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Viterbo L, Hughes J, Milner PI, Bardell D. Arterial Blood Gas, Electrolyte and Acid-Base Values as Diagnostic and Prognostic Indicators in Equine Colic. Animals (Basel) 2023; 13:3241. [PMID: 37893965 PMCID: PMC10603645 DOI: 10.3390/ani13203241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
The study aimed to investigate if arterial blood analysis in conscious horses presenting with signs of colic and breathing ambient air had diagnostic or prognostic value. Arterial blood samples from 352 horses presenting with colic at a university equine referral hospital were analysed for pH, partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2), concentrations of sodium (Na+), potassium (K+), ionised calcium (Ca2+) and chloride (Cl-), actual and standardised plasma bicarbonate concentration (HCO3- (P) and HCO3- (P, st)), blood and extracellular fluid base excess (Base (B) and Base (ecf)) and anion gap (AG). Results were compared to previously reported values for healthy horses, and comparisons were made between final diagnosis, treatment and survival to hospital discharge. Significant differences were found between colic cases and healthy reference values between some primary aetiologies. Overall, surgical and non-surgical colic cases differed in Ca2+ and Cl- concentrations and Ca2+ differed between cases that survived to discharge and those that did not. PaO2 differed between small intestinal surgical cases that survived and those that did not. From these results, we developed regression models that demonstrated excellent or good predictive value in identifying the likelihood of surgical versus medical management and survival to hospital discharge.
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Affiliation(s)
- Luisa Viterbo
- North Downs Specialist Referrals, Part of Linnaeus Veterinary Limited, The Fresian Buildings 3–4, Dairy Business Park, Brewer Street, Bletchingley RH1 4QP, UK;
| | - Jodie Hughes
- North Downs Specialist Referrals, Part of Linnaeus Veterinary Limited, The Fresian Buildings 3–4, Dairy Business Park, Brewer Street, Bletchingley RH1 4QP, UK;
| | - Peter I. Milner
- Department of Equine Clinical Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK; (P.I.M.); (D.B.)
| | - David Bardell
- Department of Equine Clinical Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK; (P.I.M.); (D.B.)
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Anderson T, Beever L, Hall J, Moores A, Llanos C, Adams R, Meakin L, Coppola M, Bowlt-Blacklock K, Holmes MA, Barnes D. Outcome following surgery to treat septic peritonitis in 95 cats in the United Kingdom. J Small Anim Pract 2021; 62:744-749. [PMID: 33999425 DOI: 10.1111/jsap.13346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/31/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To review the cause, management and outcome in cats with septic peritonitis within the United Kingdom (2008 to 2018) and to identify if previously identified prognostic factors were associated with survival in this population. MATERIALS AND METHODS Clinical records from 10 referral hospitals in United Kingdom were reviewed. Data collected included signalment, clinicopathological data and management techniques. Serum albumin, glucose, lactate and ionised calcium concentration; presence of intraoperative hypotension and correct empirical antibiosis were analysed via logistic regression for association with survival. RESULTS Ninety-five cats were included. The overall survival rate was 66%. Lethargy (89%) and anorexia (75%) were the most common clinical signs, with abdominal pain and vomiting in 44% and 27% of cases, respectively. Gastro-intestinal leakage was the most common source of contamination. The presence of an abdominal mass on clinical examination was not strongly predictive of the presence of neoplasia on histology and did not confer a worse prognosis. Cats presenting with dehiscence of a previous enterotomy/enterectomy did not have a worse prognosis than those presenting with other aetologies. Intraoperative hypotension (adjusted odds ratio 0.173, 95% confidence intervals 0.034 to 0.866, P=0.033) was associated with non-survival. Cats that survived beyond 1 day postoperatively had an improved likelihood of survival (87.5%). All cats that survived beyond 6 days were successfully discharged. CLINICAL SIGNIFICANCE This study describes the largest group of cats with septic peritonitis with an overall survival rate of 66%. The presence of an abdominal mass on clinical examination or having dehiscence of a previous gastrointestinal surgery did not confer a worse prognosis.
