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Retrospective Evaluation of the Prognosis and Prevalence of Hyperchloremia in Dogs and Cats
Yu Ueda1, Steven E Epstein2, Kate Hopper2
1Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.
Insights
High corrected chloride concentration (hyper[Cl-]) is common in dogs and cats, increasing their risk of death. Hospital-acquired hyper[Cl-] is particularly dangerous for dogs.
Area of Science:
- Veterinary Medicine
- Clinical Pathology
- Electrolyte Imbalances
Background:
- Hyperchloremia, specifically high corrected chloride concentration (hyper[Cl-]), is an electrolyte abnormality observed in veterinary medicine.
- Understanding its prevalence and impact on patient outcomes is crucial for clinical management.
Purpose of the Study:
- To determine the prevalence and case-fatality rates associated with hyper[Cl-] in dogs and cats.
- To identify primary disease processes linked to hyper[Cl-].
- To differentiate outcomes between prehospital and hospital-acquired hyper[Cl-].
Main Methods:
- A single-center retrospective study analyzed electronic medical records of dogs and cats.
- Data from 17,120 dogs and 4197 cats with simultaneous chloride and sodium measurements were reviewed over 60 months.
- Prevalence, case-fatality rates, and acquisition source (prehospital vs. hospital-acquired) of hyper[Cl-] were calculated.
Main Results:
- Corrected hyper[Cl-] was diagnosed in 21.1% of dogs and 9.1% of cats.
- Animals with corrected hyper[Cl-] had significantly higher case-fatality rates than those with normal corrected chloride levels (p < 0.0001).
- Hospital-acquired hyper[Cl-] was associated with higher case-fatality rates in dogs compared to prehospital hyper[Cl-].
Conclusions:
- Corrected hyper[Cl-] is a prevalent electrolyte abnormality in dogs and cats, linked to increased mortality.
- Hospital-acquired hyper[Cl-] presents a significant risk, especially in canine patients.
- Further research into the morbidity, mortality, and therapeutic interventions for hyper[Cl-] is warranted.
Objective:
To determine the prevalence, case-fatality rate, and primary disease processes associated with high corrected chloride concentration (hyper[Cl-]) in dogs and cats.
Design:
Single-center retrospective study.
Setting:
Electrical medical records were reviewed to identify dogs and cats with at least one chloride and sodium concentration measured simultaneously during a 60-month period.
Animals:
A total of 17,120 dogs and 4197 cats presented to a veterinary teaching hospital.
Interventions:
None.
Measurements And Main Results:
Measured hyper[Cl-] was diagnosed in 18.1% (3092/17,120) dogs and 9.4% (396/4197) cats. Corrected hyper[Cl-] was diagnosed in 21.1% (3607/17,120) dogs and 9.1% (384/4197) cats. The case-fatality rates were higher in animals with corrected hyper[Cl-] than in those with normal corrected [Cl-] (p < 0.0001). The case-fatality rate was higher in dogs with measured hyper[Cl-] than in those with corrected hyper[Cl-] (p = 0.011). Of the dogs and cats with corrected hyper[Cl-], a total of 50.9% (1835/3607) dogs and 38.3% (147/384) cats were categorized as prehospital corrected hyper[Cl-], whereas a total of 39.5% (1424/3607) dogs and 48.7% (187/384) cats with corrected hyper[Cl-] were categorized as hospital-acquired corrected hyper[Cl-]. The case-fatality rate of dogs and cats with hospital-acquired corrected hyper[Cl-] was higher than that of prehospital corrected hyper[Cl-] in dogs (p < 0.0001) but not in cats (p = 0.9). Various primary disease processes, including neurologic and urologic diseases, were identified in animals with corrected hyper[Cl-].
Conclusions:
Corrected hyper[Cl-] was a common electrolyte abnormality identified in dogs and cats, and it was associated with higher case-fatality rates than normal corrected [Cl-]. Hospital-acquired corrected hyper[Cl-] was less common but was associated with a higher case-fatality rate than prehospital corrected hyper[Cl-] in dogs. Further investigation of corrected hyper[Cl-] in association with its morbidity and mortality and the role of therapy to target normal [Cl-] is warranted.
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