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?
Continue reading “From Novice to Expert: How to Master Small Animal Electrolyte and Acid-Base Disorders?”Tag: Electrolytes
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).
Continue reading “Refeeding syndrome in dogs and cats”Citrate Toxicity Calculator for Dogs
Those of you who have ever participated in canine blood donation might have encountered a situation when the blood flow through a sampling line has significantly slowed down or even completely stopped, and despite your best efforts, you had to abort the mission. As a result, the blood bag may end up being half full and contain only 200-250 ml of blood. Since the majority of commercially available donor bags contain 63-70 ml of citrate-based anticoagulant, they are designed to be filled up with 400-450 ml of donor blood to maintain a 1:7 – 1:9 citrate-to-blood ratio. If not, the citrate-to-blood ratio goes up, which creates a risk for citrate toxicity during a blood transfusion. In this situation, a clinician or technician may elect to waste this blood product and send this donor home since collecting another full bag of blood will not be safe for the donor animal. On the other hand, there is an extreme shortage of blood products in veterinary medicine, and, if possible, any waste should be avoided. In this blog post, I will give you a tool that may help you decide on whether a blood product with a high citrate-to-blood ratio should be discarded or safely given to a prospective recipient.
Continue reading “Citrate Toxicity Calculator for Dogs”Approach to Hypernatremia in Dogs and Cats
Hypernatremia is defined as a serum sodium level above the reference range. It is a relatively infrequently encountered electrolyte disturbance in dogs and cats. In one retrospective study (Ueda et al. 2015), 5.7% dogs and 8.0% cats were diagnosed with hypernatremia. It was associated with increased case fatality rates in this population of patients. Understanding hypernatremia requires a comprehension of body fluid compartments, as well as concepts of the preservation of normal body water balance. The animal body maintains a normal osmolality between 280 and 310 mOsm/kg via Arginine Vasopressin (AVP), thirst, and the renal response to AVP; dysfunction of all three of these factors can cause hypernatremia (Mushin et al. 2016). In this post, I present a step-by-step approach to the hypernatremia in canine and feline patients. Further reading is recommended to deepen understanding of the physiology and pathophysiology of sodium and water balance.
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Approach to Hypokalemia: Diagnosis and Treatment
All causes of hypokalemia can be divided into 3 big groups:
- Decreased intake (unlikely to be a sole cause)
- Intracellular shift
- External loss (GI or renal)
A step-by-step approach to diagnosis of hypokalemia
Step 1: Review current medication history. Drugs that can promote hypokalemia (via intracellular shifting or increased losses/decreased intake):
- K-deficient fluids
- loop/thiazide diuretics
- insulin, dextrose
- albuterol, terbutaline and other beta agonists
- catecholamines