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Affiliation(s)
- T Anderson
- Surgery Department, Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
| | - L Beever
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hertfordshire, AL9 7TA, UK
| | - J Hall
- Surgery Department, Wear Referrals, Bradbury, Stockton-on-Tees, TS21 2ES, UK.,Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Midlothian, Edinburgh, EH25 9RG, UK
| | - A Moores
- Surgery Department, Anderson Moores Veterinary Specialists, Winchester, Hampshire, SO21 2LL, UK
| | - C Llanos
- Surgery Department, Willows Referral Service, Solihull, West Midlands, B90 4NH, UK
| | - R Adams
- Surgery Department, Northern Ireland Veterinary Specialists, Hillsborough, Co. Down, NI, BT26 6 PB, UK.,Surgery Department, Davies Veterinary Specialists, Higham Gobion, Hitchin, SG5 3HR, UK
| | - L Meakin
- Surgery Department, Langford Vets, Langford, BS40 5DU, UK
| | - M Coppola
- Surgery Department, University of Glasgow, Glasgow, G61 1QH, UK
| | - K Bowlt-Blacklock
- Surgery Department, Animal Health Trust, Newmarket, Suffolk, CB8 7UU, UK
| | - M A Holmes
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - D Barnes
- Surgery Department, Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
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Scotti KM, Koenigshof A, Sri-Jayantha LSH, Kato M, Bishop M, Barr JW, Pashmakova MB. Prognostic indicators in cats with septic peritonitis (2002-2015): 83 cases. J Vet Emerg Crit Care (San Antonio) 2019; 29:647-652. [PMID: 31654546 DOI: 10.1111/vec.12896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 12/25/2017] [Accepted: 01/11/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To identify physical exam findings, clinicopathological parameters, time to surgery, empirical antimicrobial use, and culture results that could be associated with outcome in cats with septic peritonitis (SP). DESIGN Retrospective cohort study of cats from 2002 to 2015. SETTING Four university teaching hospitals. ANIMALS Eighty-three cats diagnosed with SP by cytology or culture. INTERVENTIONS None MEASUREMENTS AND MAIN RESULTS: Fifty-eight cats survived to discharge (69.9%); 1 cat was euthanized in surgery; 20 were euthanized postoperatively; 4 cats suffered cardiac arrest after surgery. The most common etiology of SP was secondary SP due to gastrointestinal perforation (49.4%), followed by primary SP (22.3%). Mean blood glucose concentration was significantly different between survivors and nonsurvivors (P = 0.006). Cats that received appropriate empirical antibiotic therapy were 4.4 times more likely to survive than cats that did not receive appropriate antibiotics (P = 0.018). CONCLUSIONS As previously documented, SP secondary to gastrointestinal leakage was the most common etiology. In this population, cats with a higher blood glucose concentration on presentation had a worse prognosis. Cats that received appropriate empirical antimicrobial therapy were more likely to survive.
