Features of detection and treatment of hyperparathyroidism in domestic animals. Primary and secondary hyperparathyroidism in cats: methods of treatment and symptoms

Hyperparathyroidism in dogs and cats is an endocrine pathology that occurs as a result of excessive production of parathyroid hormone. With this pathology, there is an increase in the level of calcium and a decrease in the content of phosphorus in the blood, damage to bone tissue in the form of increased fragility. Hyperparathyroidism can be primary or secondary. A secondary form of pathology in cats is called juvenile osteopathy.

Causes of the disease

Most often, primary hyperparathyroidism in dogs and cats appears as a result of adenoma, cancer, hyperplasia of the parathyroid glands.

The cause of secondary hyperparathyroidism in animals is considered to be an insufficient amount of calcium in the diet with an excess of phosphorus. This pathology can develop as a result of destructive lesions of the kidneys and chronic dystrophic changes in the small intestine.

Pathogenesis

A pathological increase in the production of parathyroid hormone leads to a violation of the exchange of phosphorus and calcium. With hyperparathyroidism, bone dystrophy develops. As a result of increased bone resorption, calcium from the bones moves into the bloodstream. This is accompanied by increased excretion of this element in the urine. There is a restructuring of the bone and acceleration of the processes of resorption of its parts. The bone apparatus of animals acquires softness and flexibility.

A manifestation of kidney damage is considered increased urination as a result of increased excretion of calcium. A large amount of calcium in the urine and bloodstream is the cause of the formation of urinary stones.

Clinical picture and symptoms of hyperparathyroidism

The development of the initial stages of hyperparathyroidism is slow and asymptomatic. The early stages of hyperparathyroidism are characterized by muscle weakness, depression, and performance deterioration in dogs.

As the disease progresses, thirst, increased urination, and a decrease in appetite are noted. The animal is increasingly trying to avoid contact with people, sometimes this behavior comes to aggression towards humans.

In advanced cases, hyperparathyroidism in dogs and cats leads to lameness and even paralysis of the limbs. Fibrous degeneration of bones is manifested by curvature of the limbs, swelling and soreness of the joints. There is also frequent loosening and loss of teeth, bone fractures.

Diagnosis of hyperparathyroidism

The main method for detecting hyperaparathyroidism in dogs and cats is the study of the content of calcium and phosphorus in the blood. To detect the pathology of the bone apparatus, it is necessary to conduct an x-ray examination. The X-ray sign of pathology is considered to be a thin cortical layer of the bone and the detection of bone cysts.

Hyperparathyroidism must be distinguished from diseases such as alimentary osteodystrophy, malignant hypercalcemia, etc.

Hyperparathyroidism in dogs and cats - treatment and prevention

In the early stages of development, the disease can be successfully treated. Moreover, for this it is enough to switch to super-premium class food or make a balanced diet. As a rule, after a couple of months of proper feeding, the calcium / phosphorus balance in the body is completely restored.

In advanced cases, surgery is necessary. Parathyroid adenoma is considered an indication for its surgical removal. After the operation, treatment is indicated that improves metabolic processes in the bone tissue. For this purpose, prescribe gluconate, calcium phosphate, vitamin supplements. Diet is also important. Conservative therapy is to reduce calcium in the blood and increase the content of phosphorus. First of all, we are talking about a diet rich in calcium. As a drug treatment, you can use phosphosan, etc. In case of kidney damage, intravenous sodium chloride is used. Large animals are injected with about a liter of such a liquid. To reduce the level of calcium in the blood, sodium citrate is used. Calcitrin is used to preserve calcium in the bone apparatus. With a pronounced inflammatory process in the joints, corticosteroids (prednisolone) are used.

Secondary hyperparathyroidism, due to malnutrition, involves calculation of a balanced diet. If the disease is not advanced, then a properly selected super premium food or a balanced home diet is almost guaranteed to restore the calcium / phosphorus balance in the pet's body within a few months.

Common consequences of hyperparathyroidism

This disease rarely goes unnoticed. Usually this always results in growth retardation. Irreversible deformation of the pelvic bones is also possible, which makes it difficult to defecate and urinate. In advanced cases of the disease, it is not recommended to give birth to ill animals.

Deformation of the chest often causes chronic diseases of the respiratory system. Neurological problems in animals also persist for life.

