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Suspected bisphosphate-related osteonecrosis of the jaw in a cat being treated with alendronate for idiopathic hypercalcaemia
  1. Emma Rogers-Smith1,
  2. Nat Whitley1,
  3. Clive Elwood1,
  4. David Reese2 and
  5. Paula Wong3
  1. 1Internal Medicine, Davies Veterinary Specialists, Higham Gobion, UK
  2. 2VetCT Consultants in Telemedicine, Freemantle, Western Australia, UK
  3. 3Dovecote Veterinary Hospital, Derby, UK
  1. Correspondence to Dr Emma Rogers-Smith;{at}


An 8-year-old female neutered domestic shorthair diagnosed with idiopathic hypercalcaemia and undergoing weekly treatment with alendronate presented to Davies Veterinary Specialists for progressive facial swelling and discomfort 12 months after commencement of bisphosphonate treatment. Progression of the pathology was documented through clinical history from the referring practice when the patient underwent dental treatment with dental radiographs and then subsequently CT evaluation of the lesions. Proliferative and lytic, multifocal bony changes to the jaw, with a strikingly similar radiographic appearance to that seen in humans suffering from bisphosphonate-related osteonecrosis of the jaw (BRONJ), were seen. BRONJ is a well-recognised side effect of bisphosphonate therapy in people undergoing bisphosphonate therapy for the management of malignant hypercalcaemia. The cat was eventually euthanised due to the development of an abdominal mass and declining quality of life.

  • bisphosphonates
  • osteonecrosis
  • idiopathic hypercalcaemia
  • feline
  • alendronate
  • actinomyces
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  • Contributors CE, NW and PW represent primary and referral care clinicians in this case and had active input and contributions in all draft revisions. DR was responsible for interpretation of the CT images, as well as image interpretation write-up for the case report and formatting of images to make them suitable for publication. Also had active input in all draft revisions of the case report. ER-S wrote initial draft of the case report based off of collated clinical histories and worked with co-authors throughout subsequent draft revisions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data are available.

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