DOI QR코드

DOI QR Code

A comparison of traditional and quantitative analysis of acid-base and electrolyte imbalance in 87 cats

  • Chun, Daseul (College of Veterinary Medicine, Gyeongsang National University) ;
  • Yu, DoHyeon (College of Veterinary Medicine, Gyeongsang National University)
  • Received : 2021.09.08
  • Accepted : 2021.11.29
  • Published : 2021.12.31

Abstract

Acid-base disorder is a common problem in veterinary emergency and critical care. Traditional methods, as well as the Stewart method based on strong ion difference concepts and the Fencl-Stewart method, can be used to analyze the underlying causes. On the other hand, there are insufficient comparative study data on these methods in cats. From 2018 to 2020, 327 acid-base analysis data were collected from 69 sick and 18 healthy cats. The three most well-known methods (traditional method, Stewart method, and Fencl-Stewart method) were used to analyze the acid-base status. The frequency of acid-base imbalances and the degree of variation according to the disease were also evaluated. In the traditional acid-base analysis, 5/69 (7.2%) cats showed a normal acid-base status, and 23.2% and 40.6% of the simple and mixed disorders, respectively. The Fencl-Stewart method showed changes in both the acidotic and alkalotic processes in 64/69 (92.8%), whereas all cats showed an abnormal status in the Fencl-Stewart method (semiquantitative approach). The frequencies of the different acid-base imbalances were identified according to the analysis method. These findings can assist in analyzing the underlying causes of acid-base imbalance and developing the appropriate treatment.

Keywords

Acknowledgement

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT & Future Planning (2020R1C1C1008675).

