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Paul BR, De UK, Sarkar VK, Gandhar JS, Patra MK, Agrawal RK, Singh MK, Soni S, Eregowda CG. Effect of systemic inflammatory response syndrome on thrombocytogram, acute phase proteins, electrolytes, acid-base indices and cytokine expression in naturally canine parvovirus infected dogs. Vet Immunol Immunopathol 2023; 259:110598. [PMID: 37119726 DOI: 10.1016/j.vetimm.2023.110598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/03/2023] [Accepted: 04/22/2023] [Indexed: 05/01/2023]
Abstract
Systemic inflammatory response syndrome (SIRS) in canine parvoviral enteritis (CPVE) is associated with high mortality in young puppies. Changes in acute phase response, thrombocytogram, inflammatory cytokine profiles, and disturbances in electrolyte and acid-base homeostasis are thought to have a significant impact on the development of SIRS. However, the mechanisms causing these perturbations have not been well described in CPVE puppies, especially with SIRS. The purpose of this study was to assess the changes of electrolytes, acid-base indices using strong ion model, acute phase proteins and thrombocytogram in blood and expressions of inflammatory cytokines in blood mononuclear cells of CPVE puppies with or without SIRS at admission. Additionally, the positive predictive value (PPV) and cut-off value with specificity and sensitivity of the biomarkers were determined by receiver operating characteristic (ROC) curve analysis to predict the development of SIRS in CPVE puppies at admission. A case-controlled, prospective and observational study was conducted on fifteen SIRS-positive CPVE, twenty-one SIRS-negative CPVE and six healthy puppies. Our data showed marked hyponatremia, hypokalemia, hypoalbuminemia and hypoproteinemia, decreased ATot-albumin and ATot-total protein and increased mean platelet volume (MPV), platelet distribution width (PDW) and C-reactive protein (CRP) concentration and up-regulation of TNF-α, IL-8 and IL-10 expressions in SIRS-positive CPVE puppies as compared to SIRS-negative CPVE puppies at admission. Based on sensitivity, specificity and AUC from ROC curve analysis and PPV, the CRP concentration in serum at a cut-off value of 141.9 mg/L and TLC of blood at a cut-off value of 3.355 × 103/μL were identified as potential prognostic biomarkers followed by ATot-total protein and total protein at a cut-off value of 11.80 and 4.72 g/dL, respectively to predict the development of SIRS in CPVE puppies at admission. In conclusion, the findings of the current study will help the canine practitioners to institute the time-sensitive and need based interventions to disrupt progression along the continuum of shock and multi-organ dysfunction syndrome in CPVE puppies that develop SIRS at admission.
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Affiliation(s)
- Babul R Paul
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Ujjwal K De
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India.
| | - Varun K Sarkar
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Jitendra S Gandhar
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Manas K Patra
- Livestock Production and Management Section, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Ravi K Agrawal
- Division of Biological Standardization, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Mithilesh K Singh
- Immunology Section, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Srishti Soni
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Chethan G Eregowda
- Department of Veterinary Medicine, College of Veterinary Sciences and Animal Husbandry, Selesih, Aizawl 796014, Mizoram, India
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Bonatto NCM, Alves LSS, Silva LE, Milhorine CA, de Barros LD, Santos JA, de Almeida BFM, da Costa Flaiban KKM. Does postprandial lipemia interfere with blood gas analysis and assessment of acid-base status in dogs? Res Vet Sci 2023; 154:52-58. [PMID: 36459719 DOI: 10.1016/j.rvsc.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/30/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022]
Abstract
To evaluate the interference of postprandial lipemia on blood gas parameters and to assess the acid-base status by the quantitative approach of the strong ion model blood samples of 15 healthy dogs were collected during fasting (0 h) and at one (1 h), three (3 h) and five (5 h) hours after the induction of lipemia with a hypercaloric diet. Total cholesterol (TC) and triglyceride (TG) levels were used to assess lipemia and these were correlated with the parameters evaluated accordingly. Anion gap decreased at 5 h without correlation with TC and TG, whereas other parameters measured by the blood gasometer did not change. In the evaluation of the acid base state, the apparent strong ion difference (SIDa) and the strong ion gap (SIG) showed a decrease at 5 h without correlation with lipemia. Lipid levels correlated with the effective strong ion difference (SIDe), the concentration of total non-volatile weak acids (Atot), albumin, phosphate, and magnesium. The SIDe increased at 1 h and at 3 h; the Atot at 1 h, 3 h, and 5 h; albumin increased at 1 h and 3 h; phosphate increased at 1 h, 3 h and 5 h; and magnesium decreased at 5 h. Though postprandial lipemia does not interfere with blood gas analysis, it can cause errors in the variables used to assess the acid-base status, which are dependent on biochemical analytes. Therefore, caution is required when interpreting electrolyte disturbances that result from the postprandial state.
