Investigations on the influence of serum d-lactate levels on clinical signs in calves with metabolic acidosis

Investigating nutritional strategies during a rest period to improve health, growth, and behavioral outcomes of transported surplus dairy calves

The objective of this study was to investigate the effects of feeding surplus dairy calves a milk replacer (MR) or one of 2 different oral rehydration solutions (ORS) during a midtransportation rest period on metabolic and clinical health indicators, growth, and behavioral outcomes after arrival at a calf-raising facility. Surplus dairy calves (n = 128) were transported in 4 cohorts from February to July 2022 for 12 h to a holding facility, rested for 8 h, then transported for an additional 6 h to a calf-raising facility. Upon arrival at the holding facility, calves were randomly assigned to 1 of 3 treatments: MR (n = 43), a high-sodium ORS developed for diarrhea (ORS-D; n = 43), or a high-potassium ORS developed for transportation (ORS-T; n = 42). The exact age of calves at transportation was unknown; however, all calves were less than 14 d of age. Calf BW at enrollment was 43.9 ± 5.9 kg, 43.7 ± 6.5 kg, and 45.0 ± 4.5 kg for calves fed MR, ORS-D, and ORS-T, respectively. Calves were fed 2.0 L of their treatment twice, once upon arrival and once before leaving the holding facility. At unloading and reloading at the holding facility, calves were weighed and blood samples were obtained. Calves were also health scored at unloading at the holding facility. After arrival at the calf-raising facility, calves were weighed, health scored, and blood samples were taken. Blood samples were collected at 24 and 48 h and BW was recorded at 24 h, 48 h, 72 h, 5 d, 7 d, 14 d, and at 8 wk after arrival at the calf-raising facility. Calves were also health scored daily for 14 d; health scoring included fecal consistency scoring and evaluating the presence or absence of respiratory disease. Lying time, lying bouts, and activity index were measured during transportation and from 3 d relative to transportation using accelerometers. At arrival to the calf-raiser, calves fed ORS-D had higher concentrations of nonesterified fatty acids (NEFA) and BHB than calves fed MR. Furthermore, calves fed ORS-T had higher concentrations of BHB at arrival to the calf raiser compared with calves fed MR. In the 14 d after arrival at the calf-raiser, there was evidence that calves fed ORS-T had a higher proportion of days with diarrhea and respiratory disease compared with those fed MR. During transportation, calves fed ORS-T had a lower activity index than calves fed MR, suggesting that ORS-T calves had lower overall activity. In addition, on the day of transportation (d 0), ORS-T and ORS-D calves had a lower activity index than calves fed MR. There were no treatment effects on growth outcomes. The results of this study suggest that feeding MR rather than an ORS during a midtransportation rest period could minimize fat mobilization and can potentially improve diarrhea and respiratory disease but does not affect growth outcomes after arrival at calf-raisers.

Calf Diarrhea Is Associated With a Shift From Obligated to Facultative Anaerobes and Expansion of Lactate-Producing Bacteria

Diarrhea is the leading cause of morbidity, mortality and antimicrobial drug use in calves during the first month of age. Alteration in the bacterial communities of the gastrointestinal tract occurs during diarrhea. Diarrheic calves often develop anion gap (AG) acidosis associated with increased concentrations of unmeasured anions including D- and L-lactate. However, studies investigating the association between gut microbiota alterations and the development of acid-base disorders in diarrheic calves are lacking. We investigated the fecal bacterial alterations of calves with diarrhea and its association with changes in blood pH, and AG. Blood and fecal samples from healthy and diarrheic veal calves were taken 7 days after arrival to the farm. The fecal microbiota of healthy and diarrheic calves was assessed by sequencing of 16S ribosomal RNA gene amplicons. Blood gas analysis was completed using an i-Stat analyzer. In healthy calves, higher richness, evenness, and diversity were observed compared to diarrheic calves. Phocaeicola, Bacteroides, Prevotella, Faecalibacterium, Butyricicoccus, Ruminococcaceae and Lachnospiraceae were enriched in healthy compared with diarrheic calves. Enterococcus, Ligilactobacillus, Lactobacilus, Gallibacterium Streptococcus, and Escherichia/Shigella were enriched in diarrheic calves. In diarrheic calves, an increased abundance of lactate-producing bacteria including Lactobacillus, Streptococcus, Veillonella, Ligilactobacillus and Olsenella was detected. Diarrheic calves had a lower pH and bicarbonate concentration and a higher AG concentration than healthy calves. Together, these results indicate that calf diarrhea is associated with a shift from obligated to facultative anaerobes and expansion of lactate-producing bacteria which are related to acidemia, low bicarbonate and increase AG. Our results highlight the importance of the gastrointestinal microbiota on the clinicopathological changes observed in diarrheic calves.

