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

Investigation of the diagnostic and prognostic importance of Tumor Necrosis Factor-alfa (TNF-α), Procalcitonin (PCT), Interleukin-6 (IL-6) and Haptoglobin (HP) in calves with neonatal diarrhea

This study aims to investigate the effects of Procalcitonin, Tumor Necrosis Factor-alpha, Interleukin-6, and Haptoglobin levels on the prognosis of calves classified according to the severity of diarrhea. The animal material comprised 48 diarrheic calves of different breeds and sexes, aged 1-30 days, and 16 healthy calves aged 1-30 days. The 48 diarrheic calves used were divided into 3 groups, each consisting of 16 calves. Group 1 was designed as Viral (Rota + Corona n = 16), Group 2 as Bacterial (E. coli n = 16), and Group 3 as Parasitic (Cryptosporidiosis n = 16). Each of these groups was further divided into 2 subgroups (moderate and severe subgroups). Blood samples were taken from the diarrheic calves before treatment (0 h) and at 24 and 72 h after treatment. Complete blood count, biochemical, blood gas analyses, and ELISA tests were performed. It was determined that 18.75 % (9/48) of the 48 diarrheic calves included in the study died, while 81.25 % (39/48) survived. The highest mortality rate among the patient groups was observed in the severe rota + corona group (37.5 %). The average PCT concentration in the diarrheic calves in the Rota-corona and E. coli groups at 0 and 24 hours was found to be higher than both the healthy calves and the diarrheic calves in the Cryptosporidium spp. group (P<0.001). This increase was also observed in the Cryptosporidium spp. group at 72 h (P<0.001). A positive and moderate correlation was observed between Procalcitonin and TNF-α (r = 0.603, P<0.001). As a result, it was concluded that the Procalcitonin value, along with other tests, could be used as a biomarker to determine the prognosis of the disease in diarrheic calves, regardless of the etiological agent. This study was evaluated as an original study in which cytokines and acute phase proteins were investigated before and after treatment, with diarrhea divided into subgroups.

Determining lactate concentrations in Korean indigenous calves and evaluating its role as a predictor for acidemia in calf diarrhea

BACKGROUND

Calf diarrhea leads to high mortality rates and decreases in growth and productivity, causing negative effects on the livestock industry. Lactate is closely associated with metabolic acidosis in diarrheic calves. However, there have been no reports on lactate concentrations in Korean indigenous (Hanwoo) calves, especially those with diarrhea. This study aimed to determine the reference range of L-lactate and D-lactate concentrations in Hanwoo calves and to better understand the utility of lactate as predictive factors for acidemia in diarrheic calves.

RESULTS

L-lactate and D-lactate concentrations were measured in healthy (n = 44) and diarrheic (n = 93) calves, and blood gas analysis was performed on diarrheic calves. The reference range in healthy calves was 0.2-2.25 mmol/L for L-lactate and 0.42-1.38 mmol/L for D-lactate. Diarrheic calves had higher concentrations of L-lactate and D-lactate than healthy calves. In diarrheic calves, L-lactate and D-lactate each had weak negative correlation with pH (r = - 0.31 and r = - 0.35). In diarrheic calves with hyper-L-lactatemia, the combined concentrations of L-lactate and D-lactate had moderate correlation with pH (r = - 0.51) and anion gap (r = 0.55). Receiver operating characteristic analysis showed D-lactate had fair predictive performance (AUC = 0.74) for severe acidemia, with an optimal cut-off value of > 1.43 mmol/L. The combined concentrations of L-lactate and D-lactate showed fair predictive performance for predicting acidemia (AUC = 0.74) and severe acidemia (AUC = 0.72), with cut-off values of > 6.05 mmol/L and > 5.95 mmol/L.

CONCLUSIONS

The determined reference ranges for L-lactate and D-lactate in Hanwoo calves enable the identification of hyper-L-lactatemia and hyper-D-lactatemia. Diarrheic calves exhibited increased lactate concentrations correlated with acid-base parameters. While the concentrations of L-lactate and D-lactate have limitations as single diagnostic biomarkers for predicting acidemia or severe acidemia, their measurement remains important, and L-lactate has the advantage of being measurable at the point-of-care. Assessing lactate concentrations should be considered by clinicians, especially when used alongside other clinical indicators and diagnostic tests. This approach can improve calf diarrhea management, contributing positively to animal welfare and providing economic benefits to farms.

