Retrospective evaluation of outpatient management following parathyroidectomy for treatment of primary hyperparathyroidism in dogs.

Outpatient parathyroidectomy management in dogs with PHPT is safe, with no mortality and manageable hypocalcemia morbidity.

This retrospective observational study evaluated outpatient management protocols following parathyroidectomy for primary hyperparathyroidism (PHPT) in 43 client-owned dogs at a private specialty hospital over a 10-year period (2015–2025). Researchers examined pre- and postoperative biochemical markers including ionized calcium (iCa), parathyroid hormone (PTH), and PTH-related protein, along with imaging, histopathology, and postoperative hypocalcemia incidence. Dogs were stratified into clinically hypocalcemic, nonclinically hypocalcemic, and normocalcemic groups. Key findings revealed that no preoperative variables were significantly predictive of postoperative clinical hypocalcemia, complicating efforts to identify high-risk patients prospectively. Dogs presenting with gastrointestinal signs had significantly higher preoperative iCa concentrations compared to asymptomatic dogs. Of the 43 dogs, 8 required calcium supplementation, and their mean iCa nadir (0.92 mmol/L) was significantly lower than non-supplemented dogs (1.19 mmol/L). Only 3 of the 8 supplemented dogs exhibited clinical signs prior to supplementation initiation, and one dog required emergent intravenous calcium administration. Importantly, no mortality was recorded during the 14-day follow-up period. Hypocalcemia-related morbidity was described as transient, infrequent, and clinically manageable. These findings support the feasibility of outpatient postoperative management for select canine PHPT patients following parathyroidectomy, potentially reducing hospitalization costs and stress. However, close postoperative monitoring remains essential given the unpredictable nature of hypocalcemia development.

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