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

Objective: To describe outcomes following outpatient management of dogs with primary hyperparathyroidism treated with parathyroidectomy between 2015 and 2025. Methods: The medical records of 43 client-owned dogs with primary hyperparathyroidism treated with parathyroidectomy at a private specialty hospital (2015 to 2025) were observationally, retrospectively analyzed. Pre- and postoperative variables examined included demographics, biochemical markers (ionized calcium [iCa], parathyroid hormone, and parathyroid hormone-related protein), imaging and histopathology findings, postoperative iCa nadir and time to nadir, and incidence of hypocalcemia and supplementation. Data were compared between clinically hypocalcemic, nonclinically hypocalcemic, and normocalcemic groups. Morbidity and mortality over a 14-day follow-up period were reported. Feline patients, those without accessible medical records, and those hospitalized for unrelated illnesses were excluded. Results: No variables were significantly correlated with or predictive of clinical postoperative hypocalcemia. Dogs presenting with gastrointestinal upset (n = 6) had a significantly higher preoperative iCa than those without (37). The mean iCa nadir was significantly lower in dogs receiving supplementation (0.92; 95% CI, 0.85 to 0.98; n = 8) than those that did not (1.19; 95% CI, 1.15 to 1.23; 35). Three of 8 supplemented dogs demonstrated clinical signs before supplementation. One dog received emergent IV calcium. No mortality was reported over the 14-day follow-up period. Conclusions: Outpatient postparathyroidectomy management was not associated with mortality over 14 days. Hypocalcemia-related morbidity was transient, manageable, and infrequent. No predictive variables for clinical postoperative hypocalcemia were identified. Clinical Relevance: Select postoperative parathyroidectomy patients can be managed on an outpatient basis.