Open AccessContribution of Unmeasured Anions to Acid–Base Disorders and its Association with Altered Demeanor in 264 Calves with Neonatal Diarrhea
Author(s) -
Gomez D.E.,
Lofstedt J.,
Stämpfli H.R.,
Wichtel M.,
Muirhead T.,
McClure J.T.
Publication year - 2013
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.12193
Subject(s) - diarrhea , medicine , anion gap , bicarbonate , dehydration , reflex , acidosis , acid–base homeostasis , metabolic acidosis , acid–base imbalance , acid–base reaction , gastroenterology , anesthesia , biochemistry , chemistry , organic chemistry
Background The quantitative effect of strong electrolytes, unmeasured anions ( UA s), p CO 2 , and plasma protein concentrations in determining plasma pH and bicarbonate ( HCO 3 − ) can be demonstrated using the physicochemical approach. Demeanor of calves with diarrhea is associated with acidemia, dehydration, and hyper‐ d ‐lactatemia. Hypothesis Unmeasured anions are a major factor influencing changes in plasma pH and HCO 3 − of calves with diarrhea and UA s and strong UA s, estimated by anion gap ( AG ) and strong ion gap ( SIG ), respectively, are more strongly associated with alteration of demeanor compared to other acid–base variables. Animals A total of 264 calves with diarrhea from two data sets ( DS 1 and DS 2). Methods Retrospective study. Forward stepwise regression was performed to determine the relationship between measured pH or HCO 3 − , and physicochemical variables. A two‐way ANOVA was performed to investigate the association between acid–base variables and attitude (bright, obtunded, and stuporous), posture (standing, sternal or lateral recumbency), and strength of suckling reflex (strong, weak, or absent). Results Increased strong UA s estimated by SIG was the most important contributor to changes in measured pH and HCO 3 − ( DS1 : r 2 66 and 59%, DS 2: 39 and 42%, P < .0001). SIG and AG were correlated to deteriorating calf demeanor for all three clinical scoring categories: attitude, posture, and suckle reflex ( P < .0001). Conclusion and Clinical Relevance Elevated concentrations of strong UA s were the primary cause of acidemia and had an important influence on the demeanor of calves with diarrhea. These findings emphasize the importance of the calculation of UA s when evaluating acid–base abnormalities in calves.