Role of Lactate in Inflammatory Processes: Friend or Foe

During an inflammatory process, shift in the cellular metabolism associated with an increase in extracellular acidification are well-known features. This pH drop in the inflamed tissue is largely attributed to the presence of lactate by an increase in glycolysis. In recent years, evidence has accumulated describing the role of lactate in inflammatory processes; however, there are differences as to whether lactate can currently be considered a pro- or anti-inflammatory mediator. Herein, we review these recent advances on the pleiotropic effects of lactate on the inflammatory process. Taken together, the evidence suggests that lactate could exert differential effects depending on the metabolic status, cell type in which the effects of lactate are studied, and the pathological process analyzed. Additionally, various targets, including post-translational modifications, G-protein coupled receptor and transcription factor activation such as NF-κB and HIF-1, allow lactate to modulate signaling pathways that control the expression of cytokines, chemokines, adhesion molecules, and several enzymes associated with immune response and metabolism. Altogether, this would explain its varied effects on inflammatory processes beyond its well-known role as a waste product of metabolism.

Monitoring selected behaviors of calves by use of an ear-attached accelerometer for detecting early indicators of diarrhea

One of the most important diseases in calves worldwide is neonatal calf diarrhea (NCD), which impairs calf welfare and leads to economic losses. The aim of this study was to test whether the activity patterns of calves can be used as early indicators to identify animals at risk for suffering from NCD, compared with physical examination. We monitored 310 healthy female Holstein-Friesian calves on a commercial dairy farm immediately after birth, equipped them with an ear tag-based accelerometer (Smartbow, Smartbow GmbH), and conducted daily physical examinations during the first 28 d of life. The Smartbow system captured acceleration data indicative of standing and lying periods and activity levels (active and inactive), shown as minutes per hour. We categorized calves as diarrheic if they showed fecal scores of ≥3 on a 4-point scale on at least 2 consecutive days. Incidence of diarrhea was 50.7% (n = 148). A mixed logistic regression model showed that lying [odds ratio (OR) = 1.19], inactive (OR = 1.14), and active (OR = 0.92) times, 1 d before clinical identification of diarrhea (d -1), were associated with the odds of diarrhea occurring on the subsequent day. Receiver operating characteristics curve showed that lying time at d -1 was a fair predictor for diarrhea on the subsequent day (area under curve = 0.69). Average lying time on d -1 was 64.8 min longer in diarrheic calves compared with their controls. Median lying and inactive times decreased, and active time increased with age over the study period. The 24-h pattern of behavior indices based on the output of the Smartbow system followed periods of resting and active times, and showed that between 2200 h and 0600 h, calves spent the greatest percentage of time lying and inactive. These results showed that the accelerometer system has the potential to detect early indicators associated with NCD. In future studies, additional data for the development and testing of calf- and event-specific algorithms (e.g., for detecting milk intake, playing behavior) should be collected, which might further improve the early detection of diarrhea in calves.

Dependence of the apparent bicarbonate space on initial plasma bicarbonate concentration and carbon dioxide tension in neonatal calves with diarrhea, acidemia, and metabolic acidosis

BACKGROUND

Marked strong ion (metabolic) acidosis in neonatal diarrheic calves usually is corrected by IV administration of NaHCO₃ . The distribution space for IV-administered bicarbonate, called the apparent bicarbonate space (ABS), appears to depend on initial plasma bicarbonate concentration (cHCO₃ ) and varies considerably in calves.

OBJECTIVE

To determine whether ABS was associated with initial plasma cHCO₃ and other acid-base variables.

ANIMALS

Twenty-five neonatal diarrheic calves with acidemia and metabolic acidosis.

METHODS

Prospective observational study using a convenience sample. Calves received NaHCO₃ (10 mmol/kg) and glucose (1.4 mmol/kg) IV in a crystalloid solution at 25 mL/kg over 60 minutes. The ABS (L/kg) was calculated at 4 time points over 2 hours after the end of the infusion. The relationship between ABS and initial acid-base variables was characterized using nonlinear, linear, and stepwise regression.

RESULTS

The median value for ABS calculated from the initial plasma cHCO₃ increased from 0.53 L/kg (range, 0.40-0.79) at the end of IV infusion to 0.96 L/kg (range, 0.54-1.23) 120 minutes later. Data obtained at the end of infusion provided the best fit to initial plasma cHCO₃ and jugular venous blood Pco₂ , such that: ABS = 0.41 + 1.06/cHCO₃ and ABS = 0.87-0.0082 × Pco₂ .