A randomized controlled trial evaluating the effect of providing a rest period during long-distance transportation of surplus dairy calves: Part II. Impact on hematological variables

The objective of this randomized controlled trial was to determine if providing a rest stop including provision of feed and water between periods of continuous transportation mitigates the impact of long-distance transportation on markers of energy status and hydration in calves transported by road for 16 h. This study was conducted between September 2022 to January 2023 and included male and female Holstein and crossbred dairy calves ≥7 d old from 2 commercial dairy farms in Ontario, Canada (n = 96). On the day before transportation, calves were enrolled and randomly assigned to one of 2 treatment groups: 1) continuous transportation by road for 16 h or 2) 8 h of transport, 8 h of rest, and a further 8 h of transport to a single calf-raising facility. Calves that received a rest stop were fed 2 L of milk replacer at the time of unloading for the rest period and again immediately before reloading for the second leg of the journey. Blood samples were collected before and after transportation as well as daily for 3 d following arrival to the calf-raising facility. Serum was analyzed for concentrations of β-hydroxybutyrate (BHBA), nonesterified fatty acid (NEFA), haptoglobin, and creatine kinase, while acid-base disturbances were evaluated within 1 h of collection of whole blood to assess glucose, sodium, potassium, ionized calcium, hematocrit, hemoglobin, pH, base excess, pO2, TCO2, HCO3, pCO2, and sO2. Mixed linear regression models with repeated measures were built to assess the effect of treatment group, age at transportation, breed, and sex on these parameters. Immediately after transportation, calves that received the rest period had lower BHBA (-68.04 μmol/L, 95% CI: -99.59 to -36.49), NEFA (-0.14 mmol/L, 95% CI -0.22 to -0.07), and sodium (-1.10 mmol/L, 95% CI = -2.18 to -0.02), and higher glucose (0.48 mmol/L, 95% CI = 0.21 to 0.74), potassium (0.27 mmol/L, 95% CI = 0.11 to 0.43), ionized calcium (0.06 mmol/L, 95% CI = 0.03 to 0.08), and sO2 (8.76%, 95% CI = 1.61 to 15.91) compared with calves that were continuously transported for 16 h. Additionally, calves transported between 11 and 12 d old had lower hematocrit (-1.22%, 95% CI = -2.19 to -0.25), hemoglobin (-3.07 g/L, 95% CI = -5.70 to -0.43), haptoglobin (-0.13 g/L, 95% CI = -0.23 to -0.02), and potassium (-0.13 mmol/L, 95% CI = -0.22 to -0.04) and higher sodium (0.83 mmol/L, 95% CI = 0.03 to 1.63) than 7-8 d old calves. Furthermore, calves that were 13-24 d old at transport had lower haptoglobin (-0.16 g/L, 95% CI = -0.27 to -0.06) and potassium (-0.14 mmol/L, 95% CI = -0.23 to -0.05), and higher sodium (1.02 mmol/L, 95% CI = 0.22 to 1.82) and ionized calcium (0.02 mmol/L, 95% CI = 0.002 to 0.035) compared with calves transported at 7-8 d old. The results of this trial demonstrate that a rest period improves energy status upon arrival to a calf-raising facility, suggesting that the benefit of a rest period may be mostly related to the provision of mid-journey milk meals.

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.

Association of the type of metabolic acidosis and non-survival of horses with colitis

Background

Metabolic acidosis (MA) is the most common acid-base disorder reported in horses with colitis but its association with survival is yet to be determined.

Objective

Investigate the types of MA in horses with colitis to determine effects of various anions on fatality rates.

Animals and procedures

We studied 158 horses with colitis. Horses were classified into 4 groups depending on the anion contributing to MA: i) no MA, ii) lactic acidosis (LA), iii) unmeasured strong ion (USI) acidosis, and iv) hyperchloremic acidosis (HA).

Results

Sixty percent (95/158) of horses had no MA, 22% (34/158) had LA, 12% (19/158) had HA, and 6% (10/158) had USI acidosis. The fatality rate of horses without MA was 20% (20/95), whereas the rates for those with LA, USI, and HA were 53% (18/34), 30% (3/10), and 16% (3/19), respectively. Horses with LA were more likely to die or be euthanized than horses without MA (OR: 4.2, 95% CI: 1.83 to 9.72, P < 0.001) and HA (OR: 5.9, 95% CI: 1.47 to 24.4, P < 0.01).