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Affiliation(s)
| | - Amy Koenigshof
- Michigan State University Veterinary Medical Center, East Lansing, Missouri
| | - Loren S H Sri-Jayantha
- Cummings School of Veterinary Medicine at Tufts University, North Grafton, Massachusetts
| | - Michael Kato
- William R. Pritchard Veterinary Medical Teaching Hospital, Davis, California
| | - Micah Bishop
- WAVE Veterinary Internal Medicine, Naples, Florida
| | - James W Barr
- BluePearl Veterinary Partners, Grand Rapids, Michigan
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Coady M, Fletcher DJ, Goggs R. Severity of Ionized Hypercalcemia and Hypocalcemia Is Associated With Etiology in Dogs and Cats. Front Vet Sci 2019; 6:276. [PMID: 31508432 PMCID: PMC6714612 DOI: 10.3389/fvets.2019.00276] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 08/06/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Calcium disorders are common in small animals, but few studies have investigated the etiology of ionized hypercalcemia and hypocalcemia in large populations. This study aimed to determine the incidence of ionized calcium disorders in dogs and cats treated at a tertiary referral clinic and to describe the associated diseases. Methods: An electronic database of electrolyte analyses conducted at the Cornell University Hospital for Animals from 2007 to 2017 was searched. Dogs and cats with ionized hypercalcemia or hypocalcemia were identified based on institution reference intervals. Duplicate case entries were removed. Medical records were reviewed to identify the cause of the calcium abnormality. Chi-squared analysis with Bonferroni adjustment was performed to compare frequencies of disease processes between mild and moderate-severe disturbances. Results: The database included 15,277 dogs and 3,715 cats. Hypercalcemia was identified in 1,641 dogs and 119 cats. The incidence of canine and feline hypercalcemia was 10.7 and 3.2%, respectively. Hypocalcemia was identified in 1,467 dogs and 450 cats. The incidence of canine and feline hypocalcemia was 9.6% and 12.1%, respectively. The most common pathologic causes of hypercalcemia in dogs were malignancy-associated (12.9%), parathyroid-dependent (4.6%) and hypoadrenocorticism (1.7%). In cats, malignancy-associated hypercalcemia (22.7%), kidney injury (13.4%) and idiopathic hypercalcemia (12.6%) were most common. Dogs presenting with moderate-severe hypercalcemia vs. mild hypercalcemia were significantly more likely to have hyperparathyroidism, malignancy-associated hypercalcemia or hypervitaminosis D, whereas cats were significantly more likely to have malignancy-associated hypercalcemia or idiopathic hypercalcemia. The most common pathologic causes of hypocalcemia in dogs were critical illness (17.4%), kidney injury (10.4%) and toxicity (7.5%). In cats, kidney injury (21.6%), urethral obstruction (15.1%), and critical illness (14.7%) were most frequent. Dogs presenting with moderate-severe hypocalcemia were significantly more likely to have hypoparathyroidism, kidney injury, eclampsia or critical illness, whereas cats were significantly more likely to have kidney injury, soft tissue trauma or urethral obstruction. Conclusions: Mild calcium disturbances are most commonly associated with non-pathologic or transient conditions. Malignancy-associated hypercalcemia is the most common cause of ionized hypercalcemia in dogs and cats. Critical illness and kidney injury are frequent causes of ionized hypocalcemia in both species.
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Affiliation(s)
- Michelle Coady
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Daniel J Fletcher
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
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Lyons BM, Ateca LB, Otto CM. Clinicopathologic abnormalities associated with increased animal triage trauma score in cats with bite wound injuries: 43 cases (1998-2009). J Vet Emerg Crit Care (San Antonio) 2019; 29:296-300. [PMID: 31012275 DOI: 10.1111/vec.12831] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 05/02/2017] [Accepted: 06/19/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To document the clinical and clinicopathologic changes in cats presenting with trauma from bite wounds, identify common abnormalities associated with bite wounds, and to determine whether the calculated animal trauma triage (ATT) score is related to any clinicopathologic abnormalities. DESIGN Retrospective descriptive study. SETTING University veterinary teaching hospital. ANIMALS Forty-three client-owned cats that presented for bite wounds to a large, urban, veterinary hospital between 1998 and 2009. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Pertinent history, physical examination findings, results of biochemical testing, and outcome were extracted from medical records. Animal triage trauma score was calculated based on the physical examination at presentation in cats with adequate available information. Patients were classified as having either a low (<5) ATT (n = 20) or a high (≥5) ATT (n = 23) score. Male cats were overrepresented (65.1%), and a majority of cats had outdoor access (53.4%). Low venous blood pH (P = 0.047), high plasma lactate concentration (P = 0.018), and low ionized calcium concentration (P = 0.004) were associated with higher ATT scores. CONCLUSIONS There is a significant association between low venous blood pH, high plasma lactate concentration, and low ionized calcium concentration and higher ATT scores at presentation in cats suffering from bite wounds. Early recognition of these abnormalities may help to identify more severely injured patients.
