Related Experiment Video
Updated: Nov 26, 2025
Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
Correction of serum chloride concentration in dogs with congestive heart failure
Darcy Adin1, Clarke Atkins2, Leonel Londoño1
1University of Florida, College of Veterinary Medicine, Gainesville, Florida, USA.
Insights
In dogs with advanced heart failure, corrected chloride levels were higher than measured levels, indicating water retention. However, hypochloremia persisted due to diuretic effects.
Area of Science:
- Veterinary Cardiology
- Canine Pathophysiology
- Electrolyte Imbalances
Background:
- Hypochloremia in dogs with congestive heart failure (CHF) is complex, influenced by loop diuretics causing sodium and chloride loss and water retention causing dilution.
- Mathematical correction of chloride levels can help differentiate these effects.
Purpose of the Study:
- To evaluate if corrected chloride levels (c[Cl-]) differ from measured chloride levels (m[Cl-]) in dogs with varying stages of CHF.
- To determine if higher c[Cl-] compared to m[Cl-] in refractory CHF indicates relative water excess.
Main Methods:
- Retrospective analysis of clinicopathological data from dogs with no CHF, Stage C CHF, and Stage D CHF.
- Calculation of c[Cl-] using a formula based on sodium levels and m[Cl-].
- Comparison of c[Cl-] and m[Cl-] across different CHF stages.
Main Results:
- Serum chloride levels (both corrected and measured) were significantly lower in Stage D CHF dogs compared to Stage C and no CHF dogs.
- Corrected chloride levels were higher than measured levels in Stage D CHF dogs, but not in Stage C or no CHF dogs.
- While corrected chloride levels suggested relative water excess in Stage D CHF, persistent hypochloremia was noted, consistent with diuretic use.
Conclusions:
- Mathematical correction of serum chloride levels revealed a relative water excess in dogs with Stage D CHF.
- Despite evidence of water retention, hypochloremia persisted in advanced CHF, likely due to the effects of loop diuretics on electrolytes.
- Further research correlating corrected chloride levels with antidiuretic hormone is recommended.
Background:
Hypochloremia associated with congestive heart failure (CHF) in dogs is likely multifactorial. Loop diuretics cause 1:2 sodium [Na+ ]:chloride [Cl- ] loss, whereas water retention causes a 1:1 [Na+ ]:[Cl- ] dilution. Mathematical [Cl- ] correction separates these effects on [Cl- ].
Hypothesis:
We hypothesized that corrected [Cl- ] (c[Cl- ]) would not differ from measured [Cl- ] (m[Cl- ]) in dogs with controlled CHF because of loop diuretics, and dogs with refractory CHF would have higher c[Cl- ] than m[Cl- ], indicating relative water excess.
Animals:
Seventy-one client-owned dogs with acquired heart disease, without CHF (NO-CHF), 76 with Stage C CHF and 24 with Stage D CHF.
Methods:
Clinicopathological data from a previous study were retrospectively analyzed. Corrected [Cl- ], m[Cl- ], and differences were compared among NO-CHF, Stage C CHF, and Stage D CHF, using the formula: c[Cl- ] = (mid-reference range [Na+ ]/measured [Na+ ]) × m[Cl- ].
Results:
Corrected [Cl- ] and m[Cl- ] were lower in Stage D vs Stage C and NO-CHF (all P < .0001). The c[Cl- ] was higher than m[Cl- ] in Stage D (P < .0001) but not Stage C or NO-CHF. Median difference between c[Cl- ] and m[Cl- ] was higher for Stage D vs Stage C (P = .0003). No hypochloremic Stage D dogs had normal c[Cl- ], but 11/24 had [Cl- ] that was increased by >2 mmol/L.
Conclusions And Clinical Importance:
Serum [Cl- ] increased after mathematical correction in Stage D CHF dogs but not in Stage C and NO-CHF dogs. Although c[Cl- ] was higher than m[Cl- ] in Stage D dogs supportive of relative water excess, hypochloremia persisted, consistent with concurrent loop diuretic effects on electrolytes. Future study correlating c[Cl- ] to antidiuretic hormone concentrations is warranted.
More Related Videos
08:39Ferric Chloride-induced Canine Carotid Artery Thrombosis: A Large Animal Model of Vascular Injury
Published on: September 7, 2018
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
01:22Heart Failure Drugs: Diuretics
01:30Heart Failure V: Medical Management
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:28Mitral Regurgitation IV: Nursing Management