behaviour change – an introduction Idiopathic facial paralysis Stay updated, free articles. Join our Telegram channel Join Tags: Saunders Solutions in Veterinary Practice Small Animal Neurology Sep 3, 2016 | Posted by admin in SMALL ANIMAL | Comments Off on Hypocalcaemia Full access? Get Clinical Tree
64 Hypocalcaemia INTRODUCTION Clinical signs of hypocalcaemia reflect calcium’s importance to the electrical stability of excitable tissue. Spasms, cramp and tetany are commonly observed. Handling and excitement typically induce or worsen the signs. Onset is sudden and dramatic and may follow a period of non-specific illness comprising lameness, stiffness, pain, nervousness, panting, lethargy, weakness, inappetance and fever. Total serum calcium may not reflect the low ionized calcium and the latter should always be specifically checked. The neuromuscular signs may be episodic despite a persistent hypocalcaemia. Diagnosis: ionized serum calcium <1.0 mmol/l. The muscle spasms are often painful (cramp). Rigid abdominal muscles and pain induced by palpation of the spinal epaxial muscles may be confused with spinal pain from IVDD, discospondylitis, etc. Pancreatitis may be an equally erroneous conclusion. A stiff, stilted hunched gait, with fasciculation and trembling occurs (Fig. 64.1). Figure 64.1 Hypocalcaemic muscle pain. Arched back, low neck carriage, wide hindlimb stance. Ear and facial twitching may occur. Elevated third eyelids are reported in the cat. Intense facial rubbing occurs in cats and is seen in over 50% of dogs. Intense biting or licking of the paws is another manifestation of what may be a paraesthesia. Humans report numbness and tingling of the fingers, feet and the perioral area. Seizures are commonly reported, and witnessed at the veterinary practice, while those caused by idiopathic epilepsy or intracranial lesions have usually resolved before the animal is presented. Muffled heart sounds, weak pulses and paroxysmal tachyarrhythmias are commonly detected on physical examination. SIGNALMENT A 5-year-old neutered female terrier dog. CASE PRESENTING SIGNS Neck pain. CASE HISTORY The dog had been quiet and depressed for months and was inappetant. Vomiting had been intermittent. Painful episodes had occurred in the week prior to presentation. NSAID administration had not improved the dog’s condition. The dog had been referred for treatment of suspected IUD disease. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Metabolic encephalopathy: hepatic encephalopathy Meningioma Behaviour change – an introduction Idiopathic facial paralysis Stay updated, free articles. Join our Telegram channel Join