CONCLUSIONS AND CLINICAL IMPORTANCE

The observed median value for ABS of 0.53 L/kg in our study was similar to the empirically used value of 0.6. However, ABS values varied widely and were increased in calves with severe metabolic acidosis. We therefore recommend calculating ABS using the initial plasma cHCO₃ or venous blood Pco₂ , if respective measurements are available.

Determining the predictive capability of a Clinical Assessment Scoring Chart to differentiate severity of the clinical consequences of neonatal calf diarrhea relative to gold-standard blood gas analysis

Neonatal calf diarrhea (NCD) is a major problem to calf health worldwide, in terms of both morbidity and mortality. A five-point ordinal scale clinical assessment scoring (CAS) chart was utilized to assess calves suffering from NCD-related clinical abnormalities (acidosis and dehydration) on commercial farms. The objective of this research was to determine the predictive capability of this CAS chart against gold standard blood gas parameters, designed to assist farmers in the accurate assessment of the clinical consequences of NCD. A total of 443 diarrheic and non-diarrheic calves were enrolled in the study. The CAS chart rated a calf’s health from no clinical signs to varying degrees of clinical severity on a 0 (clinically normal) to 4 (grave) scale, based on clinical indicators including calf demeanour, ear position, mobility, suckle reflex, desire-to-feed, and enophthalmos. Blood gas analysis was conducted for individual calves, consisting of pH, base excess, Na⁺, K⁺, Ca²⁺, Cl⁻, glucose, total hemoglobin, bicarbonate, anion gap, and strong ion difference. Statistical evaluation was performed by comparison of the CAS score with blood gas profiles using ordinal logistic regression and a non-parametric estimation of the Receiver Operating Characteristics (ROC). The ROC analysis indicated that the CAS chart had acceptable specificity (>95%) with low sensitivity (<60%) in differentiating clinically normal from acidotic/dehydrated cases. Assessment of individual severity classes indicated that the chart can predict and differentiate both clinically normal and advanced cases from the other severity classes (peak estimations >80%) but had reduced accuracy in differentiating mild and moderate cases (peak estimations >50%). The chart, as presented, provides a simple tool to differentiate clinically normal from calves suffering the consequences of diarrhea, but fails to accurately differentiate severity for NCD related acidosis and dehydration. Further efforts are required to enhance the sensitivity and differential diagnostic value of this type of chart.

Plasma diamine oxidase activity decline with diarrhea severity in calves indicating systemic dysfunction related to intestinal mucosal damage

The aim of the present study was to investigate whether abnormalities in plasma diamine oxidase (DAO) activity reflect the degree of intestinal mucosal disorder in calves with diarrhea. A total of 50 Holstein calves were enrolled. Thirty-six of the 50 calves presented diarrhea and were sub-classified by severity based on fecal status (0: firm, 1: pasty, 2: loose, and 3: watery) and blood pH (acidemia: blood pH <7.25) as follows: Seventeen calves exhibiting watery diarrhea and/or fall into acidemia were sub-categorized into the severe group. The other nineteen calves exhibiting pasty or loose diarrhea and not fall into acidemia were sub-categorized into the moderate group. The remaining 14 calves without diarrhea were assigned to the control group. The plasma DAO activity was significantly lower (p < .01) in the calves with severe or moderate diarrhea than in the control group. In addition, the plasma DAO activity was significantly lower (p < .05) in the severe group than in the moderate group. The relationship between plasma DAO activity and fecal score (r = -0.55, p < .01) in calves with diarrhea were found to have significantly and negatively correlated by Spearman's rank test in this study. Our results suggested that plasma DAO activity reflect the degree of intestinal mucosal disorder due to diarrhea.

Experimental protocol for metabolic acidosis induction by intravenous administration of hydrochloric acid in sheep

ABSTRACT The aim of this study was to assess the magnitude and duration of blood and urine changes and the side effects of hyperchloremic acidosis induced by the intravenous administration of hydrochloric acid in sheep. Five healthy, crossbred adult ewes, with a mean body weight of 44±2.9kg were used. The hydrochloric acid solution was administered intravenously at a rate of 25mL/kg/h for 4 hours continuously. Venous blood and urine samples were collected and pH values, blood carbon dioxide partial pressure, bicarbonate, base excess, strong ion difference, anion gap, total concentration of nonvolatile buffers, creatinine, plasma L-lactate, plasma and urine sodium, potassium, and chloride were determined. The experimental protocol induced severe hyperchloremic acidosis at the end of the infusion, with a decreased plasma strong ion difference. The fractional excretion of sodium and chloride remained increased during 4 hours after the infusion. Aciduria was observed at approximately 24 hours. Twenty-four hours after the infusion, the animals showed mild and compensated metabolic acidosis. This protocol was effective in inducing severe and long-lasting hyperchloremic acidosis and did not cause serious side effects. Therefore, this protocol can be used safely in adult sheep for studies on the treatment of this condition.

