Today's Veterinary Practice

SEP-OCT 2018

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48 SEPTEMBER/OCTOBER 2018 PEER REVIEWED concentration. Magnesium supplementation should be considered during the management of patients with diabetic ketoacidosis, refractory ventricular arrhythmias, refractory hypokalemia, and renal disease. CONCLUSION Electrolyte disturbances commonly occur in dogs and cats and may carry varying degrees of significance. Certain disorders are associated with increased risk for morbidity and mortality, so it is important to identify and promptly treat electrolyte abnormalities that may be associated with adverse outcomes. 20 Fluid and electrolyte therapy should be tailored to each individual patient and doses calculated as is done with the administration of any drug. Veterinarians have traditionally approached fluid therapy by considering the volemic status of the patient and correcting volume deficits but have paid less attention to ongoing electrolyte abnormalities and administration of electrolyte-balanced solutions to critically ill patients. However, identification of these electrolyte disturbances can be complicated by endogenous or exogenous factors. In particular, failure to identify clinically significant alterations in sodium, potassium, and magnesium may be detrimental to patient care. Thus, clinicians must consider the entire clinical picture when evaluating laboratory results in order to minimize chances of inappropriate management. References 1. Schaer M. Disorders of serum potassium, sodium, magnesium and chloride. J Vet Emerg Crit Care 1999;9:209-217. 2. Burkitt Creedon JM. Sodium disorders. In: Silverstein DC, Hopper K, eds. Small Animal Critical Care Medicine, 2 nd ed. St. Louis: Elsevier; 2015:263-268. 3. Dibartola SP. Disorders of sodium and water: hypernatremia and hyponatremia. In: Dibartola SP, ed. Fluid, Electrolyte and Acid-Base Disorders in Small Animal Practice, 4 th ed. St. Louis: Elsevier; 2012:45- 79. 4. Sakr Y, Rother S, Ferreira AM, et al. Fluctuations in serum sodium level are associated with an increased risk of death in surgical ICU patients. Crit Care Med 2013;41:133-142. 5. Katz MA. Hyperglycemia-induced hyponatremia—calculation of expected serum sodium depression. N Engl J Med 1973;289:843-844. 6. Bruskiewicz KA, Nelson RW, Feldman EC, et al. Diabetic ketosis and ketoacidosis in cats: 42 cases (1980-1995). JAVMA 1997;211:188-192. 7. Hume DZ, Drobatz KJ, Hess RS. Outcome of dogs with diabetic ketoacidosis: 127 dogs (1993-2003). J Vet Intern Med 2006;20:547-555. 8. Koenig A, Drobatz KJ, Beale AB, et al. Hyperglycemic, hyperosmolar syndrome in feline diabetics: 17 cases (1995-2001). J Vet Emerg Crit Care 2004;14:30-40. 9. Trotman TK, Drobatz KJ, Hess RS. Retrospective evaluation of hyperosmolar hyperglycemia in 66 dogs (1993-2008). J Vet Emerg Crit Care (San Antonio) 2013;23:557-564. 10. Riordan LL, Schaer M. Potassium disorders. In: Silverstein DC, Hopper K, eds. Small Animal Critical Care Medicine, 2 nd ed. St. Louis: Elsevier; 2015:269-273. 11. Dibartola SP, De Morais HA. Disorders of potassium: hypokalemia and hyperkalemia. In: Dibartola SP, ed. Fluid, Electrolyte and Acid-Base Disorders in Small Animal Practice, 4 th ed. St. Louis: Elsevier; 2012:92- 119. 12. Gennari FJ. Disorders of potassium homeostasis. Hypokalemia and hyperk alemia. Crit Care Clin 2002;18:273-288, vi. 13. Tag TL, Day TK. Electrocardiographic assessment of hyperkalemia in dogs and cats. J Vet Emerg Crit Care 2008;18:61-67. 14. Sharratt CL, Gilbert CJ, Cornes MC, et al. EDTA sample contamination is common and often undetected, putting patients at unnecessary risk of harm. Int J Clin Pract 2009;63:1259-1262. 15. Humphrey S, Kirby R, Rudloff E. Magnesium physiology and clinical therapy in veterinary critical care. J Vet Emerg Crit Care (San Antonio) 2015;25:210-225. 16. Martin LG, Allen-Durrance AE. Magnesium and phosphate disorders. In: Silverstein DC, Hopper K, eds. Small Animal Critical Care Medicine, 2 nd ed. St. Louis: Elsevier; 2015:281-288. 17. al-Ghamdi SM, Cameron EC, Sutton RA. Magnesium deficiency: pathophysiologic and clinical overview. Am J Kidney Dis 1994;24:737- 752. 18. Schenck PA. Fractionation of canine serum magnesium. Vet Clin Pa thol 2005;34:137-139. 19. Toll J, Erb H, Birnbaum N, et al. Prevalence and incidence of serum magnesium abnormalities in hospitalized cats. J Vet Intern Med 2002;16:217-221. 20. Goggs R, De Rosa S, Fletcher DJ. Electrolyte disturbances are associated with non-survival in dogs–a multivariable analysis. Front Vet Sci 2017;4:135. Leo Londoño Leo Londoño, DVM, DACVECC, is a clinical assistant professor of emergency and critical care and director of the hemodialysis unit at University of Florida. He received his DVM from UF and completed his residency in emergency and critical care at UF after completing a rotating internship at Hollywood animal hospital in south Florida. His research interests include renal and non-renal applications of extracorporeal purification techniques, endothelial and glycocalyx pathophysiology in the critically ill, and hospital- acquired acute kidney injury. Jennifer Martinez Jennifer Martinez is a resident in small animal emergency and critical care at the University of Florida. Jennifer attended Duke University for her undergraduate degree and earned her DVM from Ohio State University, graduating Magna Cum Laude in 2015. She then completed a rotating internship at Michigan State University, followed by an emergency and critical care specialty internship at UF prior to beginning her residency in 2017. Her research interests include hospital-acquired acute kidney injury and extracorporeal blood purification techniques.

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