Ionized Hypocalcemia in Critically Ill Dogs

Abstract

Background: Ionized hypocalcemia (iHCa) is a common electrolyte disturbance in critically ill people, especially those with sepsis. The cause of the iHCa is not entirely understood and is likely multifactorial. Critically ill people with iHCa have longer hospital stays and higher mortality rates compared to people with normocalcemia. There are no published clinical studies evaluating the incidence and impact of iHCa in critically ill dogs.Hypothesis: iHCa occurs in critically ill dogs, is more prevalent in dogs with systemic inflammatory response syndrome (SIRS) or sepsis, and is associated with longer hospital stays and higher mortality.Animals: One hundred and forty-one client-owned dogs admitted to a companion animal intensive care unit (ICU) in a veterinary teaching hospital.Methods: Prospective observational study of sequentially enrolled dogs. Blood was collected and analyzed within an hour of admission from all dogs presented to the ICU that met study inclusion criteria.Results: The incidence of iHCa (iCa o 1.11 mmol/L) was 16%. The presence of iHCa was associated with longer ICU (P 5 .038) and hospital (P 5 .012) stays but not with decreased survival (P 5 .60). Dogs with sepsis as defined by !3 SIRS criteria and a positive culture were more likely to have iHCa (P 5 .050).Conclusions and Clinical Relevance: In dogs not previously treated with fluids or blood products intravenously, the finding of iHCa upon admission to the ICU predicted a longer duration of ICU and hospital stay. Septic dogs with positive cultures were more likely to have iHCa.

Ionized hypocalcemia as a prognostic indicator in dogs following trauma

“…To date, veterinary studies investigating the incidence and etiology of iHCa in dogs with traumatic injuries and its impact on morbidity and mortality have not been reported. A prospective study investigating iCa in critically ill dogs demonstrated a 16% incidence of iHCa; 13 dogs admitted for traumatic injuries were included but those dogs did not have an increased incidence of iHCa compared to other dogs in the study …”

Practical Interpretation and Application of Exocrine Pancreatic Testing in Small Animals

“…Decreased calcium has also been documented in dogs with acute pancreatitis and has been suggested to carry a poorer prognosis. 7,8 Many dogs with acute pancreatitis have gross lipemia, whether as a cause or consequence of the disease (Fig. 3).…”

Canine hypoparathyroidism: case report

“…The measuring of ionized calcium must be performed exclusively with heparinized total blood or plasma samples for describes (Holowaychuk et al, 2009). The measuring of intact PTH was validated in both dogs and cats, and it is extremely useful in the diagnosis of primary hypoparathyroidism, as well as for discarding other causes of hypocalcemia (Barber et al, 1993;Gear et al, 2005).…”