Hello NAVE crew! In this video lesson from the webserie Vet Anesthesia Unravelled we gonna talk about the main Electrolyte Disorders in animals.
Sodium
It is the main electrolyte in the extracellular fluid and disorders in the concentration of this anion will alter blood osmolarity. Hypernatremia basically occurs due to water deficit, intense and prolonged fever, osmotic diuretics therapy, diabetes insipidus, extensive burns and diet with sodium in excess. The most common clinical sign is thirst and the most serious are lethargy, weakness, intracranial haemorrhage, seizures and coma.
Hyponatremia occurs from overuse of diuretics, hypotonic or isotonic crystalloids fast infusions, vomiting, diarrhoea, kidney failure, excessive stomach lavage, and exhaustion from physical exercise. Common signs are peripheral and CNS oedema, resulting in lethargy, acute blindness, tremors, seizures, and coma.
Chloride
It is the main anion in the extracellular fluid and usually follows the Na+ concentration, being slightly lower. Hyperchloremia can occur in metabolic acidosis, diarrhoea, or NaCl 0.9% in excess. Hypochloremia, on the other hand, can be associated with metabolic alkalosis and in cases of hyperemesis, in which the animal loses a lot of HCl, and also with the use of loop diuretics.
Potassium
It is the main electrolyte of intracellular fluid. Hyperkalemia can be observed mainly in situations of renal obstruction or uroperitoneum, in which there is no potassium excretion, or in hypoadrenocorticism. It can also be observed in massive cellular injuries, in which there is hemolysis and, with that, potassium is released by muscle cells. Hyperkalemia also occurs due to the translocation of potassium to retain hydrogen, trying to minimize the condition of metabolic acidosis. The most common clinical signs are muscle weakness, bradycardia, and we can see on the ECG a tall and sharp T wave, and a wide QRS complex.
Hypokalemia is frequently seen in anorexic patients presenting with emesis, or with diuretics such as furosemide. It may also be associated with excess aldosterone, which stimulates the kidneys to retain Na+ and excrete K+. The main signs are depression, muscle weakness and tachyarrhythmias.
Calcium
It is one of the most important chemical elements in the body, but practically 99% of it is part of the bone composition, that is, it is difficult to mobilize. The rest is called ionized calcium, which is responsible for muscle contractility, cell permeability and homeostasis. Therefore, a clinical analysis should be based on ionized calcium.
Hypercalcemia can be seen in lymphomas, lymphosarcomas, hypervitaminosis D, and Solanum malacoxylom poisoning. The main clinical signs are anorexia, nausea and emesis, polyuria and polydipsia. In addition, drowsiness, mental confusion and torpor, even death, may be observed. On ECG, bradycardia, AV block and shortening of the QT interval are observed.
Hypocalcemia is much more common in infants, especially in high milk-producing cows. It is known as "parturient paresis" and occurs within 48 hours postpartum. This is associated with a rapid drop in serum calcium levels, leading to incoordination, paresis and recumbency. Hypocalcemia could be present in chronic renal failure and hypovitaminosis D. The common clinical signs of hypocalcemia are fasciculations, excitation, hypersensitivity, disorientation, opisthotonos, tachycardia, polyuria and polydipsia.
Find out more in this video!
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Additional Material
- DiBartola S. Fluid, electrolyte, and acid-base disorders in small animal practice. 4th ed, 744p, 2011.
- Drobatz et al. J Vet Emerg Critic Care 18:355-61,2008.
- Teixeira-Neto FJ, Garofalo NA. Fluidoterapia, equilíbrio ácido-base e eletrolítico em grandes animais. In: Luna SPL, Carregaro AB. Anestesia e Analgesia em Equídeos, Ruminantes e Suínos, 1a ed, 33-52, 2019.
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