A comparison of traditional and quantitative analysis of acid-base imbalances in hypoalbuminemic dogs

Identifying hydric, electrolytic and acid-base imbalances through traditional and quantitative approaches in dogs with hemorrhagic gastroenteritis

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.

Evaluation of the association between strong ion acid-base disturbances and mortality in dogs: a retrospective study

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.

Blood parameters as biomarkers in a Salmonella spp. disease model of weaning piglets

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.

[Blood gas analysis in dogs in veterinary practice. A review]

Blood gas analysis is useful to obtain information about acid-base state and gas exchange of the lung. Interpretation is based on the Henderson-Hasselbalch equation. This approach has its limitations especially in interpretation of complex disturbances of acid-base status and has been complemented by base excess and anion gap. Peter Stewart described a model of quantitative approach to the acid-base disturbances which has been further developed and is known as the strong ion approach. This model differs from the traditional approach in the assessment of metabolic disorders of acid base status. Both models complement each other but also have their advantages and disadvantages. For simple disorders of the acid-base state the Henderson-Hasselbalch approach can be used, however in complex disturbances of acid-base balance, especially with abnormalities of serum albumin and phosphate concentrations, the strong ion approach is recommended. With the understanding of both models and of the clinical presentation of blood gas abnormalities, optimal case management and therapy can be provided.