North American Veterinary Licensing Examination (NAVLE) Practice Test

What is the best initial treatment for mild idiopathic feline hypercalcemia?

1. Injectable fluids

2. Diet change

3. Bisphosphonates

4. Furosemide

The correct answer is: Diet change

Mild idiopathic feline hypercalcemia often requires a conservative approach, especially when the levels are not critically high and the cat does not exhibit significant clinical signs. Dietary change is considered the best initial treatment in such cases. A diet change focusing on a lower calcium formulation can be beneficial because it directly addresses the elevated calcium levels in the bloodstream. A specially formulated diet may help manage the condition by reducing calcium intake, potentially lowering serum calcium levels over time. This is particularly important in idiopathic cases where the underlying cause isn't identified; therefore, dietary management becomes a practical first step. Other treatment options such as injectable fluids, bisphosphonates, or furosemide could be used in more severe or persistent cases of hypercalcemia, but they are typically not the first-line intervention for mild idiopathic cases. Injectable fluids may help with hydration and support metabolic functions, while bisphosphonates are more directed toward more significant hypercalcemia scenarios or malignancies. Furosemide, a diuretic, may be used to facilitate calcium excretion in more severe cases. Thus, while all these treatments have their roles, dietary modification offers a non-invasive and effective initial strategy for managing mild idiopathic feline hypercalcemia.