Risk Factors for the Development of Hypokalemia in Neonatal Diarrheic Calves

Background Nonantibiotic alternatives providing local gut immunity have been recommended for managing calf diarrhea. Animals One hundred and two calves with diarrhea. Hypothesis Oral supplementation with immunoglobulins in calves with diarrhea will reduce time to resolution of diarrhea, number of treatment events, and mortality rate. Methods Randomized controlled trial. Calves were assigned into 1 of 3 groups. The treatment group was supplemented with 20 g of immunoglobulins in milk twice daily for 14 days. The placebo group was supplemented with 20 g of a product with similar nutritional value as the treatment group, but without immunoglobulins, in milk, twice daily for 14 days. The control group received no supplements. Medical treatments, time to resolution of diarrhea, and case fatality rates were compared. Results There was no difference in the proportion of treatment events (treatment, 79% versus placebo, 77% versus control, 71%) among groups ( P = .69). The median time to resolution of diarrhea was not different between the treatment (10.5 days; 95% confidence interval [CI], 7, 13) and control (8 days; 95% CI, 5, 10) groups ( P = .08) or between the placebo (6.5 days; 95% CI, 3, 9) and control groups ( P = .89). Median time to resolution was shorter ( P = .008) in the placebo compared to the treatment group (6.5 versus 10.5 days). Case fatality rates among groups (treatment, 12% versus placebo, 3% versus control, 3%) were not different ( P = .36). Conclusions and Clinical Importance Expected benefits of conferring local gut immunity by immunoglobulin supplementation in calves with diarrhea were not evident.

Section: Discussionmentioning

confidence: 99%

Randomized controlled clinical trial on the effect of oral immunoglobulin supplementation on neonatal dairy calves with diarrhea

Chung

Rayburn

Chigerwe

2019

“…Additionally segmented linear regression 38,39 was used to characterize the relationship between each ECG variable of interest and cK 1 by sequentially modeling the ECG variable-plasma cK 1 relationship using 3 models. Because the focus of the study was on the ECG changes in hyperkalemia, data from calves with hypokalemia (plasma cK 1 <3.9 mmol/L) 6 were not included in this statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Acidemia and metabolic acidosis are frequently evident in diarrheic calves and are typically characterized by a low strong ion difference as a result of hyponatremia (accompanied by normochloremia or hyperchloremia) and an increase of unmeasured anions such as d ‐lactate . Although neonatal diarrheic calves have a negative potassium balance because of intestinal potassium losses and low milk intake, they usually have normokalemic or hyperkalemic plasma concentrations in the presence of acidemia, with hypokalemia being infrequently observed …”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic findings in 130 hospitalized neonatal calves with diarrhea and associated potassium balance disorders

Trefz

Lorenz

Constable

2018

BackgroundHyperkalemia in neonatal diarrheic calves can potentially result in serious cardiac conduction abnormalities and arrhythmias.ObjectivesTo document electrocardiographic (ECG) findings and the sequence of ECG changes that are associated with increasing plasma potassium concentrations (cK+) in a large population of neonatal diarrheic calves.AnimalsOne hundred and thirty neonatal diarrheic calves (age ≤21 days).MethodsProspective observational study involving calves admitted to a veterinary teaching hospital.ResultsHyperkalemic calves (cK+: 5.8‐10.2, blood pH: 6.55‐7.47) had significantly (P < .05) longer QRS durations as well as deeper S wave, higher T wave, and higher ST segment amplitudes in lead II than calves, which had both venous blood pH and cK+ within the reference range. The first ECG changes in response to an increase in cK+ were an increase in voltages of P, Ta, S, and T wave amplitudes. Segmented linear regression indicated that P wave amplitude decreased when cK+ >6.5 mmol/L, S wave amplitude voltage decreased when cK+ >7.4 mmol/L, QRS duration increased when cK+ >7.8 mmol/L, J point amplitude increased when cK+ >7.9 mmol/L, and ST segment angle increased when cK+ >9.1 mmol/L. P wave amplitude was characterized by a second common break point at cK+ = 8.2 mmol/L, above which value the amplitude was 0.Conclusions and Clinical ImportanceHyperkalemia in neonatal diarrheic calves is associated with serious cardiac conduction abnormalities. In addition to increased S and T wave amplitude voltages, alterations of P and Ta wave amplitudes are early signs of hyperkalemia, which is consistent with the known sensitivity of atrial myocytes to increased cK+.

“…Electrolyte imbalances are also common in diarrheic calves and are closely linked to derangements of acid‐base status 2, 4, 5, 6. Although neonatal diarrheic calves have a negative potassium balance due to intestinal losses and low milk intake,7 they usually have normo‐ or hyperkalemic plasma concentrations in the presence of acidemia 4, 8.…”

mentioning

confidence: 99%

“…[1][2][3] Electrolyte imbalances are also common in diarrheic calves and are closely linked to derangements of acid-base status. 2,[4][5][6] Although neonatal diarrheic calves have a negative potassium balance due to intestinal losses and low milk intake, 7 they usually have normo-or hyperkalemic plasma concentrations in the presence of acidemia. 4,8 Hyperkalemia is a clinically relevant electrolyte imbalance in diarrheic calves and has historically been attributed to impaired intracellular translocation of potassium ions due to acidemia and decreased intracellular pH.…”

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confidence: 99%

Effect of Intravenous Small‐Volume Hypertonic Sodium Bicarbonate, Sodium Chloride, and Glucose Solutions in Decreasing Plasma Potassium Concentration in Hyperkalemic Neonatal Calves with Diarrhea

Trefz

Constable

Lorenz

2017

Self Cite

BackgroundHyperkalemia is a frequently observed electrolyte imbalance in dehydrated neonatal diarrheic calves that can result in skeletal muscle weakness and life‐threatening cardiac conduction abnormalities and arrhythmias.HypothesisIntravenous administration of a small‐volume hypertonic NaHCO3 solution is clinically more effective in decreasing the plasma potassium concentration (cK) in hyperkalemic diarrheic calves than hypertonic NaCl or glucose solutions.AnimalsTwenty‐two neonatal diarrheic calves with cK >5.8 mmol/L.MethodsProspective randomized clinical trial. Calves randomly received either 8.4% NaHCO3 (6.4 mL/kg BW; n = 7), 7.5% NaCl (5 mL/kg BW; n = 8), or 46.2% glucose (5 mL/kg BW; n = 7) IV over 5 minutes and were subsequently allowed to suckle 2 L of an electrolyte solution. Infusions with NaHCO3 and NaCl provided an identical sodium load of 6.4 mmol/kg BW.ResultsHypertonic NaHCO3 infusions produced an immediate and sustained decrease in plasma cK. Hypertonic glucose infusions resulted in marked hyperglycemia and hyperinsulinemia, but cK remained unchanged for 20 minutes. Between 30 and 120 minutes after initiation of treatment, the most marked decrements in cK from baseline occurred in group NaHCO3, which were significantly (P < .05) larger during this period of time than in calves in group NaCl, but not group glucose. After 120 minutes, the mean decrease in cK from baseline was −26 ± 10%, −9 ± 8%, and −22 ± 6% in groups NaHCO3, NaCl, and glucose, respectively.Conclusions/Clinical ImportanceSmall‐volume hypertonic NaHCO3 infusions appear to have clinical advantages for the rapid resuscitation of hyperkalemic diarrheic calves, compared to hypertonic NaCl or glucose solutions.