Conclusion and clinical relevance

Lactic acidosis was the most common type of MA in horses with colitis, and it was associated with non-survival.

A randomized controlled trial investigating the effect of transport duration and age at transport on surplus dairy calves: Part II. Impact on hematological variables

Surplus dairy calves often arrive at veal and dairy-beef rearing facilities with health and blood metabolite level abnormalities, which can affect their welfare and performance, predisposing them to future health challenges. The objective of this randomized controlled trial was to investigate the effects of transport duration and age at the time of transport on blood parameters in surplus dairy calves following 6, 12, or 16 h of continuous road transportation. All surplus calves from 5 commercial dairy farms in Ontario were enrolled and examined daily before transport (n = 175). On the day of transportation, calves were weighed, blood sampled, and randomly assigned to 6, 12, or 16 h of transportation. Blood samples were then collected immediately after transportation, as well as 24, 48, and 72 h thereafter. Serum was analyzed at a provincial diagnostic laboratory for nonesterified fatty acids (NEFA), β-hydroxybutyric acid (BHBA), creatine kinase (CK), cholesterol, and haptoglobin. In addition, blood gas and electrolyte values were also assessed at the time of sample collection. Mixed models with repeated measures were used to assess the effects of transport duration, breed, sex, transfer of passive immunity status, weight before transportation, and age at transportation on blood parameters. Immediately following transportation, NEFA and BHBA were greater for calves transported for 12 h (Δ = 0.22 mmol/L NEFA, 95% CI = 0.15 to 0.30; Δ = 0.04 mmol/L BHBA, 95% CI = 0.02 to 0.06) and 16 h (Δ = 0.35 mmol/L NEFA, 95% CI = 0.27 to 0.42; Δ = 0.10 mmol/L BHBA, 95% CI = 0.08 to 0.11) compared with calves transported for 6 h. Glucose was lower immediately following transportation in calves transported for 16 h compared with 6 h (Δ = -15.54 mg/dL, 95% CI = -21.54 to -9.54). In addition, pH and HCO3- were lower in calves transported for 12 (Δ = -0.09 pH, 95% CI = -0.13 to -0.05; Δ = -1.59 mmol/L HCO3-, 95% CI = -2.61 to -0.56) and 16 h (Δ = -0.07 pH, 95% CI = -0.12 to -0.03; Δ = -1.95 mmol/L HCO3-, 95% CI = -2.95 to -0.95) compared with calves transported for 6 h. Calves transported between 15 and 19 d of age had a higher concentration of cholesterol and CK (Δ = 0.27 mmol/L cholesterol; 37.18 U/L CK) compared with 2- to 6-d-old calves, and calves 12 to 14 d old had greater reduction in HCO3- (Δ = -0.92 mmol/L) compared with 2- to 6-d-old calves. These findings show that transporting calves for long distances results in lower glucose concentration and suboptimal energy status, and that this effect varies based on the calf's age.

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.

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.

Acid-base disorders in sick goats and their association with mortality: A simplified strong ion difference approach

OBJECTIVES

To investigate the acid-base status of sick goats using the simplified strong ion difference (sSID) approach, to establish the quantitative contribution of sSID variables to changes in blood pH and HCO3 - and to determine whether clinical, acid-base, and biochemical variables on admission are associated with the mortality of sick goats.

ANIMALS

One hundred forty-three sick goats.

METHODS

Retrospective study. Calculated sSID variables included SID using 6 electrolytes unmeasured strong ions (USI) and the total nonvolatile buffer ion concentration in plasma (Atot ). The relationship between measured blood pH and HCO3 - , and the sSID variables was examined using forward stepwise linear regression. Cox proportional hazard models were constructed to assess associations between potential predictor variables and mortality of goats during hospitalization.

RESULTS

Hypocapnia, hypokalemia, hyperchloremia, hyperlactatemia, and hyperproteinemia were common abnormalities identified in sick goats. Respiratory alkalosis, strong ion acidosis, and Atot acidosis were acid-base disorders frequently encountered in sick goats. In sick goats, the sSID variables explained 97% and 100% of the changes in blood pH and HCO3 - , respectively. The results indicated that changes in the respiratory rate (<16 respirations per minute), USI, and pH at admission were associated with increased hazard of hospital mortality in sick goats.