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Affiliation(s)
| | - Laís Sodré Santana Alves
- Department of Preventive Veterinary Medicine, State University of Londrina - (UEL), Londrina, PR, Brazil
| | - Luara Evangelista Silva
- Department of Preventive Veterinary Medicine, State University of Londrina - (UEL), Londrina, PR, Brazil
| | | | - Luiz Daniel de Barros
- Department of Preventive Veterinary Medicine, State University of Londrina - (UEL), Londrina, PR, Brazil
| | - Julian Andrade Santos
- Department of Preventive Veterinary Medicine, State University of Londrina - (UEL), Londrina, PR, Brazil
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Kadwa AR, Grace JF, Zeiler GE. Sources of error in acid-base analysis from a blood gas analyser result: a narrative review. J S Afr Vet Assoc 2022; 93:89-98. [DOI: 10.36303/jsava.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Affiliation(s)
- AR Kadwa
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
- Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital,
South Africa
| | - JF Grace
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
- Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital,
South Africa
| | - GE Zeiler
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria,
South Africa
- Section of Anaesthesia and Critical Care, Valley Farm Animal Hospital,
South Africa
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4
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Barton JC, Mäntylä Noble PJ, O'Connell EM. Acute kidney injury manifesting as renal tubular acidosis with proximal and distal renal tubular dysfunction in a dog with acute pancreatitis. J Vet Emerg Crit Care (San Antonio) 2022; 32:524-531. [PMID: 35129879 PMCID: PMC9545851 DOI: 10.1111/vec.13186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 11/28/2020] [Accepted: 12/02/2020] [Indexed: 11/28/2022]
Abstract
Objective To describe the clinical presentation and management of a critically ill dog with profound renal tubular acidosis (RTA) with proximal and distal renal tubular dysfunction. Case Summary A 3‐year‐old neutered female Border Terrier was presented with frequent regurgitation resulting from acute pancreatitis with severe ileus. Venous acid–base analysis and complete urinalysis confirmed the presence of normal anion gap metabolic acidosis with inappropriately alkaline urine (pH 8), consistent with distal RTA. Urinalysis, urine amino acids, and urinary fractional excretion of electrolytes revealed glycosuria (with normoglycemia), aminoaciduria, and increased fractional excretion of sodium, calcium, and phosphate consistent with generalized proximal renal tubulopathy or Fanconi syndrome. The dog responded well to supportive care and alkaline therapy and made a complete recovery. New or Unique Information Provided To the authors’ knowledge, this is the first description of RTA with proximal and distal renal tubular dysfunction in the veterinary literature. Furthermore, the authors hypothesize that the transient RTA was a manifestation of acute kidney injury secondary to acute pancreatitis, the first report of this in the literature.
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Affiliation(s)
- James C Barton
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Peter-John Mäntylä Noble
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Erin M O'Connell
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
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Tosuwan J, Hunprasit V, Surachetpong SD. Usefulness of peripheral venous blood gas analyses in cats with arterial thromboembolism. Int J Vet Sci Med 2021; 9:44-51. [PMID: 34754877 PMCID: PMC8555553 DOI: 10.1080/23144599.2021.1982335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Feline arterial thromboembolism (ATE) is a condition with a high mortality rate. Acid-base abnormalities may be beneficial to the prognosis of cats with ATE. Venous blood gas and electrolytes data on the first day of ATE presentation of 47 cats with ATE were retrospectively reviewed and analysed. The Cox and logistic regression were analysed to evaluate the relationship between acid-base parameters and death. The most common venous acid-base disorder was simple metabolic acidosis. Age, body weight, and partial venous pressure of carbon dioxide (PvCO2) differed between the dead and alive groups within 7 days of the onset of ATE presentation (p < 0.05). Cox-regression showed that increasing age (HR=1.175 [95% CI: 1.027-1.343], p = 0.019), increasing PvCO2 (HR=1.066 [95% CI: 1.010-1.125], p = 0.021) and PvCO2 more than 34 mmHg (HR=7.878 [95% CI: 1.036- 59.915], p = 0.046) were associated with increased hazard of death. Multivariable logistic regression showed that age > 5 years (OR=9.030, 95% CI: 1.258- 64.823; p=0.029), and PvCO2 > 34 mmHg (OR=21.764, 95% CI: 1.747-271.141; p=0.017) were associated with an increased risk of death, while concomitant administration of enoxaparin with clopidogrel (OR=0.111, 95% CI: 0.015-0.795; p=0.029) were associated with a decreased risk of death within 7 days of the onset of ATE presentation. This study demonstrated the power of venous blood gas analysis which may be used as prognostic indicators for cats with ATE.
