[Show abstract][Hide abstract] ABSTRACT: In order to determine the influence of pH and storage (7 days at −18 °C) on ionized calcium, potassium, and sodium measurement in feline serum, blood samples from 66 healthy adult cats were obtained based on aerobic method via jugular venipuncture. From each sample, the serum aliquot was divided into two samples: the first sample was processed 30 min after blood collection, and the second was frozen at −18 °C and stored for 7 days before being processed. For each serum sample, ionized calcium, potassium, and sodium were measured together with the pH. Significant differences between fresh and frozen serum samples were found for ionized calcium concentration (the average values were 4.630 ± 0.043 and 4.183 ± 0.058 mg/dl, respectively) and pH (the average values were 7.352 ± 0.007 and 7.519 ± 0.010, respectively). Sodium and potassium serum concentration showed no significant difference between fresh and frozen serum samples. For all parameters, there was no significant difference between males and females between the fresh and frozen serum samples, and therefore, the results for both genders were analyzed together.
[Show abstract][Hide abstract] ABSTRACT: Objective:
To describe 2 cats that developed acute iatrogenic water intoxication, one associated with a continuous infusion of water provided via an esophagostomy tube and one following SC administration of 5% dextrose in water (D5W).
Case or series summary:
A 10-year-old cat with squamous cell carcinoma was hospitalized for treatment of dehydration. Rehydration was provided with water via an esophagostomy tube at 5.7 mL/kg/h. After 30 hours of therapy, the cat was found dull and weak. Serum sodium was markedly decreased at 116 mmol/L (116 mEq/L). Supplemental water was stopped, and IV furosemide and mannitol were provided to eliminate free water. Hypertonic saline (1.5%) was administered IV to rapidly restore the sodium concentration. The serum sodium concentration corrected over 17 hours, and the cat was discharged without neurological complications. The second cat had previously received 300 mL D5W subcutaneously and represented 8 hours later with lethargy and paresis with a serum sodium level of 126 mmol/L (126 mEq/L). Intravenous fluid therapy was provided using 0.9% NaCl. Over the following day, the cat's mentation and paresis resolved and sodium concentrations normalized.
New or unique information provided:
These 2 cases describe a presumed uncommon iatrogenic complication of severe hyponatremia due to water provided either via an esophagostomy tube or subcutaneously. While oral rehydration is often considered ideal, it may result in signs of water intoxication if not carefully monitored; additionally, D5W is never considered an acceptable fluid choice as a SC bolus. If promptly recognized, acute hyponatremia may be corrected rapidly with no lasting consequences.
01/2013; 23(1). DOI:10.1111/vec.12015
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