High Calcium Level... Please don't let it be cancer

Sending many vibes for you & your baby.

A few years ago I went through this with Jordan. Only Jordan's main symptom was a loss of appitite. The first question that comes to my mind is, does your kitty take Lactulose or Enulose on a regular basis? Jordan had been on lactulose for mega colon. About a month after he started the lactulose Jordan developed hypercalcimia. The vets insisted the two were not related. His blood calcium was elevated for over a year. After a lot of research & against my vets judgement I took him off the lactulose. I have been able to manage his constipation through diet & cat-a-lax when needed. About a month after taking him of the lactulose his blood calcium started to drop & almost 3 years later he is doing very well & is his normal self. Now I don't know what is going on with your kitty, but I share my story because vets like to say that lactulose & hypercalcimia are not related. I want people to know that in at least one case there is evidence that it might just be a problem.

Sending healing prayers for your cat.

I have had the same experience with lactulose and hypercalcemia.

Ootay had megacolon and CRF, among other things, but at the time I am talking about she did not have hyperthyroid disease (that came later.)

She was on lactulose for megacolon. Her blood Ca began to rise shortly after starting the lactulose. We tried everything, we put her on saline fluids instead of lactated ringers, we tried special foods (which she would not eat) and I took her to Cornell twice to see a specialist, for ultrasounds.

The second time we went to Cornell the special veterinary internist mentioned a case she was seeing that was similar to Ootay's. She said the cat's owner had mentioned a possible link to high blood calcium in CRF cats and lactulose.

We searched and searched but could find no reference to it, but my vet and I agreed to take Ootay off the lactulose (switched to mineral oil) Ootay's blood calcium was up to 14 and still climbing.

Three weeks after stopping the lactulose it had dropped to 10.8 and there it remained, for the rest of her life.

So..even though there is no clinical proof yet, I agree with Rang, the word needs to get out about this link of lactulose to high blood calcium.

I am glad to see it mentioned here. I was actually banned from another pet forum for sharing my experience about this there. The resident vet of that forum was furious with me for posting my experiences insisting that because she had never heard of it it couldn't possibly be true.

As I said then, and say now, it surely isn't the ONLY cause of elevated blood calcium in senior cats, but it a cat is on lactulose, and is presenting with hypercalcemia, the first thing I advise is stopping the lactulose.

I'd like to see the use of lactulose in cats completely eliminated, frankly.

to OP:

there are other causes of course, and you can hope she's just developing some hyperthyroid that can be controlled with medication, but if she is on lactulose, do talk to your vet about trying another laxative (such as miralax)

good job getting Spivey in to the vet quickly, when you noticed she was a bit off.
keep us posted.

What is your vet lab's "normal range" for calcium? Normal ranges can vary from lab to lab. eg) my Vet lab's normal range is 9-11.1 for calcium.

Was it your Vet who told you that 10.8 was considered high? (thereby implying the high end of your vet lab's "normal range" is 10.7 or so?)

Also, I would recommend rechecking the calcium level again. It could have just been "off" due to improper handling of the blood sample, the machine used to run the blood not having been properly calibrated, etc. Hopefully your Vet knows not to conclude anything just from one potentially isolated value.

I looked back at my old cat Taco's lab results (he passed in 2009 at age 16 yrs). Starting in 2001, his calcium was 10.5, then 10.7, in 2003 it was 11.3!! then 2 months later it was 10.0, then 10.7 a year later, then 9.9 in 2005. So that "high" value of 11.3 really didn't mean anything at all, even though it scared me silly!

Does your Vet clinic run the blood in-house or do they send it off to an actual veterinary lab to be run? If it's in-house, if it were me I'd take kitty back and request that the sample be sent off to an actual local Vet lab for processing.

One of the possible causes of elevated blood calcium (hypercalcemia) in cats is Hyperparathryoidism (this is related to the parathyroid gland, not the thyroid gland - they are 2 different glands with different functions in the body). Here's a really good excerpt that speaks to this, and also explains some of the other possible causes of hypercalcemia. Notice the underlined and italicized excerpts:

Hyperparathyroidism

The parathyroid glands are sensitive to the balance of calcium and phosphorus in the blood. If there is a chronic excess of phosphorus or a deficit of calcium, the parathyroid glands will overproduce the parathyroid hormone (PTH) resulting in secondary hyperparathyroidism. This overproduction causes calcium to be removed from the bones to reestablish the proper calcium-to-phosphorus ratio in the blood. Secondary hyperparathyroidism may develop as a result of kidney disease or feeding all-meat diets.

In contrast, primary hyperparathyroidism is caused by a tumor of one or more parathyroid glands that results in an overproduction of PTH that is totally unrelated to the calcium-to-phosphorus ratio in the blood. in fact, the increased PTH in this instance causes hypercalcemia (high blood-calcium concentration). Primary tumors of the parathyroid glands are rare in the cat. When they occur, they seem to develop more commonly in older female Siamese cats. The most common clinical signs of primary hyperparathyroidism in cats are lethargy and inappetance.

Primary hyperparathyroidism may be suspected when a cat with appropriate clinical signs is found to be consistently hypercalcemic on screening laboratory tests. However, other causes of hypercalcernia (e.g., nonparathyroid tumors, vitamin D toxicity, kidney disease, hypoadrenocorticism, and spurious factors) must be ruled out.

**Determination of blood concentrations of PTH and ionized calcium may help differentiate among these causes of hypercalcemia.

Treatment of primary hyperparathyroidism involves surgical removal of the parathyroid tumor. Postoperatively, the blood-calcium concentration might fall too low, until the remaining parathyroid glands resume their function. Temporary vitamin D and calcium supplementation may be required during this transition.

http://maxshouse.com/Endocrine_System_&_Disorders.htm

Thank you very much for this. It WAS parathyroid my vet and the specialize were concerned over when Ootay's blood Ca was so high, but at the time, in fact until I just read this, I did not understand the difference.

I also agree with you on advising another blood test, to confirm the elevation.

Excellent post, all around!