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Affiliation(s)
- Jidapa Tosuwan
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok Thailand
| | - Vachira Hunprasit
- Department of Veterinary Medicine, Faculty of Veterinary Science, Chulalongkorn University, Bangkok Thailand
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Zeiler GE, Fuller A, Kamerman P, Buck RK, Pohlin F, Dzikiti BT. Describing acid-base balance using three different methods of analysis in a feline acute haemorrhage-resuscitation model. Vet Anaesth Analg 2021; 49:65-75. [PMID: 34865969 DOI: 10.1016/j.vaa.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 05/26/2021] [Accepted: 07/21/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To describe acid-base status using the Henderson-Hasselbalch, Stewart and semi-quantitative methods of analysis in a feline haemorrhage-resuscitation model. STUDY DESIGN Randomized crossover study. ANIMALS A total of six domestic cats (mean age, 21 months; weight, 4.9 kg). METHODS Venous blood samples were taken before haemorrhage, after haemorrhage at 30 minute intervals during fluid resuscitation and at 24 hours. The cats were anaesthetized and underwent following treatments: no purposeful haemorrhage and resuscitation (NoPHR), purposeful haemorrhage followed by either lactated Ringer's solution (LRS) or 6% tetrastarch 130/0.4 (Voluven) for resuscitation. LRS and Voluven were administered at 60 and 20 mL kg-1 hour-1, respectively, for 120 minutes. Variables used for the analysis methods were measured or calculated from the blood samples and then compared among treatments over time using a general linear mixed model (p < 0.05; data reported as mean and standard deviation). RESULTS The total blood loss at 120 minutes was 10.2 ± 2.3, 29.3 ± 9.0 and 29.1 ± 6.3 mL kg-1 for NoPHR, LRS and Voluven, respectively. Total volumes of LRS and Voluven administered were 120 and 40 mL kg-1, respectively. All cats became acidaemic during anaesthesia regardless of treatment. The Henderson-Hasselbalch method indicated that anaesthetized cats undergoing severe haemorrhage and resuscitation manifest a mixed acidosis. The Stewart method indicated two counter metabolic processes that contributed to the overall pH-decrease in apparent strong ion difference (acidosis) and decrease in total weak acids (alkalosis). The semi-quantitative method identified the free water and chloride effects as variables causing acidosis and the albumin effect causing alkalosis. CONCLUSIONS AND CLINICAL RELEVANCE In an experimental haemorrhage and resuscitation model in cats, blood pH was similar among treatments over time regardless of severe haemorrhage and resuscitation with LRS or Voluven or mild haemorrhage and no resuscitation.
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Affiliation(s)
- Gareth E Zeiler
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa; Anaesthesia and Critical Care Services, Valley Farm Animal Hospital, Pretoria, South Africa; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.
| | - Andrea Fuller
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Peter Kamerman
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Roxanne K Buck
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Friederike Pohlin
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Brighton T Dzikiti
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa; Clinical Sciences Department, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, South Africa
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Osborne LG, Burkitt-Creedon JM, Epstein SE, Hopper K. Semiquantitative acid-base analysis in dogs with typical hypoadrenocorticism. J Vet Emerg Crit Care (San Antonio) 2020; 31:99-105. [PMID: 33251763 DOI: 10.1111/vec.13016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 02/04/2019] [Accepted: 03/29/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the semiquantitative acid-base status of dogs with untreated naturally occurring typical hypoadrenocorticism and to compare this to the status determined by traditional acid-base analysis. DESIGN Retrospective study. SETTING University teaching hospital. ANIMALS Thirty-three dogs with newly diagnosed typical hypoadrenocorticism between 2000 and 2017. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Dogs were included if they had newly diagnosed hypoadrenocorticism, post-ACTH stimulation serum cortisol concentration <2 μg/dL, and blood collected within 6 hours of presentation for acid-base, electrolyte, and serum biochemical assays. Dogs were excluded if the Na+ :K+ ratio was ≥28 or the dog had received a mineralocorticoid-containing corticosteroid medication within the preceding month. Traditional acid-base analysis identified normal acid-base status in 1 dog, simple respiratory acid-base abnormalities in 2 of 33 dogs, and simple metabolic acidosis in 14 of 33 dogs. A mixed disorder was most common, noted in 16 of 33 dogs. The semiquantitative approach identified metabolic abnormalities in all cases. All dogs had ≥1 acidifying process, and 29 of 33 had both acidifying and alkalinizing processes. Acidosis attributable to excess free water was present in all dogs, and an acidifying phosphate effect was present in 27 of 33. Hyperlactatemia contributed to the acidosis in 8 of 33 dogs, with a median (range) lactate concentration of 1.5 mmol/L (13.5 mg/dL) (0.3-4.2 mmol/L [2.7-37.8 mg/dL]). CONCLUSIONS Dogs with untreated Addison's disease have complex acid-base derangements. The semiquantitative approach to acid-base analysis provides greater insight into the underlying mechanisms of metabolic acid-base abnormalities in these dogs, particularly because lactic acidosis appears to be a minor influence in most cases.
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Affiliation(s)
- Laura G Osborne
- Small Animal Emergency and Critical Care, Western Veterinary Specialist and Emergency Centre, Calgary, Alberta, Canada
| | - Jamie M Burkitt-Creedon
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Steven E Epstein
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Kate Hopper
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California
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8
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Hoehne SN, Yozova ID, Vidondo B, Adamik KN. Comparison of the effects of 7.2% hypertonic saline and 20% mannitol on electrolyte and acid-base variables in dogs with suspected intracranial hypertension. J Vet Intern Med 2020; 35:341-351. [PMID: 33236379 PMCID: PMC7848367 DOI: 10.1111/jvim.15973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 11/30/2022] Open
Abstract
Background Hyperosmolar agents frequently are used to decrease intracranial pressure but their effects on electrolyte and acid‐base variables have not been prospectively investigated. Objectives Compare duration and magnitude of changes in electrolyte and acid‐base variables after hyperosmolar treatment. Animals Twenty‐eight client‐owned dogs with intracranial hypertension caused by various pathologies. Methods Prospective, randomized, nonblinded, experimental cohort study. Fifteen dogs received a single dose (4 mL/kg) of 7.2% hypertonic saline (HTS), 13 dogs received 20% mannitol (MAN) 1 g/kg IV. Electrolyte and acid‐base variables were measured before (T0), and 5 (T5), 60 (T60), and 120 (T120) minutes after administration. Variables were compared between treatments and among time points within treatment groups. Results Mean plasma sodium and chloride concentrations were higher after HTS than MAN at T5 (158 vs 141 mEq/L; 126 vs 109 mEq/L) and significant differences were maintained at all time points. After HTS, plasma sodium and chloride concentrations remained increased from T0 at all time points. After MAN, plasma sodium and chloride concentrations decreased at T5, but these changes were not maintained at T60 and T120. Plasma potassium concentration was lower at T5 after HTS compared with T0 (3.6 vs 3.9 mEq/L) and compared to MAN (3.6 vs 4.1 mEq/L). At T60 and T120, plasma ionized calcium concentration was lower after HTS than MAN (1.2 vs 1.3 mmol/L). No significant differences were found in acid‐base variables between treatments. Conclusions and Clinical Importance At the administered dose, dogs receiving HTS showed sustained increases in plasma sodium and chloride concentrations, whereas dogs receiving MAN showed transient decreases. Future studies should assess the effects of multiple doses of hyperosmolar agents on electrolyte and acid‐base variables.