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Affiliation(s)
- Bridget M Lyons
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA
| | - Laura B Ateca
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA
| | - Cynthia M Otto
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA
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Klainbart S, Agi L, Bdolah-Abram T, Kelmer E, Aroch I. Clinical, laboratory, and hemostatic findings in cats with naturally occurring sepsis. J Am Vet Med Assoc 2017; 251:1025-1034. [PMID: 29035656 DOI: 10.2460/javma.251.9.1025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize clinical and laboratory findings in cats with naturally occurring sepsis, emphasizing hemostasis-related findings, and evaluate these variables for associations with patient outcomes. DESIGN Prospective, observational, clinical study. ANIMALS 31 cats with sepsis and 33 healthy control cats. PROCEDURES Data collected included history; clinical signs; results of hematologic, serum biochemical, and hemostatic tests; diagnosis; and outcome (survival vs death during hospitalization or ≤ 30 days after hospital discharge). Differences between cats with and without sepsis and associations between variables of interest and death were analyzed statistically. RESULTS The sepsis group included cats with pyothorax (n = 10), septic peritonitis (7), panleukopenia virus infection (5), bite wounds (5), abscesses and diffuse cellulitis (3), and pyometra (1). Common clinical abnormalities included dehydration (21 cats), lethargy (21), anorexia (18), pale mucous membranes (15), and dullness (15). Numerous clinicopathologic abnormalities were identified in cats with sepsis; novel findings included metarubricytosis, hypertriglyceridemia, and high circulating muscle enzyme activities. Median activated partial thromboplastin time and plasma D-dimer concentrations were significantly higher, and total protein C and antithrombin activities were significantly lower, in the sepsis group than in healthy control cats. Disseminated intravascular coagulopathy was uncommon (4/22 [18%] cats with sepsis). None of the clinicopathologic abnormalities were significantly associated with death on multivariate analysis. CONCLUSIONS AND CLINICAL RELEVANCE Cats with sepsis had multiple hematologic, biochemical, and hemostatic abnormalities on hospital admission, including several findings suggestive of hemostatic derangement. Additional research including larger numbers of cats is needed to further investigate these findings and explore associations with outcome.
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Goggs R, De Rosa S, Fletcher DJ. Multivariable analysis of the association between electrolyte disturbances and mortality in cats. J Feline Med Surg 2017; 20:1072-1081. [PMID: 29206071 PMCID: PMC6259255 DOI: 10.1177/1098612x17743564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Electrolyte disorders have been individually associated with mortality in small populations of cats with specific conditions, but the associations and interactions between electrolyte disturbances and outcome have not been evaluated in a large, heterogeneous population. It was hypothesized that abnormalities of sodium, chloride, potassium and calcium concentrations would be independently and proportionately associated with death from natural causes and with all-cause mortality in cats. METHODS An electronic database containing 7064 electrolyte profiles was constructed to assess the association between disorders of sodium, potassium, corrected-chloride and ionized calcium concentrations with non-survival by multivariable modelling. A second database containing 2388 records was used to validate the models constructed from the first database. RESULTS All four electrolytes assessed had non-linear U-shaped associations with case fatality rates, wherein concentrations clustered around the reference interval had the lowest case fatality rates, while progressively abnormal concentrations were associated with proportionately increased risk of non-survival (area under the receiver operator characteristic curve [AUROC] 0.689) or death (AUROC 0.750). CONCLUSIONS AND RELEVANCE Multivariable modelling suggested that these electrolyte disturbances were associated with non-survival and with death from natural causes independent of each other. The present study suggests that measurement of electrolyte concentrations is an important component of the assessment of cats in emergency rooms or intensive care units. Future studies should focus on confirming these associations in a prospective manner accounting for disease severity.