Clinical signs, profound acidemia, hypoglycemia, and hypernatremia are predictive of mortality in 1,400 critically ill neonatal calves with diarrhea

Profound acidemia impairs cellular and organ function and consequently should be associated with an increased risk of mortality in critically ill humans and animals. Neonatal diarrhea in calves can result in potentially serious metabolic derangements including profound acidemia due to strong ion (metabolic) acidosis, hyper-D-lactatemia, hyper-L-lactatemia, azotemia, hypoglycemia, hyperkalemia and hyponatremia. The aim of this retrospective study was to assess the prognostic relevance of clinical and laboratory findings in 1,400 critically ill neonatal calves with diarrhea admitted to a veterinary teaching hospital. The mortality rate was 22%. Classification tree analysis indicated that mortality was associated with clinical signs of neurologic disease, abdominal emergencies, cachexia, orthopedic problems such as septic arthritis, and profound acidemia (jugular venous blood pH < 6.85). When exclusively considering laboratory parameters, classification tree analysis identified plasma glucose concentrations < 3.2 mmol/L, plasma sodium concentrations ≥ 151 mmol/L, serum GGT activity < 31 U/L and a thrombocyte count < 535 G/L as predictors of mortality. However, multivariable logistic regression models based on these laboratory parameters did not have a sufficiently high enough sensitivity (59%) and specificity (79%) to reliably predict treatment outcome. The sensitivity and specificity of jugular venous blood pH < 6.85 were 11% and 97%, respectively, for predicting non-survival in this study population. We conclude that laboratory values (except jugular venous blood pH < 6.85) are of limited value for predicting outcome in critically ill neonatal calves with diarrhea. In contrast, the presence of specific clinical abnormalities provides valuable prognostic information.

An observational study using blood gas analysis to assess neonatal calf diarrhea and subsequent recovery with a European Commission-compliant oral electrolyte solution

An observational study was conducted on dairy calves (51 healthy, 31 with neonatal diarrhea) during outbreaks of diarrhea on 4 dairy farms. Clinical assessment scores (CAS) were assigned to each healthy and diarrheic calf [from 0 (healthy) to 4 (marked illness)]. Blood gas analysis [pH, base excess (BE), Na(+), K(+), Ca(2+), Cl(-), glucose, total hemoglobin, standard HCO3(-), strong ion difference (SID), and anion gap (AG)] was completed for each calf. Repeated measurements were taken in healthy animals, and pre- and postintervention measurements were taken for diarrheic calves. The mean CAS of diarrheic calves was 1.7, with 51, 30, 17, and 2% of calves scoring 1, 2, 3, and 4, respectively. The mean value for blood pH, BE, AG, and SID was 7.26, -4.93mM, 16.3mM, and 38.59mM, respectively. Calves were administered an oral rehydration and buffering solution (ORBS; Vitalife for Calves, Epsilion Ltd., Cork, Ireland) and reassessed. The mean CAS decreased to 0.38 (65% of calves scored 0 and 35% scored 1) at 6 to 18h posttreatment and to 0.03 (98% of calves scored 0 and 2% scored 1) within 24 to 48h. Significant increases in mean value for pH, BE, HCO3(-), Na(+), and SID, and significant decreases in AG, K(+), Ca(2+), and total hemoglobin were recorded posttreatment. The correlation estimates indicated that pH, HCO3(-), and BE were strongly correlated with CAS, with values exceeding 0.60 in all cases. Administration of an ORBS with a high SID and bicarbonate buffer demonstrated rapid recovery from a diarrheic episode in dairy calves.

Advances in prevention and therapy of neonatal dairy calf diarrhoea: a systematical review with emphasis on colostrum management and fluid therapy

Neonatal calf diarrhoea remains the most common cause of morbidity and mortality in preweaned dairy calves worldwide. This complex disease can be triggered by both infectious and non-infectious causes. The four most important enteropathogens leading to neonatal dairy calf diarrhoea are Escherichia coli, rota- and coronavirus, and Cryptosporidium parvum. Besides treating diarrhoeic neonatal dairy calves, the veterinarian is the most obvious person to advise the dairy farmer on prevention and treatment of this disease. This review deals with prevention and treatment of neonatal dairy calf diarrhoea focusing on the importance of a good colostrum management and a correct fluid therapy.