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Affiliation(s)
- Sabrina N Hoehne
- Division of Small Animal Emergency and Critical Care, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Ivayla D Yozova
- Massey University Pet Emergency Centre, School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - Beatriz Vidondo
- Department of Clinical Research and Public Health, Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Katja N Adamik
- Division of Small Animal Emergency and Critical Care, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Johnston L, Leister E, Singer L. Severe metabolic acidosis due to acetazolamide intoxication in a dog. Aust Vet J 2020; 99:11-14. [PMID: 33025586 DOI: 10.1111/avj.13027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/22/2020] [Accepted: 09/22/2020] [Indexed: 12/01/2022]
Abstract
CASE REPORT This case report describes the clinical signs and case management of a 1-year-old neutered male Siberian Husky that accidentally ingested 635 mg/kg of oral acetazolamide (a carbonic anhydrase inhibitor). The dog presented with severe tachypnoea due to the development of hyperchloraemic metabolic acidosis and associated hypokalaemia that persisted for 7 days. Clinical and biochemical changes resolved with intravenous and subsequent oral supplementation of sodium bicarbonate and potassium. Complete recovery occurred within 9 days of presentation. CONCLUSION To the authors' knowledge, this is the first case that reports overdosage of an oral carbonic anhydrase inhibitor in a dog and subsequent recovery with adequate supplementation and supportive care.
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Affiliation(s)
- L Johnston
- Internal Medicine, Veterinary Specialist Services, Eastlake Street, Carrara, Queensland, 4211, Australia
| | - E Leister
- Emergency and Critical care, Pet ICU, Lexington Road, Underwood, Queensland, 4119, Australia
| | - L Singer
- Internal Medicine, Veterinary Specialist Services, Eastlake Street, Carrara, Queensland, 4211, Australia
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10
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Sławuta P, Sikorska-Kopyłowicz A, Sapikowski G. Diagnostic utility of different models used to assess the acid-base balance in cats with chronic kidney disease. Acta Vet Hung 2020; 68:169-176. [PMID: 32857709 DOI: 10.1556/004.2020.00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/06/2020] [Indexed: 11/19/2022]
Abstract
Metabolic acidosis is diagnosed based on the concentration of bicarbonate ions and partial pressure of carbon dioxide in arterial blood, although acid-base balance (ABB) disorders may also be diagnosed based on the serum ion concentrations in order to determine the values of strong ion difference (SID), anion gap (AG), corrected anion gap (AGcorr) and chloride/sodium ratio (Cl-/Na+). The aim of this study was to assess and compare the classic model, the value of the AG, AGcorr, and Cl-/Na+ in the diagnosis of ABB disorders in cats with chronic kidney disease (CKD). The study group consisted of 80 cats with CKD, divided into four groups based on the guidelines of the International Renal Interest Society (IRIS). The control group (C) included 20 healthy cats. Metabolic acidosis - diagnosed based on the classic model (Hendersson-Hasselbalch equation) - was found in IRIS group IV. AG, AGcorr, SID calculated for IRIS groups II, III and IV were lower than in group C, while the value of AGdiff and Cl-/Na+ in those groups was higher than in group C. We can conclude that ABB analysis using the classic model enabled the detection of ABB disorders in cats in stage IV CKD. However, the analysis of the AG, AGcorr and Cl-/Na+ values enabled the diagnosis of acid-base balance disorders in cats with IRIS stage II, III and IV CKD.
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Affiliation(s)
- Piotr Sławuta
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Science, Norwida 32, 50-375, Wrocław, Poland
| | - Agnieszka Sikorska-Kopyłowicz
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Science, Norwida 32, 50-375, Wrocław, Poland
| | - Grzegorz Sapikowski
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, The Faculty of Veterinary Medicine, Wrocław University of Environmental and Life Science, Norwida 32, 50-375, Wrocław, Poland
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11
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Burchell RK, Gal A, Friedlein R, Leisewitz AL. Role of electrolyte abnormalities and unmeasured anions in the metabolic acid-base abnormalities in dogs with parvoviral enteritis. J Vet Intern Med 2020; 34:857-866. [PMID: 32133703 PMCID: PMC7096617 DOI: 10.1111/jvim.15749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/18/2022] Open
Abstract
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 Atot 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.
