Hypercalcaemia associated with angiostrongylus vasorum in three dogs

Hypercalcaemia was identified in three dogs that presented primarily for evaluation of respiratory disease. Angiostrongylosis was diagnosed in all three cases and both the respiratory signs and the hypercalcaemia resolved with treatment. Infection with Angiostrongylus vasorum is known to lead to formation of pulmonary granulomata. Granulomatous disease in humans may lead to hypercalcaemia secondary to increased unregulated production of 1,25-dihydroxycholecalciferol by activated macrophages in the granulomata. In one of the three dogs, 1,25-dihydroxycholecalciferol was measured and found to be increased, providing supportive evidence for a similar mechanism in dogs. To the authors' knowledge, hypercalcaemia has not previously been reported in association with angiostrongylosis in dogs. Since prolonged untreated hypercalcaemia may lead to permanent impairment of renal function, dogs with angiostrongylosis should be evaluated for the presence of hypercalcaemia.