A controlled trial on the effect of feeding dietary chestnut extract and glycerol monolaurate on liver function in newborn calves

Beginning in the fall of 2010, an increasing and alarming number of cases of calves suffering from liver dystrophy were reported in the south of Germany. An epidemiological investigation was carried out by the authors between November 2010 and July 2011, leading to the implication of a commercial dietary supplement as the potential cause for this outbreak. The components of this product were first tested in a cell culture model and two of them (dietary chestnut extract and glycerol monolaurate) showed a cytotoxic effect. The objective of this study was therefore to evaluate the effect of supplemental feeding of both components alone or in combination on liver function in newborn calves on a commercial dairy farm. Ten calves were enrolled in each of the three treatment groups and the control group (group O) following a blocked design. Treatment consisted of supplementation with chestnut extract at 0.02% of birth body mass (BM) (group C), supplementation with glycerol monolaurate at 0.006% of BM (group G) or a combined treatment (group CG) for five consecutive days. The effect of treatments on liver function was evaluated clinically and by measurement of glutamate dehydrogenase (GLDH) and aspartate aminotransferase (AST) activities as well as the determination of the concentrations of glucose, L‐lactate and total bilirubin in serum. There was a significant increase in GLDH and AST activities and a significant decrease in glucose concentration in treatment groups C and CG compared with the control group (p ≤ 0.035), whereas no difference was shown for group G. Survival was significantly decreased in groups C (p = 0.029) and CG (p = 0.001) compared with both group G and the control group. These results suggest that dietary chestnut extract in an amount of 0.02% of BM alone or in combination has a toxic effect on liver function in newborn calves.

Contribution of unmeasured anions to acid-base disorders and its association with altered demeanor in 264 calves with neonatal diarrhea

Background

The quantitative effect of strong electrolytes, unmeasured anions (UAs), pCO₂, and plasma protein concentrations in determining plasma pH and bicarbonate (HCO₃⁻) can be demonstrated using the physicochemical approach. Demeanor of calves with diarrhea is associated with acidemia, dehydration, and hyper‐d‐lactatemia.

Hypothesis

Unmeasured anions are a major factor influencing changes in plasma pH and HCO₃⁻ of calves with diarrhea and UAs and strong UAs, estimated by anion gap (AG) and strong ion gap (SIG), respectively, are more strongly associated with alteration of demeanor compared to other acid–base variables.

Animals

A total of 264 calves with diarrhea from two data sets (DS1 and DS2).

Methods

Retrospective study. Forward stepwise regression was performed to determine the relationship between measured pH or HCO₃⁻, and physicochemical variables. A two‐way ANOVA was performed to investigate the association between acid–base variables and attitude (bright, obtunded, and stuporous), posture (standing, sternal or lateral recumbency), and strength of suckling reflex (strong, weak, or absent).

Results

Increased strong UAs estimated by SIG was the most important contributor to changes in measured pH and HCO₃⁻ (DS1: r² 66 and 59%, DS2: 39 and 42%, P < .0001). SIG and AG were correlated to deteriorating calf demeanor for all three clinical scoring categories: attitude, posture, and suckle reflex (P < .0001).

Conclusion and Clinical Relevance

Elevated concentrations of strong UAs were the primary cause of acidemia and had an important influence on the demeanor of calves with diarrhea. These findings emphasize the importance of the calculation of UAs when evaluating acid–base abnormalities in calves.

Construction and validation of a decision tree for treating metabolic acidosis in calves with neonatal diarrhea

BACKGROUND

The aim of the present prospective study was to investigate whether a decision tree based on basic clinical signs could be used to determine the treatment of metabolic acidosis in calves successfully without expensive laboratory equipment. A total of 121 calves with a diagnosis of neonatal diarrhea admitted to a veterinary teaching hospital were included in the study. The dosages of sodium bicarbonate administered followed simple guidelines based on the results of a previous retrospective analysis. Calves that were neither dehydrated nor assumed to be acidemic received an oral electrolyte solution. In cases in which intravenous correction of acidosis and/or dehydration was deemed necessary, the provided amount of sodium bicarbonate ranged from 250 to 750 mmol (depending on alterations in posture) and infusion volumes from 1 to 6.25 liters (depending on the degree of dehydration). Individual body weights of calves were disregarded. During the 24 hour study period the investigator was blinded to all laboratory findings.

RESULTS

After being lifted, many calves were able to stand despite base excess levels below -20 mmol/l. Especially in those calves, metabolic acidosis was undercorrected with the provided amount of 500 mmol sodium bicarbonate, which was intended for calves standing insecurely. In 13 calves metabolic acidosis was not treated successfully as defined by an expected treatment failure or a measured base excess value below -5 mmol/l. By contrast, 24 hours after the initiation of therapy, a metabolic alkalosis was present in 55 calves (base excess levels above +5 mmol/l). However, the clinical status was not affected significantly by the metabolic alkalosis.