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Affiliation(s)
- Richard K Burchell
- Veterinary and Biomedical Sciences, James Cook University, Townsville, Queensland, Australia
| | - Arnon Gal
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Ryan Friedlein
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Andrew L Leisewitz
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
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12
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Hasuda A, Flaiban K, Lisbôa J, Gomes L, Polizelli I, Santana L. Identifying hydric, electrolytic and acid-base imbalances through traditional and quantitative approaches in dogs with hemorrhagic gastroenteritis. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Vomiting and diarrhea are two important clinical signs that can cause significant electrolytic and acid-base imbalances. The purposes of this study were to characterize hydric, electrolytic and acid-base disorders presented by puppies with hemorrhagic gastroenteritis and to compare the traditional and quantitative approaches to acid-base status interpretation. Sixty-one animals with a history of vomiting and/or diarrhea were used in this study and the following tests were performed: complete blood count, total plasma protein concentration and hemogasometry. Mean, standard deviation and Kappa values were calculated. The imbalances characterized by both approaches were: 42 (69%) animals without imbalance, 17 (28%) with metabolic alkalosis and 2 (3%) with metabolic acidosis by the traditional approach and 17 (28%) dogs without imbalance, 26 (43%) with metabolic alkalosis and 18 (29%) with metabolic acidosis by the quantitative approach. The agreement calculated between two approaches coincide in 28 cases, with a moderate Kappa value equivalent to 0.459. The most found imbalances were metabolic alkalosis, hypokalemia, and mild dehydration. Most of acid-base disturbances were not identified by the traditional approach, whereas by the quantitative approach, they were easily determined. Thus quantitative approach proved to be superior in identification of possible acid-base imbalances.
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Affiliation(s)
- A.L. Hasuda
- Universidade Estadual de Londrina, Brazil; Universidade Estadual de Londrina, Brazil
| | | | | | - L.A. Gomes
- Universidade Estadual de Londrina, Brazil
| | - I.G. Polizelli
- Universidade Estadual de Londrina, Brazil; Universidade Estadual de Londrina, Brazil
| | - L.S. Santana
- Universidade Estadual de Londrina, Brazil; Universidade Estadual de Londrina, Brazil
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13
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Zager E, Fletcher DJ, Goggs R. Evaluation of the association between strong ion acid-base disturbances and mortality in dogs: a retrospective study. Vet Med Sci 2018; 4:206-217. [PMID: 29635886 PMCID: PMC6090410 DOI: 10.1002/vms3.101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Acid-base abnormalities are frequently encountered in veterinary emergency and critical care, but information regarding the prognostic value of these findings is limited. Several systems for analysing acid-base disturbances have been reported, but the prognostic abilities of these systems have not been compared in dogs. The objectives of this retrospective study were to determine if the commonly used acid-base interpretation methods (Henderson-Hasselbalch, Stewart and semi-quantitative) have prognostic value, and to compare the performance of the three methods. Electronic medical records were searched to create a database containing point-of-care blood-gas, electrolyte and serum chemistry values for 1024 dogs assessed at a university teaching hospital. Dogs with contemporaneous blood-gas analysis, blood lactate and serum biochemistry samples were eligible for study, and only the first recorded analyses for each patient visit were included. Components of the Henderson-Hasselbalch, Stewart and semi-quantitative methods were calculated. To assess prognostic ability and to compare analysis system performance, receiver-operating characteristic (ROC) curves for survival to hospital discharge were created. Of the 1024 dogs identified, case fatality rate was 23.8%. Area under the ROC curve did not exceed 0.63 for any calculated variable. Performance of all three analysis systems was similar. While some acid-base abnormalities identified were associated with mortality, no individual abnormality or system output yielded sensitive and specific cut-off values for mortality prediction, and no interpretation method outperformed the others. This study suggests that initial acid-base abnormalities have limited prognostic utility and that various analysis systems can be used to assess acid-base disturbances in critically ill dogs.
