HIPERVITAMINOSE D SECUNDÁRIA À SUPLEMENTAÇÃO DIETÉTICA EM UM CÃO: RELATO DE CASO

Abstract

The need for vitamin D intake for dogs and cats is known, due to the inability to sufficiently synthesize it through the cutaneous action of ultraviolet B solar rays. Recommended levels of vitamin D are indicated in established guides. This work reports a case of hypervitaminosis D in a dog that presented hypercalcemia and a significant increase in the serum concentration of 25-hydroxychocalciferol after vitamin D3 supplementation through a food supplement. A dog, mixed breed, male, castrated, 4 years old, weighing 13.5 kg, body condition score 4/9 was treated for presenting apathy, anorexia, emesis, polyuria and polydipsia for five days. The dog received homemade food formulated by a professional and received 1g of supplement dispensed from a compounding pharmacy under prescription. The patient manifested hypercalcemia (total calcium 14.9 mg/dL; 9.0-11.3 mg/dL; and ionized calcium 1.75 mmol/L; 1.2-1.45 mmol/L). The main causes of malignant hypercalcemia were investigated (lymphoma, anal sac carcinoma, thymoma). Parathormone analog peptide and parathormone were normal (0.00 pmol/L; 0.0-1.0 pmol/L) and decreased (0.00 pmol/L; 0.5-5.8 pmol/L) , respectively, excluding primary hyperparathyroidism. Other causes of hypercalcemia were evaluated (hypoadrenocorticism, granulomatous diseases and chronic kidney disease) and the serum concentration of 25-hydroxycholicicalciferol was 19.7 times above the maximum expected value (7973.00 nmol/L; 109-403 nmol/L). It was concluded that it was a case of hypervitaminosis D, possibly caused by vitamin D intake that exceeded between 19 and 127 times the maximum daily or recommended limits. Once the main causes of hypercalcemia have been excluded, hypervitaminosis D should be considered, although it is uncommon. As in the case reported, if the diet is based on supplemented homemade food, the details of the prescription must be checked to ensure the patient's nutritional safety.