Ionized hypercalcemia is seen concurrently with CKD in cats, but it is not always apparent whether the hypercalcemia has resulted in development of CKD, or the CKD has led to the development of hypercalcemia. 4 Ionized calcium concentration is poorly predicted from extrapolation of total calcium concentrations in cats 3, 5 but because it is the biologically active form, its direct measurement provides a better indication of disrupted calcium homeostasis than does sole measurement of total calcium concentration.

Plasma total hypercalcemia was observed in 60 of 191 cats (31%) diagnosed with azotemic CKD, 3 and an increase in the trend of plasma total calcium concentrations was observed in 40 of 71 (56%) of cats transitioned to a phosphate-restricted clinical renal diet over 200 days. Conclusions and Clinical ImportanceĪttenuation of dietary phosphate restriction could result in normalization of iCa in cats that develop hypercalcemia while eating a clinical renal diet.Īzotemic chronic kidney disease (CKD) is a common condition in older cats, 1, 2 and is associated with changes in calcium homeostasis in this species. In contrast, the baseline hypercalcemic group overall showed no change in iCa but a decrease in plasma phosphate concentration during 8.8 months on the MP diet, although 4/11 individual cats achieved iCa <1.4 mmol/L by 3.4 months. Plasma phosphate concentrations did not change. Blood iCa decreased ( P < .001) when RD hypercalcemics were fed MP, with iCa <1.4 mmol/L in 8/10 cats after 2.2 months. ResultsĪt visit 1, iCa was 1.47 mmol/L for baseline hypercalcemics and 1.53 mmol/L for RD hypercalcemics. MethodsĬhanges in variables over time, after starting MP at visit 1, were assessed using linear mixed model analysis within each group of cats. AnimalsĬlient-owned cats with ionized hypercalcemia (ionized calcium concentration >1.4 mmol/L) at diagnosis of CKD (n = 11 baseline hypercalcemics) or after CKD diagnosis while eating a phosphate-restricted clinical renal diet (0.8 g/Mcal phosphorus Ca : P ratio, 1.9 n = 10 RD hypercalcemics). To describe the effect of feeding a moderately phosphate-restricted diet (MP 1.5 g/Mcal phosphorus Ca : P ratio, 1.3) to cats with concurrent azotemic CKD and ionized hypercalcemia.

The optimal dietary management strategy for these cats is unclear. Dietary phosphate restriction is considered standard of care but may contribute to the development of hypercalcemia. The results of the study will be used to design and built new device able to measure calcium accurately, simply, quickly and cost efficiently, to the great benefit of patients and health care providers.Hypercalcemia is commonly observed in cats with azotemic chronic kidney disease (CKD). Correlation between symptoms and calcium concentrations will be assessed by asking patients to grade their symptoms using specially designed questionnaire. These measurements will be compared to current “gold standard” methods such as total calcium concentration performed by the main laboratory and i-STAT Analyzer. Our study will assess ability of LAQUAtwin Ca prototype to measure ionized calcium in blood, urine and saliva in 30 patients undergoing thyroid and parathyroid surgery at UCLH. It can also measure calcium in urine or saliva samples. The modified LAQUAtwin Calcium prototype would allow testing for either venous or capillary blood calcium concentration in one minute with instantly available results. LAQUAtwin is a handheld device designed to measure ionized calcium in water and soil. There is an urgent need to develop a simple Point of Care testing device able to measure calcium concentration without delay either at the hospital bedside or at home. Currently, 10 ml of venous blood is send to the main laboratory for analysis, an inefficient and slow process, which delays diagnosis and treatment. This can cause acute symptoms of paraesthesia or muscle spasms and long term complications such as soft tissue calcification and psychiatric problems.Īfter surgery, calcium needs to be measured frequently both in and out of the hospital. At least 1 in 5 patients that undergo thyroid and parathyroid surgery develop low calcium in the blood.

Ionized calcium istat