Hyperparathyroidism affects both dogs and cats. In the body of sick animals, excessive production of parathyroid hormone is observed. The substance redistributes calcium ions from the bones, regulates the functioning of the kidneys. As a result of metabolic disorders, an increase in the concentration of calcium in the blood against the background of a decrease in the level of phosphorus occurs.

Types of pathology:

• Primary hyperparathyroidism in dogs is primarily due to pathological changes in the thyroid gland, which produces parathyroid hormone. Older dogs are most commonly affected. Cats get sick less often. Oncological processes (adenoma, malignant tumors), hyperplasia of the parathyroid gland are the main causes of the development of the primary form in animals.

• Secondary metabolic disorder, due to increased production of parathyroid hormone, is associated with impaired renal function. Cats suffer from this form mainly due to the development of chronic renal failure. With kidney disease in the body of an animal, a violation occurs in the electrolytic balance: the concentration of calcium in the blood decreases, and the level of phosphorus increases.
• As compensation, the parathyroid gland intensively produces parathyroid hormone, which has little effect on calcium levels. In the body, the content of calcitriol decreases, which is accompanied by a violation of mineralization in bone tissue.
• Alimentary hyperparathyroidism caused in cats and dogs most often by errors in feeding. The disease develops against the background of low levels of calcium and high doses of phosphorus in the diet. Young pets are the main risk group for nutritional hyperparathyroidism. The lack of calcium, magnesium, vitamin D and the increased content of phosphorus in the products with the active growth of the skeleton of kittens and puppies leads to a gross violation of the metabolism of minerals.
• The reason for this imbalance is often a mono-diet - feeding only meat, for example, chicken. Violation of the absorption of calcium and vitamin D from the intestine as a result of a long one can also lead to a alimentary form.

• Juvenile hyperparathyroidism- a secondary form of pathology in furry patients. So it is often referred to by veterinarians.

The disease has uncharacteristic clinical features and is often mistaken for rickets in young animals. Symptoms of hyperparathyroidism in dogs:

• lagging behind breed standards;
• the activity of the young pet is reduced, he does not want to take part in the games;
• the owner often observes drowsiness, lethargy;
• curvature of the bones of the limbs and spine;
• permanent fractures;
• the deposition of calcium salts in the synovial membranes leads to a pronounced pain syndrome;
• after jumping, running, the dog has lameness;
• chronic constipation.

Symptoms of hyperparathyroidism in cats:

• loss of activity;
• loss of appetite;
• nausea, bloating;
• loss of teeth;
• soreness when stroking;
• skeletal deformity;
• neurological manifestations: paresis, convulsions;
• against the background of metabolic disorders in the body, cats often develop urolithiasis, heart problems.

When contacting the owner about frequent fractures in the pet, curvature of the bones, lameness, the veterinarian may suspect secondary hyperparathyroidism in dogs. When collecting an anamnesis, important importance is given to the analysis of the diet of the animal. Predominantly this is how alimentary hyperparathyroidism is detected.

As a rule, subperiosteal fractures are observed in sick individuals. In this case, carry out radiographic examination. The picture clearly shows the zones of softening of the bone tissue, phenomena, creases of the tail, curvature of the vertebrae.

The differential diagnosis is carried out in relation to rickets in young pets and osteomalacia in adults. For this purpose, take blood for biochemical analysis. Calcium and phosphorus are determined in the biological fluid. An informative diagnostic method is the measurement of the hormonal status of the parathyroid gland.

In some cases, to determine the cause of hyperparathyroidism, Thyroid ultrasound in order to exclude hyperplasia of the organ and identify neoplastic formations.

Treatment of hyperparathyroidism in dogs and cats:

• With alimentary hyperparathyroidism in puppies, it is recommended to review the diet. The nutrition of a sick individual should be complete, with a high content of calcium in foods. The level of phosphorus in the diet is minimized. When feeding with natural food, the animal is given meat of different varieties: chicken, beef, rabbit meat. At least once a day, the puppy should receive fermented milk products.
• Along with calcium, the body should receive a sufficient amount of vitamin D. The pet should have regular sunbathing. On the recommendation of a doctor, vitamin supplements are introduced into the puppy's diet: meat and bone and fish meal, vitamin D concentrate, fish oil.

