Difference between revisions of "Hypophosphatemia"

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Hypophosphatemia is defined as a sustained decreased circulating blood phosphorus ≤ 2.5 (normal is 2.5 - 7.7).
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Hypophosphatemia is defined as a sustained decreased circulating blood phosphorus ≤ 2.5 mg/dL (normal is 2.5 - 7.7).
  
 
Hypophosphatemia is often associated with:
 
Hypophosphatemia is often associated with:
 +
*Dietary phosphorus deficiency<ref>Taylor MB ''et al'' (2009) Diffuse osteopenia and myelopathy in a puppy fed a diet composed of an organic premix and raw ground beef. ''J Am Vet Med Assoc'' '''234(8)''':1041-1048</ref>
 
*[[Hypocalcemia]] in dogs with [[puerperal hypocalcemia|milk fever]]
 
*[[Hypocalcemia]] in dogs with [[puerperal hypocalcemia|milk fever]]
 +
*Hypomagnesemia<ref>Dhupa N & Proulx J (1998) Hypocalcemia and hypomagnesemia. ''Vet Clin North Am Small Anim Pract'' '''28(3)''':587-608</ref>
 
*[[Fanconi's syndrome]]
 
*[[Fanconi's syndrome]]
*Primary [[hyperparathyroidism]]
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*Primary [[hyperparathyroidism]]<ref>Feldman EC ''et al'' (2005) Pretreatment clinical and laboratory findings in dogs with primary hyperparathyroidism: 210 cases (1987-2004). ''J Am Vet Med Assoc'' '''227(5)''':756-761</ref>
*[[Chronic renal failure]].
+
*Primary [[hyperaldosteronism]]<ref>Rijnberk A ''et al'' (2001) Aldosteronoma in a dog with polyuria as the leading symptom. ''Domest Anim Endocrinol'' '''20(3)''':227-240</ref>
*[[inflammatory bowel disease]]
+
*[[Chronic renal failure]]
 +
*[[Inflammatory bowel disease]]
 
*Vomiting or diarrhea
 
*Vomiting or diarrhea
 
*Phosphate-binding antacids
 
*Phosphate-binding antacids
 
*Vitamin D deficiency
 
*Vitamin D deficiency
*[[Diabetes mellitus]]
+
*[[Diabetes mellitus]] with or without [[ketoacidosis]]<ref>Nichols R (1997) Complications and concurrent disease associated with diabetes mellitus. ''Semin Vet Med Surg (Small Anim)'' '''12(4)''':263-267</ref>
 
*[[Hyperadrenocorticism]]
 
*[[Hyperadrenocorticism]]
 
*[[Renal dysplasia]]
 
*[[Renal dysplasia]]
 
*Diuretic administration
 
*Diuretic administration
*[[Hyperaldosteronism]]
 
 
*[[Hypercalcemia|Hypercalcemia of malignancy]]
 
*[[Hypercalcemia|Hypercalcemia of malignancy]]
 
*[[Refeeding syndrome]]
 
*[[Refeeding syndrome]]
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:- Xylitol - concurrent [[hypokalemia]] and [[hypercalcemia]]<ref>Xia Z ''et al'' (2009) Experimental acute toxicity of xylitol in dogs. ''J Vet Pharmacol Ther'' '''32(5)''':465-469</ref>
 
:- Xylitol - concurrent [[hypokalemia]] and [[hypercalcemia]]<ref>Xia Z ''et al'' (2009) Experimental acute toxicity of xylitol in dogs. ''J Vet Pharmacol Ther'' '''32(5)''':465-469</ref>
  