CONCLUSIONS

Assuming re-evaluation of the calf after 24 hours, the tested decision tree can be recommended for the use in field practice with minor modifications. Calves that stand insecurely and are not able to correct their position if pushed require higher doses of sodium bicarbonate, if there is clinical evidence of a marked D-lactic acidosis. In those calves, determining the degree of loss of the palpebral reflex was identified as a useful decision criterion to provide an additional amount of 250 mmol sodium bicarbonate. This work demonstrates the clinical relevance of the discovery that D-lactate is responsible for most of the clinical signs expressed in neonatal diarrheic calves suffering from metabolic acidosis.

Clinical Forum: Neonatal Diarrhoea

Diarrhoea is the most common disease in young calves, accounting for about 50% of all calf deaths. The disease can be easily recognised and it is important that treatment is administered rapidly in order to maximise the chance of survival. However, equally important is a thorough understanding of the underlying causes of the disease and the implementation of appropriate management steps to minimise the impact of the disease in the future. This article discusses the most common causes of neonatal diarrhoea and seeks the advice of the panel on how best to treat and manage them.

The prevalence and clinical relevance of hyperkalaemia in calves with neonatal diarrhoea

One hundred and twenty-four calves with neonatal diarrhoea were investigated in order to assess the prevalence of hyperkalaemia and the associated clinical signs. Hyperkalaemia (potassium concentration >5.8mmol/L) was recognized in 42 (34%) calves and was more closely associated with dehydration than with decreases in base excess or venous blood pH. In 75 calves with normal blood concentrations of D-lactate (i.e. ⩽3.96mmol/L), K concentrations were moderately correlated with base excess values (r=-0.48, P<0.001). In contrast, no significant correlation was observed in 49 calves with elevated D-lactate. Only three hyperkalaemic calves had bradycardia and a weak positive correlation was found between heart rate and K concentrations (r=0.22, P=0.014). Ten of the 124 calves had cardiac arrhythmia and of these seven had hyperkalaemia indicating that cardiac arrhythmia had a low sensitivity (17%) but a high specificity (96%) as a predictor of hyperkalaemia. In a subset of 34 calves with base excess values ⩽-5mmol/L and D-lactate concentrations <5mmol/L (of which 22 had hyperkalaemia), changes in posture/ability to stand could be mainly explained by elevations of K concentrations (P<0.001) and to a lesser extent by increases in L-lactate concentrations (P=0.024). Skeletal muscle weakness due to hyperkalaemia alongside hypovolaemia may produce a clinical picture that is similar to that in calves with marked D-lactic acidosis. However, since reductions in the strength of the palpebral reflex are closely correlated with D-lactate concentrations, a prompt palpebral reflex can assist the clinical prediction of hyperkalaemia in calves presenting with a distinct impairment in their ability to stand (specificity 99%, sensitivity 29%).

Serum D-lactate concentrations in cats with gastrointestinal disease

BACKGROUND

Increased D-lactate concentrations cause neurological signs in humans with gastrointestinal disease.

HYPOTHESIS/OBJECTIVES

To determine if serum D-lactate concentrations are increased in cats with gastrointestinal disease compared to healthy controls, and if concentrations correlate with specific neurological or gastrointestinal abnormalities.

ANIMALS

Systematically selected serum samples submitted to the Gastrointestinal Laboratory at Texas A&M University from 100 cats with clinical signs of gastrointestinal disease and abnormal gastrointestinal function tests, and 30 healthy cats.

METHODS

Case-control study in which serum D- and L-lactate concentrations and retrospective data on clinical signs were compared between 30 healthy cats and 100 cats with gastrointestinal disease. Association of D-lactate concentration with tests of GI dysfunction and neurological signs was evaluated by multivariate linear and logistic regression analyses, respectively.

RESULTS

All 100 cats had a history of abnormal gastrointestinal signs and abnormal gastrointestinal function test results. Thirty-one cats had definitive or subjective neurological abnormalities. D-lactate concentrations of cats with gastrointestinal disease (median 0.36, range 0.04-8.33 mmol/L) were significantly higher than those in healthy controls (median 0.22, range 0.04-0.87 mmol/L; P = .022). L-lactate concentrations were not significantly different between the 2 groups of cats with gastrointestinal disease and healthy controls. D-lactate concentrations were not significantly associated with fPLI, fTLI, cobalamin, folate, or neurological abnormalities (P > .05).

CONCLUSIONS AND CLINICAL IMPORTANCE

D-lactate concentrations can be increased in cats with gastrointestinal disease. These findings warrant additional investigations into the role of intestinal microbiota derangements in cats with gastrointestinal disease, and the association of D-lactate and neurological abnormalities.

