I doubt ir you have much, or anything, to worry about. Depending on the referrence ranges of the lab your vet uses, Ca++ at 11.8 is probably only slightly elevated above normal range. Albumin at 3.6 is mid-range in the reference ranges of the labs my vets have used, so I don't know what your vet's concern is with that. A Total T4 of 2.8 is also mid-range with the labs my vets use, so I don't understand why your vet feels a FT4 is necessary. 2.8 isn't even high normal in my experience.

There seem to be alarm bells sounding here when there is no fire. If you're really concerned about the slightly elevated Ca, have an ionized calcium test run. If the iCa comes back normal, then your cat has no calcium problem.

You can read more about hypercalcaemia at the link below.

Laurie

Here is a link that might be useful: hypercalcaemia

Thank you Laurie for getting back to me so quickly.

I think my Vet is concerned because of the weight loss and because my other elderly, hyperthyroid cat was actually able to gain weight while Ernie who has always been chubby has lost what she calls a dramatic amount (over a pound) in less that a year. I think she is ruling out thyroid because of the weight loss - she did state he has no obvious clinical signs but she wanted be be absolutely certain because they don't always manifest. I caught Jack's hyperthyroidism very early on and he has been doing very well for years and still has no problems with his kidneys. She knows that I am on top of my animal's heath and the fact that I brought Ernie in early with concerns raised a red flag.

She told me the next step would be to wait and retest his calcium - I don't know if she meant the ionized calcium test or not but I will request it. She also told me that she has seen older cats with higher calciums levels with no underlying cause and she has also seen cats with higher calcium levels who had lymphoma. She said she wanted me to be prepared for all scenarios.

These are Ernie's officual results:

T4 = 2.8 (range is 0.8-4.0)

Calcium = 11.8 (range is 8.2-10.8)

Albumin = 3.6 (range is 2.5-3.9)

Would you consider 11.8 Calcium slightly elevated or high?

Thanks, Renee for the extra explanations. I'm not sure how that calcium would be classified, since the lab's reference range only goes to 10.8. If it were one of my cats, I'd probably request an iCa just to make sure the calcium level was OK. You might even consider having his PTH (parathyroid hormone) level checked to see if he's hyperPTH. MSU offers a combined PTH and iCa test. As far as I know, they're the only lab who does PTH testing. You can read the particulars of their test at the link below.

Were any of Ernie's other blood values out of normal range? How about his phosphorus. Typically when calcium rises, phos does also.

Laurie

Here is a link that might be useful: PTH and iCa testing at MSU

All of Ernie's other values were well within range. I don't know what the Phosporus level was - we just discussed Thyroid, Calcium and Albumin. I am under the impression that this probably would not be an issue except for the unexplained weight loss. I will be speaking to my Vet tomorrow regarding Jack and Ernie's Free T4 results. I will keep you posted and thank you again for all of your help.

The vet mentioned albumin because calcium is bound to albumin in the blood. If the albumin is elevated, then you "correct" for a high calcium by some fancy math. But your cat doesn't have high albumin so I don't know what she is thinking.

I'd run just an ionized calcium because 1) that's the one that matters to the body and 2) I doubt anything is wrong with the calcium. I am very familiar with the MSU test and it costs $200. Most regular labs run an ionized calcium for much less money.

Hypercalcemia can be indicative of primary hyperparathyroidism, hypercalcemia of malignancy, acute or chronic renal failure (most cats will also have high phosphorus), granulamtous diseases (eosinophilic granuloma complex, etc), Addison's disease (extremely rare in cats), vitamin D toxicosis, osteolytic disease (destruction of bone), and the ever-popular idiopathic hypercalcemia of cats.

But the first step is to confirm hypercalcemia. I'd run an iCa and go from there. At that total calcium level, I'd be surprised if there was a real hypercalcemia problem. I'd not even check a fT4 in a cat with a TT4 of 2.8.

How are his teeth? In my patients, the single most common cause of weight loss in a cat is dental disease.

Meg, the PTH and iCa combined test at MSU costs $31, and you can order their prepaid insulated mailer for an additional $15. I don't know where you got that $200 figure, but it's certainly not what MSU charges for the combined test I linked above.

I should add some clarification and a correction. First, the shipping-prepaid, insulated mailer from MSU is only $12, not $15. Next, the $31 fee is MSU's charge for the combined PTH and iCa test. That doesn't include whatever your own vet may charge for collection and preparation of the blood sample. Still, if a vet is trying to charge you $200 for this particular test from MSU, the vet himself must be charging a HUGE amount for collection and prep of the sample.

Laurie

Hey Laurie, sorry, my computer didn't feel like getting to your link yesterday and I thought it was their hypercalcemia of malignancy panel. It includes ionized calcium, PTH, and PTH related peptide and is $55 cost, so my hospital would charge $110. I have no idea which panel I was thinking about that cost a client $200, but it was something I needed recently. I gotta stop "remembering" and start looking when it comes to prices!

Ernie's lab results are in. His Free T4 is 74 (normal range is laurief and meghane - I would like to thank you both very much for all of your input. I have had other kitty health issues and your both have been very informative and helpful. I appreciate that you both take the time to respond very quickly. Your knowledge throughout the years has been invaluable to me.

hI,

I was told by my vet the elevated Calcium levels can either mean thyroid disease is present, or Cancer is present somewhere in the body.

I lost Ernie due to cancer the following year. Ernie was from a feral cat colony and there was a lot of inbreeding. He had numerous health issues throughout his life but he was by far the sweetest cat I have ever had. I was devastated to lose him.

I lost my elderly cat Jack who was diagnosed as hyperthyroid in 2004 earlier this year.

I would like to thank laurief, meghane and countless others who have been a great source of information and comfort throughout the years. My two girls are fairly healthy - one has resorptive lesions (she had a tooth pulled last year) and the other has some mild allergy issues (she is double clawed - I think it is called horned paws) and this forum is the first place I go when I need someone to "talk" to.