Reversible myocardial failure in a cat with primary hypoparathyroidism

Area of Science:

• Veterinary Cardiology
• Small Animal Internal Medicine
• Endocrinology

Background:

• Primary hypoparathyroidism is a rare endocrine disorder characterized by deficient parathyroid hormone production, leading to severe hypocalcemia.
• Hypocalcemia can manifest with various clinical signs, including neuromuscular excitability (tetany) and cardiac dysfunction.
• Myocardial failure in cats can have diverse etiologies, necessitating a thorough diagnostic approach.

Observation:

• A 4-year-old domestic shorthair cat presented with tetany, indicative of severe hypocalcemia and primary hypoparathyroidism.
• The cat developed congestive heart failure secondary to myocardial failure during its hospitalization.
• Treatment involved a combination of medications including calcitriol and calcium salts.

Findings:

• The cat's congestive heart failure and myocardial failure were successfully treated with a regimen including calcitriol and calcium salts.
• Cardiac function normalized within one month of treatment initiation.
• Long-term follow-up revealed sustained normal cardiac function after discontinuing most medications, with calcitriol maintenance.

Implications:

• Hypocalcemia-associated cardiomyopathy is a rare but reversible cause of myocardial failure in veterinary patients.
• This case highlights the importance of considering metabolic derangements, specifically severe hypocalcemia, in the differential diagnosis of feline myocardial failure.
• Early diagnosis and management of hypocalcemia can lead to complete resolution of cardiac abnormalities.