Hiponatremia em cães e gatos: incidência, gravidade e prognóstico - Incidence, Severity and Prognosis Associated with Hyponatremia in Dogs and Cats

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Incidence, Severity and Prognosis Associated with Hyponatremia in Dogs and Cats

1. Y. Ueda^1,*, 
2. K. Hopper² and
3. S.E. Epstein²

Article first published online: 13 MAY 2015

DOI: 10.1111/jvim.12581

Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Issue

Journal of Veterinary Internal Medicine

Early View (Online Version of Record published before inclusion in an issue)

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Keywords:

• Dysnatremia;
• Osmolality;
• Sodium;
• Water balance

Background

Hyponatremia is a common electrolyte abnormality in human patients and is associated with substantial morbidity and death. The incidence and importance of hyponatremia in dogs and cats has not been determined.

Hypothesis/Objectives

To describe the incidence of and prognosis associated with hyponatremia in dogs and cats at a university teaching hospital.

Animals

Of 16,691 dogs and 4,211 cats with measured blood or serum sodium concentration.

Methods

Retrospective study. Medical records of animals with a blood or serum sodium concentration measured during a 60-month period were reviewed to determine the severity of hyponatremia and its associated fatality rate. Cases with moderate (11–15 mmol/L below the reference range) or severe hyponatremia (≥16 mmol/L below the reference range) were further reviewed.

Results

Of 4,254 dogs (25.5%) and 2,081 cats (49.4%) were diagnosed with hyponatremia. Case fatality rates of dogs and cats with hyponatremia were 13.7% and 11.9%, respectively, compared to 4.4% and 4.5% with a normal blood or serum sodium concentration (P < 0.0001). The magnitude of hyponatremia was linearly associated with a higher case fatality rate (P < 0.0001). Hyponatremia was associated with a lower case fatality rate than hypernatremia in the same population. Among the animals with moderate or severe hyponatremia, 92.1% of dogs and 90.6% of cats presented with community-acquired hyponatremia, and 7.9% of dogs and 9.4% of cats developed hospital-acquired hyponatremia.

Conclusions and clinical importance

Hyponatremia was found commonly in this population and was associated with increased case fatality rate. Presence and severity of hyponatremia might be useful as a prognostic indicator.

Manejo da pancreatite aguda em cães: Uma avaliação crítica focando na nutrição e analgesia - Management of acute pancreatitis in dogs: a critical appraisal with focus on feeding and analgesia

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Management of acute pancreatitis in dogs: a critical appraisal with focus on feeding and analgesia

1. C. Mansfield and
2. T. Beths

Article first published online: 14 JAN 2015

DOI: 10.1111/jsap.12296

© 2015 British Small Animal Veterinary Association

Issue

Journal of Small Animal Practice

Special Issue: Special issue on canine and feline pancreatitis

Volume 56, Issue 1, pages 27–39, January 2015

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Knowledge about acute pancreatitis has increased recently in both the medical and veterinary fields. Despite this expansion of knowledge, there are very few studies on treatment interventions in naturally occurring disease in dogs. As a result, treatment recommendations are largely extrapolated from experimental rodent models or general critical care principles. General treatment principles involve replacing fluid losses, maintaining hydrostatic pressure, controlling nausea and providing pain relief. Specific interventions recently advocated in human medicine include the use of neurokinin-1 antagonists for analgesia and early interventional feeding. The premise for early feeding is to improve the health of the intestinal tract, as unhealthy enterocytes are thought to perpetuate systemic inflammation. The evidence for early interventional feeding is not supported by robust clinical trials to date, but in humans there is evidence that it reduces hospitalisation time and in dogs it is well tolerated. This article summarises the major areas of management of acute pancreatitis in dogs and examines the level of evidence for each recommendation.

Taxa de filtração glomerular, débito urinário e taxa de clearance de eletrólitos e sua associação com a sobrevida em cães apresentando lesão renal aguda - Glomerular Filtration Rate, Urine Production, and Fractional Clearance of Electrolytes in Acute Kidney Injury in Dogs and Their Association with Survival

Glomerular Filtration Rate, Urine Production, and Fractional Clearance of Electrolytes in Acute Kidney Injury in Dogs and Their Association with Survival

1. N. Brown^1,†,*, 
2. G. Segev^2,†, 
3. T. Francey³, 
4. P. Kass⁴ and
5. L.D. Cowgill⁵

Article first published online: 16 JAN 2015

DOI: 10.1111/jvim.12518

Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Internal Medicine.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Issue

Journal of Veterinary Internal Medicine

Volume 29, Issue 1, pages 28–34, January 2015

Total views since publication: 0

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Keywords:

• Acute renal failure;
• Kidney;
• Renal/Urinary tract;
• Excretion ratio;
• Urinary clearance;
• Prognostic indicators

Background

Acute kidney injury (AKI) is common in dogs. Few studies have assessed sequential changes in indices of kidney function in dogs with naturally occurring AKI.