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Affiliation(s)
- Robert Goggs
- 1 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Sage De Rosa
- 2 Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, USA
| | - Daniel J Fletcher
- 1 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Goggs R, De Rosa S, Fletcher DJ. Electrolyte Disturbances Are Associated with Non-Survival in Dogs-A Multivariable Analysis. Front Vet Sci 2017; 4:135. [PMID: 28868302 PMCID: PMC5563317 DOI: 10.3389/fvets.2017.00135] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 08/04/2017] [Indexed: 11/13/2022] Open
Abstract
Electrolyte disorders have been individually associated with mortality in small populations of dogs and cats with specific conditions, but the associations and interactions between electrolyte disturbances and outcome have not been evaluated in a large, heterogeneous population. It was hypothesized that abnormalities of sodium, chloride, potassium, and calcium concentrations would be independently and proportionately associated with death from natural causes and with all-cause mortality in dogs. An electronic database containing 33,117 electrolyte profiles was constructed to retrospectively assess the association between disorders of sodium, potassium, corrected chloride, and ionized calcium concentrations with non-survival and with death excluding euthanasia by multivariable modeling. A second database containing 11,249 records was used to validate the models constructed from the first database. All four electrolytes assessed had non-linear U-shaped associations with case fatality rates, wherein concentrations clustered around the reference interval had the lowest case fatality rates, while progressively abnormal concentrations were associated with proportionately increased risk of non-survival (AUROC 0.624) or death (AUROC 0.678). Multivariable modeling suggested that these electrolyte disturbances were associated with non-survival and with death from natural causes independent of each other. This study suggests that measurement of electrolyte concentrations is an important component of the assessment of dogs in emergency rooms or intensive care units. Future studies should focus on confirming these associations in a prospective manner accounting for disease severity.
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Affiliation(s)
- Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Sage De Rosa
- Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, United States
| | - Daniel J Fletcher
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
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Troìa R, Gruarin M, Foglia A, Agnoli C, Dondi F, Giunti M. Serum amyloid A in the diagnosis of feline sepsis. J Vet Diagn Invest 2017; 29:856-859. [PMID: 28754082 DOI: 10.1177/1040638717722815] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Systemic inflammatory response syndrome (SIRS) and sepsis can be challenging to diagnose in cats. Retrospectively, we investigated the diagnostic and prognostic potential of serum amyloid A (SAA), a major feline acute-phase protein (APP), in a population of critically ill cats with SIRS related to trauma or sepsis. A total of 56 SIRS cats (trauma n = 27; sepsis n = 29) were included and compared with healthy controls ( n = 18). SAA concentration was significantly increased in SIRS cats compared to controls, confirming its potential for the detection of systemic inflammation in this species. Significantly higher values of SAA were detected in cats belonging to the sepsis group; however, according to the results of the receiver operating characteristic curve analysis, the value of using SAA (>81 mg/L) to discriminate septic cats was only moderate (AUC = 0.76). Additionally, cats with sepsis had significantly higher serum bilirubin concentrations and toxic neutrophil changes compared to the trauma group. Overall, 38 of 56 cats were survivors; 18 of 56 were non-survivors, with 83% of the non-survivors (15 of 18) belonging to the sepsis group. Serum bilirubin concentration, but not SAA, was able to predict outcome. Prospective studies are needed to assess the potential of SAA in the diagnosis of feline sepsis and outcome prediction.
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Affiliation(s)
- Roberta Troìa
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano dell'Emilia, Italy
| | - Marta Gruarin
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano dell'Emilia, Italy
| | - Armando Foglia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano dell'Emilia, Italy
| | - Chiara Agnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano dell'Emilia, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano dell'Emilia, Italy
| | - Massimo Giunti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano dell'Emilia, Italy
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Abstract
Hypocalcemia occurs in critically ill dogs and cats and is associated with medications, treatments, and underlying diseases such as acute kidney disease, pancreatitis, parathyroid disease, sepsis, and trauma. Possible underlying mechanisms include hypovitaminosis D, acquired or relative hypoparathyroidism, hypomagnesemia, and alterations in the ionized fraction of calcium caused by changes in chelated or protein-bound calcium. If severe or acute, hypocalcemia can cause obvious clinical signs related to muscle or neurologic hyperexcitability or more subtle signs of cardiovascular dysfunction. Emergency treatment with calcium gluconate administration is recommended when clinical signs are present or if there is moderate to severe ionized hypocalcemia.
