Open AccessRisk Factors for the Development of Hypokalemia in Neonatal Diarrheic Calves
Author(s) -
Trefz F.M.,
Lorch A.,
Zitzl J.,
Kutschke A.,
KnubbenSchweizer G.,
Lorenz I.
Publication year - 2015
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.12541
Subject(s) - medicine , hypokalemia , diarrhea , hypernatremia , odds ratio , confidence interval , prospective cohort study , gastroenterology , dehydration , bicarbonate , hyponatremia , sodium , biochemistry , chemistry , organic chemistry
Background Neonatal diarrheic calves have a clear negative potassium balance because of intestinal losses and decreased milk intake but in the presence of acidemia, they usually show normokalemic or hyperkalemic plasma concentrations. Objectives To assess whether marked hypokalemia occurs in response to the correction of acidemia and dehydration and to identify factors that are associated with this condition. Animals Eighty‐three calves with a clinical diagnosis of neonatal diarrhea. Methods Prospective cohort study. Calves were treated according to a clinical protocol using an oral electrolyte solution and commercially available packages of 8.4% sodium bicarbonate, 0.9% saline and 40% dextrose infusion solutions. Results The proportion of hypokalemic calves after 24 hours of treatment (19.3%) was twice as great as it was on admission to the hospital. Plasma K + after 24 hours of treatment was not significantly correlated to venous blood pH values at the same time but positively correlated to venous blood pH values on admission ( r = 0.51, P < .001). Base excess on admission (Odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.70–0.94), duration of diarrhea (OR = 1.37, 95% CI = 1.05–1.80), milk intake during hospitalization (OR = 0.54, 95% CI = 0.37–0.79) and plasma sodium concentrations after 24 hours (OR = 1.12, 95% CI = 1.01–1.25) were identified to be independently associated ( P < .05) with a hypokalemic state after 24 hours of treatment. Conclusions and Clinical Importance Findings of this study suggest that marked depletion of body potassium stores is evident in diarrheic calves that suffered from marked metabolic acidosis, have a low milk intake and a long history of diarrhea.