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Affiliation(s)
- Erik Zager
- Department of Clinical SciencesCornell University College of Veterinary MedicineIthacaNew YorkUSA
| | - Daniel J. Fletcher
- Department of Clinical SciencesCornell University College of Veterinary MedicineIthacaNew YorkUSA
| | - Robert Goggs
- Department of Clinical SciencesCornell University College of Veterinary MedicineIthacaNew YorkUSA
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14
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Adamik KN, Obrador R, Howard J. Comparison of acid-base and electrolyte changes following administration of 6% hydroxyethyl starch 130/0.42 in a saline and a polyionic solution in anaesthetized dogs. Vet Anaesth Analg 2018; 45:260-268. [PMID: 29506859 DOI: 10.1016/j.vaa.2017.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 11/18/2017] [Accepted: 11/29/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To evaluate the effects of a 6% hydroxyethyl starch (130/0.42) in either a buffered, electrolyte-balanced (HES-BAL) or saline (HES-SAL) carrier solution on electrolyte concentrations and acid-base parameters in healthy anaesthetized dogs. STUDY DESIGN Prospective randomised clinical study. ANIMALS A group of 40 client-owned dogs undergoing general anaesthesia for elective surgical procedures or diagnostic imaging. METHODS During anaesthesia, dogs were intravenously administered 15 mL kg-1 of either HES-SAL (n = 20) or HES-BAL (n = 20) over 30-40 minutes. Jugular blood samples were analysed before (T0) and 5 minutes (T5), 1 hour (T60) and 3 hours (T180) after fluid administration. Sodium, potassium, chloride, ionised calcium, phosphate, albumin, pH, venous pCO2, base excess (BE), bicarbonate and anion gap were determined and strong ion difference (SID) and total quantity of weak nonvolatile acids were calculated for each time point. RESULTS Chloride was significantly increased at T5, T60 and T180 compared with T0 after HES-SAL, and was significantly greater after HES-SAL than after HES-BAL at T5 (p = 0.042). Ionised calcium was significantly decreased at T5 compared with T0 after HES-SAL, and was significantly lower after HES-SAL than after HES-BAL at T5 (p < 0.001). Bicarbonate was significantly lower after HES-SAL than after HES-BAL at T5 (p = 0.004) and T60 (p = 0.032). BE was significantly lower after HES-SAL than after HES-BAL at T5 (p < 0.001) and T60 (p = 0.007). SID was significantly decreased after HES-SAL at T5 and T60 compared with T0, and was significantly lower after HES-SAL than after HES-BAL at T5 (p = 0.027). Mean electrolyte and acid-base parameters remained within or marginally outside of reference intervals. CONCLUSIONS AND CLINICAL RELEVANCE Changes in both groups were minor and short-lived with either fluid in healthy individuals, but might become clinically relevant with higher fluid doses or in critically ill dogs.
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Affiliation(s)
- Katja N Adamik
- Emergency and Critical Care Section, Small Animal Clinic, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
| | - Rafael Obrador
- Emergency and Critical Care Section, Small Animal Clinic, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Judith Howard
- Diagnostic Clinical Laboratory, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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15
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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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16
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Smart L, Reese S, Hosgood G. Food engorgement in 35 dogs (2009-2013) compared with 36 dogs with gastric dilation and volvulus. Vet Rec 2017; 181:563. [PMID: 29051308 DOI: 10.1136/vr.104353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 08/30/2017] [Accepted: 10/04/2017] [Indexed: 11/04/2022]
Abstract
The clinical features and management of food engorgement (FE) in dogs have not been previously described. This retrospective observational study describes characteristics and outcome of 35 dogs with FE, and compares features on presentation to 36 dogs with gastric dilation and volvulus (GDV). Cases were retrospectively reviewed for history, clinical findings and outcome. Gastric distension was measured by caudal gastric margin (CGM), level with lumbar vertebrae, on a lateral abdominal radiograph. Frequent characteristics of dogs with FE included tachycardia, tachypnoea, hyperproteinaemia, increased base excess (BE), mild hypernatraemia and hyperlactataemia. There was overlap in CGM between dogs with GDV (CGM range L3 to >L6) and dogs with FE (CGM range <L2 to L5-L6). In contrast to dogs with GDV, lactate concentration in dogs with FE was not associated with CGM or BE. Dogs with FE mostly received medical intervention consisting of fluid therapy and analgesia, and all dogs survived to discharge. In conclusion, dogs with FE frequently presented with acid-base and electrolyte derangements, including hyperlactataemia. While dogs with FE can have gastric distension as severe as that seen with GDV, outcome with supportive care only is excellent.
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Affiliation(s)
- Lisa Smart
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - Shona Reese
- Vet Imaging Specialists, Murdoch, Western Australia, Australia
| | - Giselle Hosgood
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
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Barba-Vidal E, Buttow Roll VF, Garcia Manzanilla E, Torrente C, Moreno Muñoz JA, Pérez JF, Martín-Orúe SM. Blood parameters as biomarkers in a Salmonella spp. disease model of weaning piglets. PLoS One 2017; 12:e0186781. [PMID: 29073182 PMCID: PMC5658074 DOI: 10.1371/journal.pone.0186781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 10/06/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The weaning pig is used as an experimental model to assess the impact of diet on intestinal health. Blood parameters (BP) are considered a useful tool in humans, but there is very scarce information of such indicators in the weaning pig. The objective of the present study is to evaluate the use of different BP as indicators in an experimental model of salmonellosis. METHODOLOGY Seventy-two 28-day-old piglets were divided into four groups in a 2x2 factorial arrangement, with animals receiving or not a probiotic combination based on B. infantis IM1® and B. lactis BPL6 (109 colony forming units (cfu)/d) and orally challenged or not a week later with Salmonella Typhimurium (5x108 cfu). Blood samples of one animal per pen (N = 24) were taken four days post-inoculation for the evaluation of different BP using an I-stat® System and of plasmatic concentrations of zinc, iron and copper. PRINCIPAL FINDINGS Results reported marginal deficiencies of zinc in piglets at weaning. Moreover, plasmatic zinc, copper and iron presented good correlations with weight gain (r 0.57, r -0.67, r 0.54 respectively; P < 0.01). Blood electrolytes (Na+, Cl- and K+) decreased (P < 0.01) only when the performance of the animals was seriously compromised and clinical symptoms were more apparent. Acid-base balance parameters such as HCO3-, TCO2 and BEecf significantly correlated with weight gain, but only in the challenged animals (r -0.54, r -0.55, and r -0.51, respectively; P < 0.05), suggesting metabolic acidosis depending on Salmonella infection. Glucose was affected by the challenge (P = 0.040), while Htc and Hgb increased with the challenge and decreased with the probiotic (P < 0.05). Furthermore, correlations of Glu, Htc and Hgb with weight gain were observed (P < 0.05). Overall, BP could be regarded as simple, useful indexes to assess performance and health of weaning piglets.