Objective

To document sequential changes of conventional indices of renal function, to better define the course of AKI, and to identify a candidate marker for recovery.

Animals

Ten dogs with AKI.

Methods

Dogs were prospectively enrolled and divided into surviving and nonsurviving dogs. Urine production was measured with a closed system for 7 days. One and 24-hour urinary clearances were performed daily to estimate solute excretion and glomerular filtration rate (GFR). Solute excretion was calculated as an excretion ratio (ER) and fractional clearance (FC) based on both the 1- and 24-hour urine collections.

Results

Four dogs survived and 6 died. At presentation, GFR was not significantly different between the outcome groups, but significantly (P = .03) increased over time in the surviving, but not in the nonsurviving dogs. Fractional clearance of Na decreased significantly over time (20.2–9.4%, P < .0001) in the surviving, but not in the nonsurviving dogs. The ER and FC of solutes were highly correlated (r, 0.70–0.95).

Conclusion and Clinical Impact

Excretion ratio might be used in the clinical setting as a surrogate marker to follow trends in solute excretion. Increased GFR, urine production, and decreased FC of Na were markers of renal recovery. The FC of Na is a simple, noninvasive, and cost-effective method that can be used to evaluate recovery of renal function.

Caracterização da anemia das doenças inflamatórias em felinos com abcessos, piotorax e necrose lipidica - Characterization of the Anemia of Inflammatory Disease in Cats with Abscesses, Pyothorax, or Fat Necrosis

Characterization of the Anemia of Inflammatory Disease in Cats with Abscesses, Pyothorax, or Fat Necrosis

1. Mareike Ottenjann¹, 
2. Christiane Weingart¹,
3. Gisela Arndt² and
4. Barbara Kohn^1,†

Article first published online: 5 FEB 2008

DOI: 10.1111/j.1939-1676.2006.tb00713.x

Issue

Journal of Veterinary Internal Medicine

Volume 20, Issue 5, pages 1143–1150, September 2006

Total views since August 2010: 0

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Keywords:

• Erythrocyte survival;
• Erythropoietin;
• Feline;
• Inflammation;
• Iron metabolism

The purpose of this study was to describe the anemia of inflammatory disease (AID) in cats with naturally-occurring inflammatory diseases, such as abscesses (n = 12), pyothorax (n = 6), and fat necrosis (n = 3). Exclusion criteria were positive FeLV/FIV tests, neoplasia, nephro-, hepato-or endocrinopathies, and blood loss anemia. CBC, clinical biochemistry, measurements of serum erythropoietin, iron, total iron-binding capacity (TIBC), ferritin, acute phase proteins, erythrocytic osmotic fragility (OF), and Coombs' tests were performed. A decrease in hematocrit of 1–28% (median, 10%) occurred within 3–16 days (median, 8 days). The anemia was mild (n = 11), moderate (n = 8), or severe (n = 2). In most cases it was normocytic normochromic, non-regenerative (n = 18), or mildly regenerative (n = 3). Sixteen cats had leukocytosis and 5 mild hyperbilirubinemia. The Coombs' test results were negative for 8 cats and positive for 1 cat. OF was increased in 2 out of 14 cats. Hypoalbuminemia (n = 18) and hyperglobulinemia (n = 16) resulted in a lowered albumin/globulin-ratio in 19 cats. Iron and TIBC were low in 2/19 and 6/19 cats, respectively. The ferritin concentrations were normal in 7 cats and increased in 12 cats. The acute phase proteins α₁-acid-glycoprotein and haptoglobin were increased in 14/14 and 13/14 cats, respectively. Erythropoietin was normal (n = 4), mildly increased (n = 7) or severely increased (1). Two cats were euthanized due to their underlying disease, 3 cats needed blood transfusions. AID in cats is usually mild to moderate, non-regenerative, and normocytic normochromic. It can be clinically relevant causing severe and transfusion-dependent anemia. AID seems to be multifactorial with evidence of iron sequestration, decreased RBC survival, and insufficient erythropoietin production and bone marrow response. Specific and supportive therapy, including transfusions, can reverse these processes.