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Hypochloremia in cats - prevalence and associated diseases
Florian K Zeugswetter1, Maximilian Pagitz, Mona Sarah Friedrich
1Florian K. Zeugswetter, University of Veterinary Medicine Vienna, University Clinic for Small Animals, Internal Medicine, Veterinärplatz 1, 1210 Vienna, Austria,
Insights
Hypochloremia, a common electrolyte imbalance in cats, affects 27% of hospital patients. This condition is often linked to gastrointestinal issues, diabetes mellitus, and azotemia, necessitating blood-gas analysis for proper diagnosis.
Area of Science:
- Veterinary Medicine
- Internal Medicine
- Clinical Pathology
Background:
- Hypochloremia is an electrolyte disorder characterized by low chloride levels in the blood.
- Identifying the prevalence and underlying causes of hypochloremia in feline populations is crucial for effective clinical management.
Purpose of the Study:
- To determine the prevalence of hypochloremia in a local hospital cat population.
- To investigate potential causes and associated conditions contributing to hypochloremia in cats.
Main Methods:
- A retrospective study analyzing electronic medical records of cats.
- Data collection involved searching for "chloride" and "blood gas analysis" in feline records.
- Medical records were reviewed to identify hypochloremic cats, prior treatments, and underlying diseases, with a control group for comparison.
Main Results:
- Hypochloremia was identified in 27% of cat blood samples, decreasing to 19% after applying a correction formula.
- Vomiting (44%), gastrointestinal diseases, respiratory diseases, azotemia, and diabetes mellitus were common associated conditions.
- An inverse correlation was observed between corrected chloride and standardized base excess and anion gap, with 99% of hypochloremic cats showing acid-base derangements.
Conclusions:
- Hypochloremia is a frequent electrolyte disorder in cats, often requiring a correction formula for accurate assessment.
- The condition is associated with metabolic alkalosis but frequently presents with normal or decreased pH.
- Clinicians should consider blood-gas analysis for hypochloremic cats and include diabetes mellitus and renal disease in diagnostic algorithms.
Objective:
To describe the prevalence and possible causes of hypochloremia in the local hospital cat population.
Material And Methods:
Retrospective study consisting of two parts. Data were collected from the local electronic medical records database using the search terms "chloride" and "cats" (part A), and "blood gas analysis" and "cats" (part B). The medical records of the hypochloremic cats were then reviewed to determine prior treatment or infusions and to identify major underlying disease processes. Part A included an age and gender matched non-hypochloremic control group, whereas in part B acid-base status was assessed.
Results:
Hypochloremia was detected in 367 (27%) of 1363 blood samples. The application of a correction formula to adjust for free water changes decreased the number of hypochloremic cats to 253 (19%). Only a minority had received glucocorticoids or loop diuretics and the prevalence of vomiting was 44%. Common associated disorders were gastrointestinal and respiratory diseases, as well as azotemia and diabetes mellitus. Polyuria/polydipsia, dehydration, prednisolone or furosemide pretreatment, azotemia and diabetes mellitus increased, whereas fluid therapy and the diagnosis of neoplasia decreased the prevalence of hypochloremia. An inverse correlation was found between corrected chloride and standardized base excess (rs = -0.597, p = 0.001) as well as anion gap (rs = -0.4, p = 0.026). 99% of the hypochloremic cats had derangements of acid-base balance.
Conclusion:
Hypochloremia is a common electrolyte disorder in the local cat population. The correction formula is necessary to adjust for changes in plasma osmolality. Although associated with metabolic alkalosis, most of the hypochloremic cats have a normal or decreased pH. The inverse correlation of chloride and anion gap als well as the high proportion of azotemic or diabetic animals support the concept of compensatory acidosis induced hypochloremia.
Clinical Relevance:
Hypochloremia should prompt the clinician to performe blood-gas analysis. Diabetes mellitus (especially ketoacidosis) and renal disease should be included in current algorithms for the evaluation of hypochloremic patients.
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