Acute hypophosphatemia has been associated with anorexia, muscle weakness, muscle and bone pain, rhabdomyolysis, increased fragility of RBC, and ensuing intravascular hemolysis. Other potential effects of hypophoshatemia are neurologic signs presumably related to the altered energy metabolism, impaired cardiac and respiratory function (decreased contractility of striated and heart muscle), and dysfunction of WBC and platelets that are believed to be caused by ATP depletion.
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Acute mild hypophosphatemia if often subclinical in effect, but severe hypophosphatemia can result in muscle weakness, myalgia, [[seizures]], rhabdomyolysis<ref>Knochel JP (1992) Hypophosphatemia and rhabdomyolysis. ''Am J Med'' '''92(5)''':455-457</ref>, intravascular hemolysis and death<ref>Willard MD ''et al'' (1987) Severe hypophosphatemia associated with diabetes mellitus in six dogs and one cat. ''J Am Vet Med Assoc'' '''190(8)''':1007-1010</ref>.
 +
 
 +
A severely ill diabetic patient, for example, is more likely to die from dehydration, hyperosmolality, metabolic acidosis, [[hypokalemia]] or hypophosphatemia than from hyperglycemia or lack of [[insulin]] therapy. Proper fluid therapy and treatment of electrolyte abnormalities make a major difference in the survival rate of critically ill animals<ref>Garvey MS (1989) Fluid and electrolyte balance in critical patients. ''Vet Clin North Am Small Anim Pract'' '''19(6)''':1021-1057</ref>.
  
 
Mild to moderate phosphorus depletion can effectively be treated by oral phosphorus supplementation, either by adding dairy products to the diet or by providing solutions of sodium-phosphate salts for oral consumption.
 
Mild to moderate phosphorus depletion can effectively be treated by oral phosphorus supplementation, either by adding dairy products to the diet or by providing solutions of sodium-phosphate salts for oral consumption.

Latest revision as of 04:17, 7 December 2012

Hypophosphatemia is defined as a sustained decreased circulating blood phosphorus ≤ 2.5 mg/dL (normal is 2.5 - 7.7).

Hypophosphatemia is often associated with:

- Xylitol - concurrent hypokalemia and hypercalcemia[6]

Acute mild hypophosphatemia if often subclinical in effect, but severe hypophosphatemia can result in muscle weakness, myalgia, seizures, rhabdomyolysis[7], intravascular hemolysis and death[8].

A severely ill diabetic patient, for example, is more likely to die from dehydration, hyperosmolality, metabolic acidosis, hypokalemia or hypophosphatemia than from hyperglycemia or lack of insulin therapy. Proper fluid therapy and treatment of electrolyte abnormalities make a major difference in the survival rate of critically ill animals[9].

Mild to moderate phosphorus depletion can effectively be treated by oral phosphorus supplementation, either by adding dairy products to the diet or by providing solutions of sodium-phosphate salts for oral consumption.

References

  1. Taylor MB et al (2009) Diffuse osteopenia and myelopathy in a puppy fed a diet composed of an organic premix and raw ground beef. J Am Vet Med Assoc 234(8):1041-1048
  2. Dhupa N & Proulx J (1998) Hypocalcemia and hypomagnesemia. Vet Clin North Am Small Anim Pract 28(3):587-608
  3. Feldman EC et al (2005) Pretreatment clinical and laboratory findings in dogs with primary hyperparathyroidism: 210 cases (1987-2004). J Am Vet Med Assoc 227(5):756-761
  4. Rijnberk A et al (2001) Aldosteronoma in a dog with polyuria as the leading symptom. Domest Anim Endocrinol 20(3):227-240
  5. Nichols R (1997) Complications and concurrent disease associated with diabetes mellitus. Semin Vet Med Surg (Small Anim) 12(4):263-267
  6. Xia Z et al (2009) Experimental acute toxicity of xylitol in dogs. J Vet Pharmacol Ther 32(5):465-469
  7. Knochel JP (1992) Hypophosphatemia and rhabdomyolysis. Am J Med 92(5):455-457
  8. Willard MD et al (1987) Severe hypophosphatemia associated with diabetes mellitus in six dogs and one cat. J Am Vet Med Assoc 190(8):1007-1010
  9. Garvey MS (1989) Fluid and electrolyte balance in critical patients. Vet Clin North Am Small Anim Pract 19(6):1021-1057