• If primary hyperparathyroidism is found in an animal, then we can talk about the surgical removal of the neoplasm. Surgical intervention is reduced to resection of the damaged lobes of the parathyroid gland and is carried out in specialized institutions.
• When hyperparathyroidism is detected in kittens first of all, they limit their activity: they are placed in a small box, cage or box. This is the prevention of spontaneous fractures. For the entire period of treatment, which can be 2-3 months or more, the animal is prescribed a therapeutic diet enriched with calcium. The best option would be to use specialized feeds with calcium.
• Treatment of metabolic disorders in advanced cases is not complete without the use of medications. For example, borgluconate, calcium gluconate, calcium chloride are injected into the pet's body intravenously.
• Therapy includes symptomatic treatment. So, sick animals often suffer from chronic constipation, with which vaseline oil will help.

Read more in our article on hyperparathyroidism.

Read in this article

What is hyperparathyroidism?

Pets are prone to a number of metabolic diseases, among which owners often experience hyperparathyroidism. The disease affects both dogs and cats. In the body of sick animals, excessive production of parathyroid hormone is observed. The substance redistributes calcium ions from the bones, regulates the functioning of the kidneys. As a result of metabolic disorders in the body, an increase in the concentration of calcium in the blood occurs against the background of a decrease in the level of phosphorus.

Active excretion of calcium from the bone tissue, saturation of the blood with it leads to the destruction of bones, their thinning. Violation of the metabolism of minerals in the body is accompanied by the development of osteoporosis, urolithiasis. In advanced cases, the digestive system is involved in the pathological process.

Types of pathology

In veterinary practice, it is customary to distinguish between primary and secondary disease.

Primary and secondary (alimentary)

Primary hyperparathyroidism in dogs is primarily due to pathological changes in the thyroid gland, which produces parathyroid hormone. According to the observation of veterinary specialists, older dogs most often suffer from the primary form of the disease. Cats get sick less often.

Oncological processes (adenoma, malignant tumors), hyperplasia of the parathyroid gland are the main causes of the development of the primary form of impaired parathyroid hormone production in domestic animals.

A secondary metabolic disorder due to increased production of parathyroid hormone is associated with impaired renal function. Cats suffer from this form of the disease mainly due to the development of chronic renal failure. With kidney disease in the body of an animal, a violation occurs in the electrolytic balance: the concentration of calcium in the blood decreases, and the level of phosphorus increases.

As compensation, the parathyroid gland intensively produces parathyroid hormone, which has little effect on calcium levels. In addition, the content of calcitriol in the body decreases, which is accompanied by a violation of the mineralization of bone tissue.

Alimentary

Most often faced with alimentary hyperparathyroidism in dogs and cats, due to errors in feeding. The disease develops against the background of low levels of calcium and high doses of phosphorus in the animal's diet. Young pets with a high need for building material for bones are the main risk group for nutritional hyperparathyroidism.

The lack of calcium, magnesium, vitamin D and the increased content of phosphorus in the products with the active growth of the skeleton of kittens and puppies leads to a gross violation of the metabolism of minerals. The reason for this imbalance is often a mono-diet - feeding a young animal only with meat, for example, chicken.

Malabsorption of calcium and vitamin D from the intestines as a result of prolonged diarrhea can also lead to the alimentary form of the disease.

Juvenile

It is not uncommon for cat owners to hear from a veterinarian that a cat has juvenile hyperparathyroidism. Professionals call this term a secondary form of pathology in fluffy patients.

Symptoms in puppies and kittens, adults

The insidious disease has uncharacteristic clinical signs, and is often mistaken for rickets in young animals. The owner should carefully look at the state of health and know the symptoms of hyperparathyroidism in dogs:

• Lagging behind breed standards.
• The activity of the young pet is reduced. The puppy does not want to take part in the games. The owner often observes drowsiness, lethargy.
• Curvature of the bones of the limbs and spine.
• Permanent fractures.
• The deposition of calcium salts in the synovial membranes leads to a pronounced pain syndrome.
• After jumping, active movement, running, the dog has lameness.
• Chronic constipation.

With hyperparathyroidism in cats, the owner may observe the following symptoms:

• Loss of activity.
• Decreased appetite.
• Nausea, bloating.
• Loss of teeth.
• Pain when stroking.
• Skeletal deformity.
• Numerous fractures.
• Neurological manifestations: paresis, convulsions.

Against the background of a metabolic disorder in the body, cats often develop heart problems.

