Clinical use of sodium bicarbonate in small animals: indications, electrolyte changes and survival outcome

The objective of the study was to describe the use of sodium bicarbonate in dogs and cats.

Retrospective descriptive study of animals administered sodium bicarbonate from 2019 to 2023 in a university teaching hospital. Data collected included clinical use, dose and infusion duration, pre- and post- sodium bicarbonate venous blood gas values and perfusion parameters and outcome.

Twenty-five dogs and 28 cats were identified. Kidney disease was the most common indication for sodium bicarbonate administration in dogs and cats. The median dose of sodium bicarbonate administered in dogs and cats was 2.12 mEq/kg (range: 0.68 to 6.48 mEq/kg) and 2.49 mEq/kg (range: 1 to 6.48 mEq/kg), respectively. The most common dilution of sodium bicarbonate administered was 1 mL sodium bicarbonate diluted with 6 mL of sterile water, and the median infusion time was 6 hours (range <1 to 24 hours). The overall mean pH was significantly higher following sodium bicarbonate administration (N = 46; pH 7.020 vs. 7.128). Ionised hypocalcaemia following sodium bicarbonate was identified in 33% (15/46) of animals. Hypernatraemia was rare (N = 2). There was no correlation between sodium bicarbonate dose with change in pH, HCO₃, ionised calcium, sodium or potassium. There was no significant association with sodium bicarbonate dose and survival (OR: 0.724, 95% CI 0.410 to 1.277) or pH change and survival (OR: 0.676, 95% CI 0.323 to 1.410).

This study provides a description of current indications, dosing and electrolyte changes that may occur in animals administered sodium bicarbonate.