CONCLUSIONS AND CLINICAL IMPORTANCE

The sSID approach is a useful methodology to quantify acid-base disorders in goats and to determine the mechanisms of their development. Clinicians should consider calculation of USI in sick goats as part of the battery of information required to establish prognosis.

Role of electrolyte abnormalities and unmeasured anions in the metabolic acid-base abnormalities in dogs with parvoviral enteritis

BACKGROUND

The strong ion model (SIM) is an alternative paradigm in the characterization of acid-base disturbances particularly in complex disorders.

HYPOTHESIS/OBJECTIVES

To compare the acid-base changes in dogs with parvoviral enteritis (PE) using the Henderson-Hasselbalch (HH) approach, with 2 strong ion approaches.

ANIMALS

Forty-four dogs with PE, and 16 age-matched control dogs.

METHODS

Prospective controlled observational study. Acid-base status was evaluated using the HH model, Fencl-Stewart (FS) approach and a validated strong ion model (VDM). The acid-base changes according to each model were classified and compared. Statistical correlations between pH, CO₂ , and various SIM variables were performed, as well as between the sum of effects (SOE) of the SIM and the individual variables comprising the SOE.

RESULTS

The HH model identified acid-base disorders in 31/44 cases of which 16/31 were mixed with metabolic acidosis and concurrent respiratory alkalosis the most common (10/31). Using the FS approach, metabolic changes were present 36/42 cases, with changes in free water (FW), chloride, and unmeasured anions (UA) being the most prevalent. Both FW and UA correlated well with pH; however, UA were most consistently abnormal in severe acidemia. Similarly to the HH, the VDM detected acid-base disturbances in 28/44 cases. Major contributors to the acid-base changes were hyponatremia, hypochloremia, and A_tot acidosis because of elevated globulins and increased UA.

CONCLUSIONS AND CLINICAL IMPORTANCE

Acid-base changes are common and complex in dogs with PE, and were easier to understand using a SIM paradigm. Increases in UA have not been documented in PE in dogs.

Association of unmeasured strong ions with outcome of hospitalized beef and dairy diarrheic calves

Increased systemic concentrations of L-lactate and unmeasured strong ions (USI) are associated with an increased risk of mortality in human neonates and adults suffering from various diseases. This exploratory study aimed to investigate if values of certain acid-base parameters, especially L-lactate and USI, on admission to hospital are associated with mortality in diarrheic calves. Fifty-five calves < 28 days old admitted to 2 teaching hospitals for diagnosis and treatment of diarrhea were included. Admission demographic, physical examination, blood gas and biochemistry analysis, and outcome data were recorded. Admission acid-base values associated with outcome were assessed using multivariable regression modeling. Calves with elevated plasma L-lactate (OR: 1.30, 95% CI: 1.08 to 1.55; P = 0.005) and USI (OR: 1.40, 95% CI: 1.12 to 1.74; P = 0.003) at admission were more likely to die or to be euthanized. This study revealed that elevated concentrations of L-lactate and USI at admission were positively associated with mortality.

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.

Quantitative physicochemical analysis of acid-base balance and clinical utility of anion gap and strong ion gap in 806 neonatal calves with diarrhea

BACKGROUND

Acid-base abnormalities in neonatal diarrheic calves can be assessed by using the Henderson-Hasselbalch equation or the simplified strong ion approach which use the anion gap (AG) or the strong ion gap (SIG) to quantify the concentration of unmeasured strong anions such as D-lactate.

HYPOTHESIS/OBJECTIVES

To determine and compare the clinical utility of AG and SIG in quantifying the unmeasured strong anion charge in neonatal diarrheic calves, and to examine the associations between biochemical findings and acid-base variables by using the simplified strong ion approach. We hypothesized that the SIG provides a more accurate prediction of unmeasured strong anions than the AG.

ANIMALS

Eight hundred and six neonatal diarrheic calves admitted to a veterinary teaching hospital.

METHODS

Retrospective study utilizing clinicopathologic findings extracted from medical records.

RESULTS

Hyperphosphatemia was an important predictor of venous blood pH. Serum inorganic phosphorus and plasma D-lactate concentrations accounted for 58% of the variation in venous blood pH and 77% of the variation in AG and SIG. Plasma D- and total lactate concentrations were slightly better correlated with SIG (rs = -0.69; -0.78) than to AG (rs = 0.63; 0.74).