Animal diagnostics

When contacting the owner about frequent fractures in the pet, curvature of the bones, lameness, the veterinarian may suspect secondary hyperparathyroidism in dogs. When collecting an anamnesis, important importance is given to the analysis of the diet of the animal. A mono-diet, a monotonous diet of only cereals or only meat, the absence of vegetables and lactic acid products in the menu makes it possible to suspect alimentary hyperparathyroidism in a shaggy patient.

As a rule, subperiosteal fractures are observed in sick individuals. In this case, to confirm the diagnosis, the veterinarian conducts an x-ray examination. The picture clearly shows the zones of softening of the bone tissue, the phenomena of osteoporosis, tail creases, curvature of the vertebrae.

The differential diagnosis is carried out in relation to rickets in young pets and osteomalacia in adults. For this purpose, blood is taken from a sick animal for biochemical analysis. Calcium and phosphorus are determined in the biological fluid. An informative diagnostic method is the measurement of the hormonal status of the parathyroid gland.

In some cases, to determine the cause of hyperparathyroidism in pets, specialized clinics perform an ultrasound examination of the thyroid gland in order to exclude hyperplasia of the organ and identify neoplastic formations.

Treatment of Hyperparathyroidism in Dogs and Cats

In case of detection of alimentary hyperparathyroidism in puppies, the first thing a veterinarian recommends is to review the diet. The nutrition of a sick individual should be complete, with a high content of calcium in foods. The level of phosphorus in the diet is minimized. When feeding with natural food, the animal is given meat of different varieties: chicken, beef, rabbit meat.

In the event that the animal has primary hyperparathyroidism, then we can talk about the surgical removal of the neoplasm. Surgical intervention is reduced to resection of the damaged lobes of the parathyroid gland and is carried out in specialized institutions.

When hyperparathyroidism is detected in kittens, their activity is primarily limited. For this, a sick pet is placed in a small box, cage or box. This is done to prevent spontaneous fractures. For the entire period of treatment, which can be 2-3 months or more, the animal is prescribed a therapeutic diet enriched with calcium.

The best option would be to use specialized feeds that take into account the low need of the sick organism for phosphorus and the high need for calcium.

Treatment of metabolic disorders in advanced cases is not complete without the use of medications. For example, borgluconate, calcium gluconate, calcium chloride are injected into the body of a sick pet intravenously.

Therapy for hyperparathyroidism in pets, in addition to enriching the body with calcium, also includes symptomatic treatment. So, sick animals often suffer from chronic constipation. Vaseline oil can help solve the problem.

Such a serious metabolic disorder in four-legged family members as hyperparathyroidism often develops as a result of a gross violation of the rules for feeding young animals. Deficiency in the diet of calcium and vitamin D, an excess of phosphorus is the main cause of the alimentary form of the disease. In cats, the disease often occurs against the background of chronic renal failure.

Treatment includes, first of all, dietary nutrition, the introduction of minerals and vitamins into the body of a sick pet. If neoplastic processes are detected, the veterinarian performs surgical removal of the damaged lobes of the parathyroid gland.

Useful video

Watch this video about the causes and treatment of hyperparathyroidism in cats and dogs:

Also, the pathology is called fibrous generalized osteodystrophy (juvenile osteopathy)

This disease develops mainly in kittens and most often in representatives of large breeds of cats (British), however, all breeds of cats, including outbred ones, are affected. The main condition for the development of the disease is an exceptional meat diet, or more often a very different diet, a combination of meat and cereals, meat and dairy products, that is, a diet without calcium.

The problem is that with this type of feeding, without the addition of calcium, a huge amount of phosphorus enters the body and with a significant lack of calcium. Thus, such pseudo-natural feeding does not provide the animal with an adequate dose of minerals and requires the notorious balancing of calcium and vitamins A and D. A quite reasonable question may arise, but how does the propagandized feeding regimen, with reference to its correctness and compliance with the predator’s natural diet, result in such violations? But the answer is quite simple: in nature, predators do not eat only meat, an important source of calcium for them is the eaten bone, and the internal organs of animals are a source of fat-soluble vitamins. This is exactly what is missing or almost at home keeping cats.

As a result of such feeding and an excess of phosphorus in the blood, the parathyroid gland produces an excess amount of parathyroid hormone, which in turn leads to calcium leaching from its main depot - the bones. As a result of such processes, the bone becomes decalcified, soft, brittle. Kittens with such disorders can break the bones of the limbs and spine even without injury, under their own weight or during normal activity.