References

  1. de Morais HA, Bach JF, DiBartola SP. Metabolic acid-base disorders in the critical care unit. Vet Clin North Am Small Anim Pract 2008;38:559-574. https://doi.org/10.1016/j.cvsm.2008.02.003
  2. Ha YS, Hopper K, Epstein SE. Incidence, nature, and etiology of metabolic alkalosis in dogs and cats. J Vet Intern Med 2013;27:847-853. https://doi.org/10.1111/jvim.12122
  3. Hopper K, Epstein SE, Kass PH, Mellema MS. Evaluation of acid-base disorders in dogs and cats presenting to an emergency room. Part 2: comparison of anion gap, strong ion gap, and semiquantitative analysis. J Vet Emerg Crit Care (San Antonio) 2014;24:502-508. https://doi.org/10.1111/vec.12214
  4. Hopper K. Respiratory acid-base disorders in the critical care unit. Vet Clin North Am Small Anim Pract 2017;47:351-357. https://doi.org/10.1016/j.cvsm.2016.09.006
  5. Hume DZ, Drobatz KJ, Hess RS. Outcome of dogs with diabetic ketoacidosis: 127 dogs (1993-2003). J Vet Intern Med 2006;20:547-555. https://doi.org/10.1892/0891-6640(2006)20[547:OODWDK]2.0.CO;2
  6. Hayes G, Mathews K, Doig G, Kruth S, Boston S, Nykamp S, Poljak Z, Dewey C. The Feline Acute Patient Physiologic and Laboratory Evaluation (Feline APPLE) Score: a severity of illness stratification system for hospitalized cats. J Vet Intern Med 2011;25:26-38. https://doi.org/10.1111/j.1939-1676.2010.0648.x
  7. Stillion JR, Fletcher DJ. Admission base excess as a predictor of transfusion requirement and mortality in dogs with blunt trauma: 52 cases (2007-2009). J Vet Emerg Crit Care (San Antonio) 2012;22:588-594. https://doi.org/10.1111/j.1476-4431.2012.00798.x
  8. Constable PD. Clinical assessment of acid-base status: comparison of the Henderson-Hasselbalch and strong ion approaches. Vet Clin Pathol 2000;29:115-128. https://doi.org/10.1111/j.1939-165x.2000.tb00241.x
  9. De Caro Carella C, de Morais HA. Compensation for acid-base disorders. Vet Clin North Am Small Anim Pract 2017;47:313-323. https://doi.org/10.1016/j.cvsm.2016.11.003
  10. Fidkowski C, Helstrom J. Diagnosing metabolic acidosis in the critically ill: bridging the anion gap, Stewart, and base excess methods. Can J Anaesth 2009;56:247-256. https://doi.org/10.1007/s12630-008-9037-y
  11. Fencl V, Jabor A, Kazda A, Figge J. Diagnosis of metabolic acid-base disturbances in critically ill patients. Am J Respir Crit Care Med 2000;162:2246-2251. https://doi.org/10.1164/ajrccm.162.6.9904099
  12. Stewart PA. Modern quantitative acid-base chemistry. Can J Physiol Pharmacol 1983;61:1444-1461. https://doi.org/10.1139/y83-207
  13. Constable PD. Clinical assessment of acid-base status: strong ion difference theory. Vet Clin North Am Food Anim Pract 1999;15:447-471. https://doi.org/10.1016/S0749-0720(15)30158-4
  14. Adrogue HJ, Madias NE. Assessing acid-base status: physiologic versus physicochemical approach. Am J Kidney Dis 2016;68:793-802. https://doi.org/10.1053/j.ajkd.2016.04.023
  15. Hopper K. Nontraditional Acid-Base Analysis. In: Silverstein D, Hopper K, eds. Small Animal Critical Care Medicine. 2nd ed. pp. 296-299, Elsevier, St. Louis, 2015.
  16. Hopper K, Epstein SE, Kass PH, Mellema MS. Evaluation of acid-base disorders in dogs and cats presenting to an emergency room. Part 1: comparison of three methods of acid-base analysis. J Vet Emerg Crit Care (San Antonio) 2014;24:493-501. https://doi.org/10.1111/vec.12215
  17. Dubin A, Menises MM, Masevicius FD, Moseinco MC, Kutscherauer DO, Ventrice E, Laffaire E, Estenssoro E. Comparison of three different methods of evaluation of metabolic acid-base disorders. Crit Care Med 2007;35:1264-1270. https://doi.org/10.1097/01.CCM.0000259536.11943.90
  18. Boniatti MM, Cardoso PR, Castilho RK, Vieira SR. Acid-base disorders evaluation in critically ill patients: we can improve our diagnostic ability. Intensive Care Med 2009;35:1377-1382. https://doi.org/10.1007/s00134-009-1496-2
  19. Siggaard-Andersen O. The van Slyke equation. Scand J Clin Lab Invest Suppl 1977;146:15-20. https://doi.org/10.3109/00365517709098927
  20. Maehle K, Haug B, Flaatten H, Nielsen E. Metabolic alkalosis is the most common acid-base disorder in ICU patients. Crit Care 2014;18:420. https://doi.org/10.1186/cc13802
  21. Johnson RA, Autran de Morais H. Respiratory Acid-Base Disorders. In: DiBartola S, ed. Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice. 4th ed. pp. 292-298, Elsevier, St Louis, 2012.
  22. Pillai SR, Damaghi M, Marunaka Y, Spugnini EP, Fais S, Gillies RJ. Causes, consequences, and therapy of tumors acidosis. Cancer Metastasis Rev 2019;38:205-222. https://doi.org/10.1007/s10555-019-09792-7
  23. Kluge S, de Heer G, Jarczak D, Nierhaus A, Fuhrmann V. Lactic acidosis: update 2018. Dtsch Med Wochenschr 2018;143:1082-1085. https://doi.org/10.1055/a-0585-7986
  24. Khanna A, Kurtzman NA. Metabolic alkalosis. Respir Care 2001;46:354-365.
  25. Boag AK, Coe RJ, Martinez TA, Hughes D. Acid-base and electrolyte abnormalities in dogs with gastrointestinal foreign bodies. J Vet Intern Med 2005;19:816-821. https://doi.org/10.1892/0891-6640(2005)19[816:AAEAID]2.0.CO;2
  26. Muir WW. Acid-base and electrolyte disturbances in dogs with gastric dilatation-volvulus. J Am Vet Med Assoc 1982;181:229-231.
  27. Robinson EP, Hardy RM. Clinical signs, diagnosis, and treatment of alkalemia in dogs: 20 cases (1982-1984). J Am Vet Med Assoc 1988;192:943-949.
  28. Grantham JJ, Schloerb PR. Acute subtraction alkalosis from gastric juice loss in dogs. Am J Physiol 1964;207:619-626. https://doi.org/10.1152/ajplegacy.1964.207.3.619
  29. Bachmann K, Kutter AP, Schefer RJ, Marly-Voquer C, Sigrist N. Determination of reference intervals and comparison of venous blood gas parameters using standard and non-standard collection methods in 24 cats. J Feline Med Surg 2017;19:831-840. https://doi.org/10.1177/1098612X16663269
  30. Vanova-Uhrikova I, Rauserova-Lexmaulova L, Rehakova K, Scheer P, Doubek J. Determination of reference intervals of acid-base parameters in clinically healthy dogs. J Vet Emerg Crit Care (San Antonio) 2017;27:325-332. https://doi.org/10.1111/vec.12589
  31. Tamura J, Itami T, Ishizuka T, Fukui S, Miyoshi K, Sano T, Yamashita K. Central venous blood gas and acid-base status in conscious dogs and cats. J Vet Med Sci 2015;77:865-869. https://doi.org/10.1292/jvms.14-0503
  32. Chew DJ, Leonard M, Muir WW 3rd. Effect of sodium bicarbonate infusion on serum osmolality, electrolyte concentrations, and blood gas tensions in cats. Am J Vet Res 1991;52:12-17.