CONCLUSIONS AND CLINICAL IMPORTANCE

Strong ion gap is slightly better at quantifying the unmeasured strong anion concentration in neonatal diarrheic calves than AG. Phosphorus concentrations should be included as part of the calculation of Atot when applying the simplified strong ion approach to acid-base balance to critically ill animals with hyperphosphatemia.

Physicochemical Approach to Determine the Mechanism for Acid-Base Disorders in 793 Hospitalized Foals

BACKGROUND

The quantitative effect of strong electrolytes, unmeasured strong anions (UAs), pCO2, and plasma protein concentrations in determining plasma pH can be demonstrated using the physicochemical approach. Plasma anion gap (AG) and strong ion gap (SIG) are used to assess UAs in different species.

HYPOTHESES

Strong ions are a major factor influencing changes in plasma pH of hospitalized foals. AG and SIG accurately predict severe hyper-L-lactatemia ([L-lac(-)] > 7 mmol/L).

ANIMALS

Seven hundred and ninety three hospitalized foals < 7 days old.

METHODS

Retrospective study. The relationship between measured pH and physicochemical variables, and the relationship between plasma [L-lac(-)] and AG and SIG, were determined using regression analyses. Optimal AG and SIG cut points to predict hyper-L-lactatemia were identified using an ROC curve analysis.

RESULTS

Combined, the measured strong ion difference and SIG accounted for 54-69% of the changes in the measured arterial pH of hospitalized foals. AG and SIG were significantly associated with plasma [L-lac(-)] (P < .0001). The receiver operator characteristics (ROC) AUC of AG and SIG for prediction of severe hyper-L-lactatemia were 0.89 (95%CI, 0.8-0.95; P < .0001) and 0.90 (95%CI, 0.81-0.96; P < .0001), respectively. Severe hyper-L-lactatemia was best predicted by AG > 27 mmol/L (sensitivity 80%, 95%CI, 56-94, specificity 85%, 95%CI, 73-93; P < .0001) and SIG <-15 mmol/L (sensitivity 90%, 95%CI, 68-98; specificity 80%; 95%CI, 68-90; P < .0001).

CONCLUSION AND CLINICAL RELEVANCE

Altered concentrations of strong ions (Na(+), K(+), Cl(-)) and UAs were the primary cause of acidemia of hospitalized foals. AG and SIG were good predictors of hyper-L-lactatemia and could be used as surrogate tests.

Acid-base disorders in calves with chronic diarrhea

The aim of this study was to analyze disorders of acid-base balance in calves with chronic diarrhea caused by mixed, viral, bacterial and Cryptosporydium parvum infection. We compared results ob- tained with the classic model (Henderson-Hasselbalch) and strong ion approach (the Steward model). The study included 36 calves aged between 14 and 21 days. The calves were allocated to three groups: I - (control) non-diarrheic calves, group II - animals with compensated acid-base imbalance and group III calves with compensated acid-base disorders and hypoalbuminemia. Plasma concentrations of Na+, K+, Cl-, C12+, Mg2+, P, albumin and lactate were measured. In the classic model, acid-base balance was determined on the basis of blood pH, pCO2, HCO3-, BE and anion gap. In the strong ion model, strong ion difference (SID), effective strong anion difference, total plasma concentration of nonvolatile buffers (A(Tot)) and strong ion gap (SIG) were measured. The control calves and the animals from groups II and III did not differ significantly in terms of their blood pH. The plasma concentration of HCO3-, BE and partial pressure of CO2 in animals from the two groups with chronic diarrhea were significantly higher than those found in the controls. The highest BE (6.03 mmol/l) was documented in calves from group II. The animals from this group presented compensation resulted from activation of metabolic mechanisms. The calves with hypoal- buminemia (group III) showed lower plasma concentrations of albumin (15.37 g/L), Cl (74.94 mmol/L), Mg2+ (0.53 mmol/L), P (1.41 mmol/L) and higher value of anion gap (39.03 mmol/L). This group III presented significantly higher SID3 (71.89 mmol/L), SID7 (72.92 mmol/L) and SIG (43.53 mmol/L) values than animals from the remaining groups (P < 0.01), whereas A(Tot) (6.82 mmol/L) were significantly lower. The main finding of the correlation study was the excellent relationship between the AGcorr and SID3, SID7, SIG. In conclusion, chronic diarrhea leads to numerous water-electrolyte disorders. Characterization of acid-base disturbance in these cases suggests that classic model have some limitations. This model can not be recommended for use whenever serum albumin or phosphate concentrations are markedly abnormal.