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Murphy K, Hibbert A. The flat cat: 2. the emergency database and management of common metabolic abnormalities. J Feline Med Surg 2013; 15:189-99. [PMID: 23422363 DOI: 10.1177/1098612x13477539] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM Detailed information regarding the causes and treatment of acute collapse in the cat can be difficult to locate in a single published source. This two-part review aims to provide a logical approach to the clinical assessment and stabilisation of the critically ill collapsed cat. PRACTICAL RELEVANCE Laboratory evaluation, in the form of an emergency database, is an important part of the initial assessment of a collapsed patient and should be considered in conjunction with physical abnormalities. CLINICAL CHALLENGES Rapid identification and correction of life-threatening metabolic abnormalities, including hypoglycaemia, hypocalcaemia and hyperkalaemia, is essential in stabilising this group of patients. Clinicians often lack confidence if they are not dealing with these problems regularly. AUDIENCE The information provided in this article will be of use to any veterinarian working with feline patients and particularly those dealing with emergencies on a regular basis. EVIDENCE BASE There is an extensive body of published literature, both original studies and textbook chapters, pertaining to the causes and treatment of the important metabolic abnormalities covered in this article. The authors draw on information from original articles, reviews and their clinical experience to provide simple but detailed practical information to guide interpretation of the emergency database and its application to therapy in the emergency setting.
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Affiliation(s)
- Kate Murphy
- Bath Veterinary Referrals, Rosemary Lodge, Wellsway, Bath BA2 5RL, UK.
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Holowaychuk MK, Birkenheuer AJ, Li J, Marr H, Boll A, Nordone SK. Hypocalcemia and hypovitaminosis D in dogs with induced endotoxemia. J Vet Intern Med 2012; 26:244-51. [PMID: 22369159 DOI: 10.1111/j.1939-1676.2012.00886.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 11/25/2011] [Accepted: 01/04/2012] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Hypocalcemia is a documented electrolyte disturbance in people and animals with sepsis, but its mechanism is poorly understood. OBJECTIVE To investigate mechanisms of hypocalcemia in dogs with experimentally induced endotoxemia. ANIMALS Six healthy mixed breed dogs were included in this nonrandomized, placebo-controlled, crossover study. METHODS Dogs initially were injected with placebo (0.9% NaCl; 1 mL, IV) and then lipopolysaccharide (LPS; 2 μg/kg, IV) after a 5-day washout period. Blood and urine samples were collected for measurement of serum total calcium (tCa), ionized calcium (iCa), total magnesium (tMg), ionized magnesium (iMg), parathyroid hormone (PTH), 25-hydroxyvitamin D (vitamin D), venous blood gases, and fractional excretion (FE) of calcium. RESULTS After LPS administration, body temperature increased and blood pressure decreased. Both iCa and tCa decreased (P < .01), but iMg was not significantly different between control and LPS treatments. PTH concentrations increased (P < .01) and vitamin D concentrations decreased (P < .01). Venous pH, bicarbonate, base excess, and blood glucose also decreased (P < .01). Urine tCa concentration was below the limit of detection for all dogs after LPS administration. CONCLUSIONS Hypocalcemia occurs during endotoxemia in dogs and is associated with hypovitaminosis D. Hypomagnesemia, hypoparathyroidism, alkalosis, and increased calciuresis are not associated with hypocalcemia in endotoxemic dogs.
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Affiliation(s)
- M K Holowaychuk
- Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
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Digestive System, Liver, and Abdominal Cavity. THE CAT 2012. [PMCID: PMC7158306 DOI: 10.1016/b978-1-4377-0660-4.00023-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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