Development of a diagnostic diagram for rapid field assessment of acidosis severity in diarrheic calves

OBJECTIVE

To develop a diagnostic diagram for rapid field assessment of acidosis severity in diarrheic calves.

DESIGN

Prospective cross-sectional study.

ANIMALS

148 Piedmontese calves (38 calves in preliminary experiments; 83 diarrheic calves and 27 healthy control calves in the primary experiment).

PROCEDURES

Physical examination was performed and a standard data collection form was completed for each calf. Blood samples were obtained and submitted for evaluation of acid-base balance, performance of a CBC, and measurement of electrolyte and total protein concentrations.

RESULTS

Severe metabolic acidosis (extracellular base excess more negative than -10 mmol/L) was associated with abnormal mental status, delayed or absent suckle reflex, abnormal posture or gait, enophthalmos, and cold oral mucosal membranes. Clinical signs associated with severe metabolic acidosis were arranged into a grid to create a diagnostic diagram. Sensitivity and specificity of the diagnostic diagram for the prediction of severe metabolic acidosis were 88% and 79%, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Use of the diagnostic diagram may aid differentiation between severe and nonsevere acidosis patterns as determined on the basis of clinical signs.

Metabolic acidosis in neonatal calf diarrhea-clinical findings and theoretical assessment of a simple treatment protocol

BACKGROUND

Clinical assessment of metabolic acidosis in calves with neonatal diarrhea can be difficult because increased blood concentrations of d-lactate and not acidemia per se are responsible for most of the clinical signs exhibited by these animals.

OBJECTIVES

To describe the correlation between clinical and laboratory findings and d-lactate concentrations. Furthermore, the theoretical outcome of a simplified treatment protocol based on posture/ability to stand and degree of dehydration was evaluated.

ANIMALS

A total of 121 calves with diagnosis of neonatal diarrhea admitted to a veterinary teaching hospital during an 8-month study period.

METHODS

Prospective blinded cohort study. Physical examinations were carried out following a standardized protocol. Theoretical outcome of treatment was calculated.

RESULTS

Type and degree of metabolic acidosis were age dependent. The clinical parameters posture, behavior, and palpebral reflex were closely correlated to base excess (r = 0.74, 0.78, 0.68; P < .001) and d-lactate concentrations (r = 0.59, 0.59, 0.71; P < .001), respectively. Thus, determining the degree of loss of the palpebral reflex was identified as the best clinical tool for diagnosing increase in serum d-lactate concentrations. Theoretical outcome of treatment revealed that the tested dosages of sodium bicarbonate are more likely to overdose than to underdose calves with diarrhea and metabolic acidosis.

CONCLUSIONS AND CLINICAL IMPORTANCE

The degree of metabolic acidosis in diarrheic calves can be predicted based on clinical findings. The assessed protocol provides a useful tool to determine bicarbonate requirements, but a revision is necessary for calves with ability to stand and marked metabolic acidosis.

Comparison of the effects of intravenous administration of isotonic and hypertonic sodium bicarbonate solutions on venous acid-base status in dehydrated calves with strong ion acidosis

OBJECTIVE-To compare the effects of IV administration of isotonic (1.3%) and hypertonic (8.4%) sodium bicarbonate (NaHCO(3)) solutions on acid-base status in dehydrated calves with strong ion (metabolic) acidosis. DESIGN-Randomized controlled clinical trial. ANIMALS-50 calves with diarrhea and severe dehydration. PROCEDURES-Calves were randomly assigned to receive isotonic NaHCO(3) solution (65 mL/kg [29.5 mL/lb], IV) over 3 hours (n = 30) or hypertonic NaHCO(3) solution (10 mL/kg [4.5 mL/lb], IV) over 20 minutes (20). Blood samples were collected at 0 hours (immediately prior to solution administration) and at 0.5, 1, 2, and 4 hours after administration began. Samples were submitted for blood gas analysis, serum biochemical analysis, and determination of blood Na(+), K(+), and Cl(-) concentrations and percentage change in plasma volume. RESULTS-Calves that received isotonic NaHCO(3) solution had an increase in venous blood pH, HCO(3) concentration, and base excess; a small, transient increase in Po(2); and no change in Pco(2) within 4 hours after administration began. Calves that received hypertonic NaHCO(3) solution had an immediate increase in venous blood pH, HCO(3) concentration, and base excess; a small, transient increase Pco(2); and no change in Po(2) within 0.5 hours after treatment began. Plasma volume increased to a greater extent following administration of isotonic solution than after administration of hypertonic solution. CONCLUSIONS AND CLINICAL RELEVANCE-IV administration of 8.4% NaHCO(3) solution in small volumes provided fast and effective improvement of severe acid-base abnormalities in calves with severe strong ion acidosis but did not improve hydration status as well as administration of a larger volume of isotonic NaHCO(3) solution.