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Affiliation(s)
- Emili Barba-Vidal
- Animal Nutrition and Welfare Service, Departament de Ciència Animal i dels Aliments, Universitat Autònoma de Barcelona; Bellaterra, Spain
| | - Victor Fernando Buttow Roll
- Federal University of Pelotas, Faculty of Agronomy Eliseu Maciel, Department of Animal Science; Pelotas, RS, Brazil
| | - Edgar Garcia Manzanilla
- Pig Development Department, Animal and Grassland Research and Innovation Centre, TEAGASC, The Irish Food and Agriculture Authority, Moorepark; Fermoy, Co. Cork, Ireland
| | - Carlos Torrente
- Emergency and Critical Care Service FHCV-UAB, Departament de Medecina i Cirurgia animal, Universitat Autònoma de Barcelona; Bellaterra, Spain
| | | | - José Francisco Pérez
- Animal Nutrition and Welfare Service, Departament de Ciència Animal i dels Aliments, Universitat Autònoma de Barcelona; Bellaterra, Spain
| | - Susana María Martín-Orúe
- Animal Nutrition and Welfare Service, Departament de Ciència Animal i dels Aliments, Universitat Autònoma de Barcelona; Bellaterra, Spain
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18
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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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Goggs R, Myers M, De Rosa S, Zager E, Fletcher DJ. Chloride:Sodium Ratio May Accurately Predict Corrected Chloride Disorders and the Presence of Unmeasured Anions in Dogs and Cats. Front Vet Sci 2017; 4:122. [PMID: 28824926 PMCID: PMC5539434 DOI: 10.3389/fvets.2017.00122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/17/2017] [Indexed: 11/16/2022] Open
Abstract
Disorders of chloride and mixed acid-base disturbances are common in veterinary emergency medicine. Rapid identification of these alterations and the presence of unmeasured anions aid prompt patient assessment and management. This study aimed to determine in dogs and cats if site-specific reference values for [Cl-]:[Na+] ratio and [Na+] - [Cl-] difference accurately identify corrected chloride abnormalities and to evaluate the predictive ability of the [Cl-]:[Na+] ratio for the identification of unmeasured anions. A database containing 33,117 canine, and 7,604 feline blood gas and electrolyte profiles was generated. Institution reference intervals were used to calculate site-specific reference values for the [Cl-]:[Na+] ratio and the [Na+] - [Cl-] difference. Contingency tables were used to assess the ability of these values to correctly identify corrected chloride disorders. Unmeasured anions were estimated by calculating strong ion gap (SIG). Continuous variables were compared using the Mann-Whitney U test. Correlations between continuous variables were assessed using Spearman's rho (rs). In dogs, site-specific reference values for the [Cl-]:[Na+] ratio correctly identified 94.6% of profiles as hyper-, normo-, or hypochloremic. For dogs with normal sodium concentrations, site-specific reference values for the [Na+] - [Cl-] difference correctly identified 97.0% of profiles. In dogs with metabolic acidosis (base deficit > 4.0), [Cl-]:[Na+] ratio and SIG were moderately but significantly negatively correlated (rs -0.592, P < 0.0001). SIG was significantly greater in dogs with metabolic acidosis and hypochloremia compared to those without hypochloremia (P < 0.0001). In cats, site-specific reference values for the [Cl-]:[Na+] ratio correctly identified 93.3% of profiles as hyper-, normo-, or hypochloremic, while site-specific reference values for [Na+] - [Cl-] difference correctly identified 95.1% of profiles. In cats with metabolic acidosis [Cl-]:[Na+] ratio and SIG were moderately significantly negatively correlated (rs -0.730, P < 0.0001). SIG was significantly greater in cats with metabolic acidosis and hypochloremia compared to those without hypochloremia (P < 0.0001). Site-specific values for [Cl-]:[Na+] ratio and [Na+] - [Cl-] difference accurately identify corrected chloride disorders in both dogs and cats and may aid identification of the presence of unmeasured anions.