What are the symptoms of the disease?

In most cases, the violation of itself reveals itself at the age of 3 to 7 months, during the period of main growth, when the mother's milk feeding is no longer there, and calcium is not supplied from the outside. Kittens have lameness on one or several limbs, lameness can change its localization. The kitten may scream during awkward movements, and if spontaneous fractures occur that occur without injury, it may enter a state of shock. Especially painful are fractures of the vertebral bodies and irritation of the membranes of the spinal cord. Kittens do not allow themselves to be touched, they try to lie down. Clinically, both the entire described picture of the disease and its individual signs in various degrees of manifestation can be observed.

When examined in a clinical setting, subperiosteal fractures, bone curvature, and poor mineralization of bone structures are found.

Arrows show the sites of spontaneous bone fractures.

Pay attention to the weak contrast of the bone elements of the image, although without fractures of the vertebral bodies

Treatment of hyperparathyroidism in kittens

Treatment of the disease, first of all, consists in correcting the diet for the content of calcium and vitamins. The most informative article on this topic is here (Mineral and vitamin supplement to the diet of dogs and cats with natural nutrition). This is done if the owners still plan to feed the kitten natural food. An alternative is to switch to a complete kitten food, which already contains a dose of minerals adjusted to the needs of cats.

Bone fractures rarely require surgical treatment, it is enough to give the kitten peace for gradual rehabilitation. In some cases, more active treatment with drugs may be required, but this is already determined by the attending physician.

Today we have an instructive article.
Scientifically, what I want to talk about today is called secondary alimentary hyperparathyroidism. It is about him, as a very common pathology, that I will not talk about other forms of hyperaparathyroidism today.
Secondary alimentary hyperparathyroidism mainly affects kittens from a few weeks to a few months of age.

Causes and pathogenesis:
The root of the problem is most often an improper, unbalanced diet.
As a result, we have a lack of calcium and / or an excess of phosphorus. The body is severely deficient in calcium (either there is little calcium in the diet, or an excess of phosphorus prevents calcium from being absorbed, or both). As a result, in order to maintain a normal level of calcium in the blood, the parathyroid gland releases a hormone (parathyroid hormone), with the help of which calcium is "taken" from the bones into the circulatory system. The bones "thin" and cease to grow normally, becoming brittle. Pains appear. Bones break and crack at the slightest stress.

By experience:
Most often, kittens come with this illness, which are fed only with meat / fish, explaining this by the fact that he “does not want” food, vitamins and supplements. Meat and fish are very rich in phosphorus and poor in calcium, and disease is a natural result of such feeding.
There are breeds believed to be susceptible to this disease: British/Scottish cats, Sphynx cats, Siamese cats. But to be honest, these breeds do not stand out among my kittens with a diagnosis of secondary hyperparathyroidism, most often they come with Scottish Fold and Maine Coons. And the latter, not because the breed is such, but because people believe that the Maine Coon should be fed mainly with meat.
Another reason for poor absorption of calcium from the gastrointestinal tract is diseases of the stomach and intestines, kidney failure (for example, against the background of polycystic in Persian cats), hypervitaminosis A and D. Also, fast-growing animals, such as large dog breeds, are also very sensitive to lack of calcium.

Symptoms:
First, the kitten has a feeling of soreness, discomfort, weakness. He plays less, tries to move more carefully. Sometimes it comes to the point that the kitten hurts when touched, he tries to avoid contact with hands, up to the manifestation of aggressiveness. The main and most visible sign - lameness - is manifested as a result of the same soreness in the bones and muscles. At the same time, the bones become soft, like tight plasticine. It is undesirable to check the last statement on your own - it is fraught with fractures.
The logical outcome of the disease is multiple fractures, bone fractures, and also due to the fact that the bones of the spine are also affected, paresis / paralysis of the limbs, urinary and fecal incontinence, or, conversely, constipation may occur. Also, in the absence of treatment, deformation of the paws and chest, curvature of the spine, violation of the change and growth of teeth take place.