Treatment of calf diarrhea: antimicrobial and ancillary treatments

Adjunct treatment of diarrhea should be routinely undertaken in all calves with systemic signs of illness, manifest as fever, inappetance, or lethargy. Ancillary treatments with documented efficacy in undifferentiated calf diarrhea include parenteral administration of antimicrobials with a predominantly gram negative spectrum of activity, parenteral administration of non-steroidal anti-inflammatory agents such as meloxicam and flunixin meglumine, and continued feeding of cow's milk. Halofuginone and azithromycin have efficacy in calves with diarrhea due to Cryptosporidium parvum, and their administration should be considered in calves documented or suspected to have cryptosporidiosis.

Treatment of calf diarrhea: intravenous fluid therapy

Severely dehydrated calves that are unable to suckle need intravenous fluids for effective resuscitation. Intravenous fluid therapy is also indicated for sick calves without obvious dehydration, such as calves with strong ion acidosis, ruminal acidosis (rumen drinkers), severe pneumonia, septicemia, or hypothermia. This article presents an updated overview of intravenous fluid therapy for calves, recent insights into the development of metabolic acidosis in young calves resulting from accumulation of D-lactate, a simplified algorithm for intravenous fluid therapy, and a procedure for ear vein catheterization under field conditions.

D-Lactic acid-induced neurotoxicity in a calf model

Lactic acidosis (DAC) occurs as a complication of short-bowel syndrome in humans and in a variety of other gastrointestinal disorders in monogastrics and ruminants. DAC is associated with signs of impaired central nervous system (CNS) function including ataxia and coma. The objective of this experiment was to determine whether either acidification of nervous tissue or d-lactic acid is responsible for decreased neurological function. Eight Holstein calves (32 +/- 11 days, 70 +/- 10 kg) were surgically catheterized with indwelling intravenous jugular and atlanto-occipital space cerebrospinal fluid (CSF) catheters and infused for 6 h in random order with isomolar dl-lactic acid (dl-LA), l-lactic acid (l-LA), hydrochloric acid (HCl), or saline. dl-LA induced ataxia after 4 h of infusion and produced the greatest obtunding of CNS function (at 7 h, score 8.0 +/- 0.4), whereas the other infusions caused neither ataxia nor scores over 1.5 (P < 0.01 from dl-LA). dl-LA induced significantly less acidemia than HCl (at 6 h pH 7.13 +/- 0.06 and 7.00 +/- 0.04, base excess -16 +/- 1 and -23 +/- 3 mmol/l, bicarbonate 11 +/- 1 and 8 +/- 1 mmol/l respectively, all P < 0.01) but greater than l-LA and saline (P < 0.01). CSF changes followed a similar but less pronounced pattern. Although HCl infusion produced a severe acidemia and CSF acidosis, only minor effects on neurological function were evident suggesting that d-lactate has a direct neurotoxic effect that is independent of acidosis. Conversely, l-LA produced only minor neurological changes.

Investigations on the association of D-lactate blood concentrations with the outcome of therapy of acidosis, and with posture and demeanour in young calves with diarrhoea

The objective of this prospective study was to elucidate whether amounts of bicarbonate needed for correction of acidosis and normalization of clinical signs are influenced by blood D-lactate concentrations in calves with diarrhoea. In 73 calves up to 3 weeks old with acute diarrhoea and base excess values below -10 mmol/l correction of acidosis was carried out within 3.5-h by intravenous administration of an amount of sodium bicarbonate which was calculated using the formula: HCO (mmol) = body mass (kg) x base deficit (mmol/l) x 0.6 (l/kg). Clinical signs, venous base excess, and plasma D-lactate concentrations were monitored immediately following admission, following correction of acidosis at 4 h and 24 h after admission. The base excess and plasma D-lactate concentrations throughout the study were -17.8 +/- 4.0, -0.4 +/- 0.4, -3.0 +/- 5.5 mmol/l (base excess), and 10.0 +/- 4.9, 9.8 +/- 4.8, 5.4 +/- 3.4 mmol/l (D-lactate) for the three times of examination. Metabolic acidosis was not corrected in more than half of the calves (n = 43) by the calculated amount of bicarbonate, whereas the risk of failure to correct acidosis increases with D-lactate concentrations. The study shows that calves with elevated D-lactate concentrations do not need additional specific therapy, as D-lactate concentrations regularly fall following correction of acidosis and restitution of body fluid volume, for reasons that remain unclear. However, calves with distinct changes in posture and demeanour need higher doses of bicarbonate than calculated with the factor of 0.6 in the formula mentioned above probably because of D-hyperlactataemia.