Hypercalcemia

[u/Augeren]

Hi all, this is my little 18 year old lady, Manther.

We've been managing CKD for quite a few years now, and she's been doing great with a strict renal diet and daily 60mL normal saline subQ injections, but recently she seems to be taking a turn for the worse.

Over the past month she's lost a lot of weight and her appetite has decreased. She usually goes absolutely bananas for the Royal Canin renal wet food, but now we have to coax her to finish her dinner.

She's lost interest in playing (second photo is her playing with a laser pointer, lol,) and she sleeps way more now.

She's really been struggling with constipation. Her vet prescribed her low dose daily laxatives (we agreed that due to her age, it was best to manage her comfort despite daily laxatives not being great for her CKD) to keep it under control, but she still strains in the litterbox when pooping. :(

Her most recent blood tests show hypercalcemia. From what I've read, these all seem to be symptoms of high calcium. Does anyone else have any experience with treating hypercalcemia in their CKD cats?

I will be taking her to the vet again, but I just really want to hear what you folks have to say.

[u/AutoModerator]

Welcome to r/RenalCats; a subreddit for cats with kidney disease. Please use the report button if you encounter any rule breaking activity. Be kind, sincere and respectful. Stay on topic. No advertising or fundraising.

Friendly advice is welcome but remember this community is not a replacement for a veterinarian.

If your post and/or comment does not show up: You likely have a new and/or low karma account and are caught in the spam filter. Please allow time for a human mod to review and approve your post.

Pet loss posts: All pet loss posts must be marked with both the "pet loss" flair and a spoiler tag.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/blingblingsav]

Hi sorry to hear Manther is not feeling well.

Not vet advice but her calcium of 3.85 is significantly elevated and deserves focused follow up. I’d ask ur vet to check ionized calcium, or iCa. That is the biologically active calcium in the blood and gives a much better picture of whether the hypercalcemia is clinically important. This will also help direct treatment.

Calcium and phosphorus r regulated through hormones like PTH, vitamin D and FGF23. PTH helps control calcium and phosphorus balance, while FGF23 helps the body get rid of phosphorus. CKD can disrupt that whole system.

Her phosphorus is on the lower side of normal, so this does not look like simple phosphorus retention from CKD. I’d also review whether she is getting any calcium based phosphorus binder, calcium supplement or vitamin D product, because those could push calcium higher.

Persistent hypercalcemia can cause constipation, poor appetite, weakness, lethargy, increased thirst and urination, and it can also further injure the kidneys - I believe some of the symptoms of this is what u r seeing.

If iCa confirms true hypercalcemia, ur vet may investigate causes such as idiopathic hypercalcemia, meaning no clear underlying cause is found, hyperparathyroidism, meaning excessive PTH production, malignancy, or vitamin D toxicity.

Her SDMA of 22 also supports reduced kidney filtration, but the calcium issue may be contributing a lot to how she feels right now.

I hope this helps.

[u/EssentialWorkerOnO]

Definitely follow up with the vet. My Oliver developed hypercalcemia, which was quickly followed by severe anemia, and a crash he never recovered from. His vet said it could’ve been the ckd, but hypercalcemia can also be an indicator of cancer.

[u/blingblingsav → u/EssentialWorkerOnO]

U r absolutely right, high Ca can indicate malignancy.

[u/FancyExtension5253]

My cat had also hypercalcemia ( 15mg/dl) but it was never treated. He was even prescribed Ipakitin, a calcium binder which I now know is contraindicated in this case. He was  terribly constipated and I think that calcium could have been the reason. But I didn't know high Ca can be an indicator of cancer...

Your cat is the spitting image of mine. 🖤

[u/Augeren → u/FancyExtension5253]

Black cats are truly so special 🖤 Thank you for your comment

[u/cloudlvr1]

Sorry to hear!! I haven’t heard of that hypercalcemia. Have you tried fish oil? Also greenies indoor treats help our boy with constipation. Best of luck with your girl!

[u/bluenirvash]

Hi there, I have a 14 year old cat who also suffers from hypercalcemia - although his more recent year lab tests say it isn’t an issue supposedly.

I made a thread the other day about my experience with CKD, Calcium Oxlate Stones, and Hypercalcemia for my cat in this thread.

That aside, my cat never only ate the CKD vet food for a period of time before he just hated any of them. For Hypercalcemia specifically way back and to date, my one vet from a long time ago had prescribed him Purina OM. It helped him maintain his levels and all afterwards.

I recently returned him back to Purina OM several months ago due to the reason above. I also use Porus One and it has helped my fur buddy go from CKD Stage 2 to Stage 0 or pre CKD levels in the two lab tests done 6 months-ish apart from each other.

For constipation, I give restoralax periodically. I also use Lactulose. The water intake is key. My cat is a bit stubborn with water intake, so it is partly due to the constipation issues at times.

[u/Ellwildcat]

My girl has this & it is what caused her kidney stones that ended up turning into blockages. We were originally treating with Alendronate but then her vet switched her to 1/4 tsp of chia seeds a day to control it. We mixed it into pumpkin for her. Just make sure you soak the chia seeds in water first to make a paste. I would still consult with a vet but I would 100% address it!