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Affiliation(s)
- Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Marc Myers
- MedVet Columbus, Worthington, OH, United States
| | - Sage De Rosa
- Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, United States
| | - Erik Zager
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Daniel J. Fletcher
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
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20
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Bachmann K, Kutter APN, Schefer RJ, Marly-Voquer C, Sigrist N. Determination of reference intervals and comparison of venous blood gas parameters using standard and non-standard collection methods in 24 cats. J Feline Med Surg 2017; 19:831-840. [PMID: 27542821 PMCID: PMC11104123 DOI: 10.1177/1098612x16663269] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Objectives The aim of this study was to determine in-house reference intervals (RIs) for venous blood analysis with the RAPIDPoint 500 blood gas analyser using blood gas syringes (BGSs) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGSs. Methods Venous blood was collected from 24 healthy cats and directly transferred into a BGS and an LH tube. The BGS was immediately analysed on the RAPIDPoint 500 followed by the LH tube. The BGSs and LH tubes were compared using paired t-test or Wilcoxon matched-pairs signed-rank test, Bland-Altman and Passing-Bablok analysis. To assess clinical relevance, bias or percentage bias between BGSs and LH tubes was compared with the allowable total error (TEa) recommended for the respective parameter. Results Based on the values obtained from the BGSs, RIs were calculated for the evaluated parameters, including blood gases, electrolytes, glucose and lactate. Values derived from LH tubes showed no significant difference for standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate, while pH, partial pressure of carbon dioxide and oxygen, actual bicarbonate, extracellular base excess, ionised calcium and anion gap were significantly different to the samples collected in BGSs ( P <0.05). Furthermore, pH, partial pressure of carbon dioxide and oxygen, extracellular base excess, ionised calcium and anion gap exceeded the recommended TEa. Conclusions and relevance Assessment of actual and standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate can be made based on blood collected in LH tubes and analysed within 5 mins. For pH, partial pressure of carbon dioxide and oxygen, extracellular base excess, anion gap and ionised calcium the clinically relevant alterations have to be considered if analysed in LH tubes.
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Affiliation(s)
- Karin Bachmann
- Department for Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Annette PN Kutter
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Rahel Jud Schefer
- Department for Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Charlotte Marly-Voquer
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Nadja Sigrist
- Department for Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Vanova-Uhrikova I, Rauserova-Lexmaulova L, Rehakova K, Scheer P, Doubek J. Determination of reference intervals of acid-base parameters in clinically healthy dogs. J Vet Emerg Crit Care (San Antonio) 2017; 27:325-332. [DOI: 10.1111/vec.12589] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/10/2015] [Accepted: 11/19/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Ivana Vanova-Uhrikova
- Department of Physiology; University of Veterinary and Pharmaceutical Sciences Brno; 612 42 Brno Czech Republic
| | - Leona Rauserova-Lexmaulova
- Department of Surgery and Orthopedics; University of Veterinary and Pharmaceutical Sciences Brno; 612 42 Brno Czech Republic
| | - Kristina Rehakova
- Small Animal Clinical Laboratory; University of Veterinary and Pharmaceutical Sciences Brno; 612 42 Brno Czech Republic
| | - Peter Scheer
- Department of Physiology; University of Veterinary and Pharmaceutical Sciences Brno; 612 42 Brno Czech Republic
| | - Jaroslav Doubek
- Department of Physiology; University of Veterinary and Pharmaceutical Sciences Brno; 612 42 Brno Czech Republic
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Heilmann RM, Pashmakova M, Lamb JH, Spaulding KA, Cook AK. [Subcutaneous ureteral bypass devices as a treatment option for bilateral ureteral obstruction in a cat with ureterolithiasis]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2016; 44:180-8. [PMID: 26898228 DOI: 10.15654/tpk-150128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 07/20/2015] [Indexed: 11/13/2022]
Abstract
A 6-year-old female spayed Domestic Shorthair cat was presented with acute lethargy, dehydration, marked azotemia, metabolic acidosis, left-sided renomegaly, and bilateral hydronephrosis. Ureterolithiasis and ureteral obstruction were suspected based on further diagnostics including abdominal sonography. Medical treatment was not successful. Fluoroscopically guided antegrade pyelography confirmed the diagnosis of bilateral ureteral obstruction due to ureterolithiasis. Subcutaneous ureteral bypass (SUB) devices were placed bilaterally, followed by close patient monitoring. Frequent reassessment of patient parameters and blood work served to adjust the fluid needs of the patient and to ensure proper hydration, correction of azotemia at an appropriate rate, and cardiovascular stability. After significant improvement of all patient parameters within 5 days, the patient was discharged from the hospital. Treatment included a dietary change to reduce the risk of stone formation as well as a phosphorus binder. Clinical and clinicopathologic parameters were unchanged at the 1- and 4- and 7-month rechecks (consistent with IRIS CKD stage II-NP-AP0), and both SUB devices continued to provide unobstructed urine flow. Bilateral placement of subcutaneous ureteral bypass devices may be a safe and potentially effective treatment option for acute bilateral ureteral obstruction in cats with ureterolithiasis. Strict patient monitoring and patient-centered postoperative treatment decisions are crucial to successful treatment outcomes.
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Affiliation(s)
- Romy M Heilmann
- Romy M. Heilmann, Dr. med. vet., Ph. D., Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, 4474 TAMU, Texas A&M University, College Station, TX 77843-4474, USA, E-Mail:
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23
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Hopper K, Epstein SE, Kass PH, Mellema MS. Evaluation of acid-base disorders in dogs and cats presenting to an emergency room. Part 2: Comparison of anion gap, strong ion gap, and semiquantitative analysis. J Vet Emerg Crit Care (San Antonio) 2014; 24:502-8. [DOI: 10.1111/vec.12214] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 07/04/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Kate Hopper
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Steven E. Epstein
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Philip H. Kass
- Population, Health and Reproduction; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
| | - Matthew S. Mellema
- Departments of Veterinary Surgical and Radiological Sciences; School of Veterinary Medicine; University of California at Davis; Davis CA 95616
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