Metabolic alkalosis

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Vomiting, the most common cause of metabolic alkalosis in dogs[1]

Metabolic alkalosis, defined as a venous pH > 8.0, is relatively uncommon in dogs[2].

The opposite condition is metabolic acidosis.

Metabolic alkalosis is characterized by an increase in plasma bicarbonate concentration < 24 mEq/L, with low H+ concentrations, high pH and a compensatory increase in CO2 tension.

Concurrent hypochloremia, hypokalemia, hyponatremia and hypoalbuminemia[3] are commonly observed.

It occurs as a result of loss of Cl- and H+ ion-rich fluids from the alimentary tract or kidneys and is usually accompanied by volume depletion.

Causes include:

Clinical signs may vary depending on metabolic cause, but specific signs may include muscle weakness, dehydration, cardiac arrhythmias, ileus and rarely, seizures.

Diagnosis is often based on hematological findings, augmented with blood gas analysis for the qualitative and quantitative assessment of both metabolic and respiratory alkalosis[10].

Treatment usually requires administration of 0.9% saline solutions with adjunctive KCl. Patients with concurrent hypokalemia may require larger doses of KCl.

References

  1. The Valiens
  2. de Morais HA et al (2008) Metabolic acid-base disorders in the critical care unit. Vet Clin North Am Small Anim Pract 38(3):559-574
  3. Spevakow AB et al (2010) Chronic mesenteric volvulus in a dog. Can Vet J 51(1):85-88
  4. Lopez I et al (2003) Direct suppressive effect of acute metabolic and respiratory alkalosis on parathyroid hormone secretion in the dog. J Bone Miner Res 18(8):1478-1485
  5. Boag AK et al (2005) Acid-base and electrolyte abnormalities in dogs with gastrointestinal foreign bodies. J Vet Intern Med 19(6):816-821
  6. Westerlind A et al (1994) Effects of metabolic pH-alterations on cerebral blood flow and oxygen uptake following E. coli endotoxin in dogs. Acta Anaesthesiol Scand 38(2):130-135
  7. Davies DR et al (2008) Hypokalaemic paresis, hypertension, alkalosis and adrenal-dependent hyperadrenocorticism in a dog. Aust Vet J 86(4):139-146
  8. Roberts PA et al (2002) Bicarbonate-induced alkalosis augments cellular acetyl group availability and isometric force during the rest-to-work transition in canine skeletal muscle. Exp Physiol 87(4):489-498
  9. Taylor SM et al (2009) Evaluations of labrador retrievers with exercise-induced collapse, including response to a standardized strenuous exercise protocol. J Am Anim Hosp Assoc 45(1):3-13
  10. Proulx J et al (1999) Respiratory monitoring: arterial blood gas analysis, pulse oximetry, and end-tidal carbon dioxide analysis. Clin Tech Small Anim Pract 14(4):227-230
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