This Thursday webinar was presented by Myles McKenna MVB MVetSci MVetMed DACVIM (SAIM) DECVIM-CA MRCVS. Detailing canine calcium homeostasis, the main focus is on parathyroid disorders and how to manage them. Dr. McKenna has an obvious deep understanding of the processes involved and his clear presentation lays it out for both the experienced and the ones who need some more explanation. Rather than just listing clinical signs, he describes the processes behind why they are. 

Parathyroids and Calcium Homeostasis

Why do we need it and what does it do? 

Dr. McKenna starts off the webinar discussing calcium homeostasis and the general workup of hyper and hypocalcaemia. This includes both acute and chronic presentations of calcium imbalances. Dr. McKenna also covers how a measurement on biochemistry may not be the whole picture. The webinar covers other reasons why there may be abnormalities as well.  McKenna also covers the canine parathyroid glands and their role in calcium homeostasis. Which is, of course, what this webinar is focusing on!

Hyperparathyroidism

Recognising and Understanding

Although uncommon, this is a disorder that general practitioners should be aware of. Usually presenting with quite vague signs in older dogs, the clinical signs can progress rapidly into seizures and muscle tremors that can be alarming for owners. The three major systems influenced by calcium homeostasis are the renal system, gastrointestinal system, and neuromuscular. Myles McKenna covers the reasoning behind the changes that you see as well! Knowing the underlying mechanics and systems leads to a greater understanding, which means better retention as well! 

Hyperparathyroidism

Sorting and Solving

Myles McKenna also covers the approach to the most common reasons for hypercalcaemia and hyperparathyroidism. Identifying not only the overarching reasons, such as neoplasia, but covering the specific clinical investigations to help you identify specific neoplasias. These are investigations that are for general practitioners, and investigations which are mostly available at referral clinics. Helpful tips are also abound in this webinar, with suggestions for people to call for help if needed. 

Management of hypercalcamiea can often involve management of the secondary effects as well. Including azotemia from acute kidney injury, correcting the initial imbalance, and further. Covering management ideas to follow, and treatments to avoid it gives you a good guide to correct hypercalcaemia and disorders of the parathyroid glands. The slides in this section, as the other slides in the webinar, are clear and easy to read. Clear slides are easy enough to print out and put in a ‘folder of knowledge’ for quick references, which is why I love Myles McKenna’s webinars! 

Hypoparathyroidism

Recognising and Understanding

Often idiopathic in dogs, hypoparathyroidism is a dramatic disease presentation. Especially compared to how hyperparathyroidism presents! Simple hypocalcaemia in a biochemistry reading may make you suspicious, but coupled with clinical signs you might want to start treatment while waiting for further results to come back from the lab. Further, consider causes of hypocalcaemia other than hypoparathyroidism – kidney dysfunction, pancreatitis, eclampsia. The webinar covers other reasons as well, to flesh out your differential list and make sure that you aren’t missing anything.

Hypoparathyroidism

Sorting and Solving

As results may take multiple days to come back from external labs, especially PTH assays. In this case, Myles McKenna covers treatment options – including doses and precautions. Short term and long hypoparathyroidism management is covered, and explained in a clear way as well. Goals to aim for are delineated to help guide management as well, which is helpful. Finally, Myles McKenna mentions that in the case of no 24hr care, or if you feel that the calcium levels can’t be monitored accurately or in a timely enough manner, or even if you just feel like it’s out of your control – referral is completely okay. Calcium and parathyroid can be tricky to manage!

Summary

Another brilliant webinar by Myles McKenna. Although there’s a lot of information in this blog, there was so much more in the slides that I just can’t put into a short blog. I’d highly recommend this webinar! You can find the webinar here or you can buy it for £40+VAT here. Myles also presented two other members webinars. These were on the subject of challenging cases of canine IBD and a webinar on canine leishmaniosis. We’re looking forward to Myles’ next webinar is next year on Thursday March 18th in 2021!