Diagnostics:
The "gold standard" for diagnosing secondary alimentary hyperparathyroidism is x-ray. In the blood, the level of phosphorus and calcium is likely to be normal, if the case is not of the last severity.
On the x-ray we see:
Thinned, "transparent" bones, with reduced density, the walls of the bones are thinned. Sometimes the density is comparable to the density of the surrounding tissues. You can see pathological fractures, sometimes already fused, cracks, deformation of the bones. In severe cases or with neurological disorders, one can see fractures and curvature of the spine, deformity of the vertebrae, overflowing bladder and intestines.
Diagnosis is mandatory, only on the basis of symptoms such a diagnosis is not made, because. The causes of lameness can be many, ranging from viral diseases to injuries.

Treatment:
In the early stages of the disease, the prognosis is favorable.
The basis of treatment is the transfer of a kitten to industrial super-premium food. For those who like to feed "natural food", I usually explain that just adding supplements and vitamins to the diet is not enough, a balanced diet is needed. Usually a month of proper nutrition brings the body back to normal.
If there are fractures, it is recommended to limit mobility.
If necessary, painkillers, calcium injections are administered.
Neurological problems require separate treatment.

Possible consequences:
Growth retardation, deformation of the pelvic bones, which can lead to difficulty defecation, urination, giving birth to such cats is not recommended. Deformation of the chest can lead to chronic diseases of the respiratory system. Neurological problems can persist throughout life.
Pathological fractures are fixed if necessary. Spinal fractures can have serious consequences, all of which are described above, but they have a poor prognosis.
Sometimes it proceeds imperceptibly, and only on an x-ray in an already adult cat can one notice old fused fractures and cracks.

Secondary (food) hyperparathyroidism (butcher's dog disease, paper bone disease).

Secondary nutritional hyperparathyroidism is a compensatory hyperfunction of the parathyroid gland that develops with prolonged hypocalcemia (decreased calcium levels) and hyperphosphatemia (increased phosphorus levels).

Sounds confusing to the average pet owner? Let's deal with this topical problem in kittens and puppies together.

We will consider the pathology associated with improper feeding of babies, because. it occurs most often.

With improper, unbalanced feeding of kittens and puppies in the diet there is a large amount of phosphorus and an insufficient amount of calcium. As a result, the growing body lacks building material for the development of organs containing large amounts of calcium - bones and joints. The bones become soft, easy to bend even with a slight load. With increased activity, which is demonstrated by all healthy puppies and kittens, this leads to multiple fractures of the "green branch" type, causing severe suffering to the animal. Bent and break not only the long bones of the limbs, but also the vertebrae. As a result, neurological problems may arise - paresis and paralysis of the limbs, impaired innervation of the bladder and intestines. Puppies and kittens suffering from secondary nutritional hyperparathyroidism often refuse to move, lameness and pain appear when moving. They may have deformed limbs.

What is causing all these horrors? The answer is malnutrition. Although dogs and cats are carnivores, however, in nature they do not eat only meat, along with meat they eat bones, which are a source of calcium and help to balance the phosphorus-calcium ratio.

Loving owners begin to feed their little charming treasure with goodies - meat, fish, meat baby food or, even worse, "from the table" - soup, sausages, servelat. All these products contain a lot of phosphorus and little calcium. Such a violation of mineral metabolism leads to a decrease in the calcium content in the blood and its leaching from the bones.

Most often, animals come to our clinic with fractures, neurological disorders or severe pain of unknown origin. The diagnosis is confirmed by x-ray of the entire skeleton. Sometimes it can be very difficult to carry out this type of examination, as laying down the animal causes him great pain.

On x-rays we see transparent bones, multiple creases on the bones, and in severe cases - deformation of the vertebrae, curvature of the spine, fractures of the vertebrae, an overflowing bladder, an intestine "clogged" with feces. These animals need urgent help!

Medical treatment - anesthesia. With neurological deficits, treatment is even more complicated and does not always lead to recovery.

To cope with this disease will help only well-chosen diet animal, since the simple addition of vitamin and mineral supplements is not effective! At home, it is difficult to make a diet so that the animal is provided with vitamins and minerals in the proper quantity and proportion. Even if you make up a similar diet, it’s not a fact that a little fussy will eat it completely. A good way out is industrial feed (dry or wet). Animals should be taught to them from early childhood.

To prevent fractures of the bones of the limbs and spine, the animal is limited in mobility for up to 6 weeks (carrying or cage may be required).

The practice of our clinic has shown that within 2-4 weeks after the start of proper nutrition, the bones of animals return to normal.

The chief doctor of the clinic "Klyk", Gady M.Yu.