Abstract
BackgroundThe strong ion model (SIM) is an alternative paradigm in the characterization of acid‐base disturbances particularly in complex disorders.Hypothesis/ObjectivesTo compare the acid‐base changes in dogs with parvoviral enteritis (PE) using the Henderson‐Hasselbalch (HH) approach, with 2 strong ion approaches.AnimalsForty‐four dogs with PE, and 16 age‐matched control dogs.MethodsProspective controlled observational study. Acid‐base status was evaluated using the HH model, Fencl‐Stewart (FS) approach and a validated strong ion model (VDM). The acid‐base changes according to each model were classified and compared. Statistical correlations between pH, CO2, and various SIM variables were performed, as well as between the sum of effects (SOE) of the SIM and the individual variables comprising the SOE.ResultsThe HH model identified acid‐base disorders in 31/44 cases of which 16/31 were mixed with metabolic acidosis and concurrent respiratory alkalosis the most common (10/31). Using the FS approach, metabolic changes were present 36/42 cases, with changes in free water (FW), chloride, and unmeasured anions (UA) being the most prevalent. Both FW and UA correlated well with pH; however, UA were most consistently abnormal in severe acidemia. Similarly to the HH, the VDM detected acid‐base disturbances in 28/44 cases. Major contributors to the acid‐base changes were hyponatremia, hypochloremia, and Atot acidosis because of elevated globulins and increased UA.Conclusions and Clinical ImportanceAcid‐base changes are common and complex in dogs with PE, and were easier to understand using a SIM paradigm. Increases in UA have not been documented in PE in dogs.
Highlights
Acid-base assessment is predominately used in the critical care setting, as a conceptual paradigm of critical illness severity.[1,2] Because acid-base homeostasis is tightly controlled,[3] acid-base disease represents a physiological derangement that has overcome compensatory mechanisms and can be looked at as a critical care “window.” Resolution of the acidbase disorder can be used to track the success of treatment.[1]
In a retrospective study using the strong ion model (SIM), chloride and albumin were found to be important contributors to the metabolic acid-base changes,[5] but the retrospective nature of that study precluded the calculation of the anion gap (AG) and unmeasured anions (UA), and the authors were unable to compare these findings to the HH model
There were no significant differences between the parvoviral enteritis (PE) and control groups for any of the Henderson-Hasselbalch (HH) variables
Summary
Acid-base assessment is predominately used in the critical care setting, as a conceptual paradigm of critical illness severity.[1,2] Because acid-base homeostasis is tightly controlled,[3] acid-base disease represents a physiological derangement that has overcome compensatory mechanisms and can be looked at as a critical care “window.” Resolution of the acidbase disorder can be used to track the success of treatment.[1]. 15 The purpose of the present study was to describe the acid-base changes in PE using both the HH and SIM models, and to compare and contrast the findings. The strong ion model (SIM) is an alternative paradigm in the characterization of acid-base disturbances in complex disorders. Hypothesis/Objectives: To compare the acid-base changes in dogs with parvoviral enteritis (PE) using the Henderson-Hasselbalch (HH) approach, with 2 strong ion approaches. Results: The HH model identified acid-base disorders in 31/44 cases of which 16/31 were mixed with metabolic acidosis and concurrent respiratory alkalosis the most common (10/31). Using the FS approach, metabolic changes were present 36/42 cases, with changes in free water (FW), chloride, and unmeasured anions (UA) being the most prevalent Both FW and UA correlated well with pH; UA were most consistently abnormal in severe acidemia.
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