Learn about Electrolytes in Veterinary Care

Dextrose:insulin ratio when treating hyperkalemia

Hyperkalemia in dogs and cats can be treated with a wide variety of methods in an emergency veterinary setting. These methods may include intravenous isotonic crystalloid fluid therapy, insulin with dextrose, sodium bicarbonate, adrenergic receptor agonists (e.g. albuterol or terbutaline) and, ultimately, treatment of the underlying condition (e.g. relief of the urethral obstruction).

Hypercalcemia in dogs with Addison’s disease

Hypoadrenocorticism (i.e., Addison’s disease) is an important differential for hypercalcemia. The etiology of hypercalcemia in hypoadrenocorticism in dogs is unclear. Hall et. al (JVIM 2023) wanted to find out the prevalence and factors associated with hypercalcemia in this population of dogs by performing a multicenter retrospective observational study at the 4 UK referral hospitals. They analyzed data from 110 dogs and found that about 34.5% of the dogs with Addison’s had either total and/or ionized hypercalcemia. The odds of hypercalcemia were increased (P < .05) in dogs with classic Addison’s (deficient in both mineralo- and glucocorticoids), higher serum creatinine, and higher serum albumin. The odds of ionized hypercalcemia were increased (P < .05) with reduced serum potassium concentration and younger age.

Metabolic alkalosis in animals with upper GI obstruction

If you are presented with an acutely vomiting canine or feline patient who happened to have a metabolic alkalosis on the blood gas analysis, an upper gastrointestinal (GI) obstruction should be suspected. Lozano et al. (Texas A&M University, JSAP 2023) recently published a study that looked at the prevalence of various acid-base and electrolyte disorders in this population of dogs. A total of 115 dogs were included in the study, with 22% of dogs showing either a simple metabolic alkalosis or a mixed metabolic alkalosis before surgery. While 37% of dogs had a normal acid–base status on presentation.

From Novice to Expert: How to Master Small Animal Electrolyte and Acid-Base Disorders?

For emergency veterinarians, interns and residents, ECC and anesthesia technicians seeking to truly master emergency and critical care topics, traditional continuing education (CE) courses, webinars, and lectures may prove to be inadequate. These conventional methods often fall short in several key aspects, hindering effective learning and retention. Over the last 15 years, I have attended dozens of CE events and watched hundreds of hours of webinars, only to realize a week later that I can recall 5-10% of this information. Have you ever felt that way?

Refeeding syndrome in dogs and cats

Refeeding syndrome refers to a potentially fatal constellation of metabolic derangements that occur upon refeeding a patient with an extended period of complete anorexia or severe malnutrition (Crook 2001; Kraft 2005). These metabolic derangements include severe hypophosphatemia, hypomagnesemia, hypokalemia, hyponatremia, hypocalcemia, hyperglycemia and vitamin deficiencies (Skipper 2012).