Acid-Base and Electrolyte Abnormalities in Dogs with Gastrointestinal Foreign Bodies

Abstract

Gastrointestinal foreign bodies occur commonly in dogs. The objective of the study was to describe the acid-base and electrolyte abnormalities identified in dogs with gastrointestinal foreign bodies and determine if these abnormalities are related to the site or type of foreign body present. Medical records of 138 dogs were reviewed, and information on signalment, initial venous electrolyte and acid-base values, surgical findings, relevant historical information, imaging modalities used, cost of hospital visit, intra-or postoperative complications, and survival was obtained. The site of the foreign body was recorded in 94.9% of cases and the most common site was the stomach (50%), followed by the jejunum (27.5%). The foreign bodies were linear in 36.2% of cases. The most common electrolyte and acid-base abnormalities regardless of the site or type of foreign body were hypochloremia (51.2%), metabolic alkalosis (45.2%), hypokalemia (25%), and hyponatremia (20.5%). No significant association was found between electrolyte or acid-base abnormalities and the site of foreign body. Linear, as opposed to discrete, foreign bodies were more likely to be associated with a low serum sodium concentration (odds ratio, 0.85; 95% confidence interval, 0.75-0.95). Hyperlactatemia (Ͼ2.4 mmol/L) was seen in 40.5% of dogs. A wide variety of electrolyte and acid-base derangements are found in dogs with gastrointestinal foreign bodies. Hypochloremia and metabolic alkalosis are common in these dogs. Hypochloremic, hypokalemic metabolic alkalosis is seen with both proximal and distal gastrointestinal foreign bodies.Key words: Alkalosis; Hypochloremia; Hypokalemia; Hyponatremia; Linear. Dogs with clinical signs resulting from gastrointestinal foreign bodies are common in small-animal veterinary practice.1 Dogs ingest a large variety of objects that either pass through the gastrointestinal (GI) tract or cause a complete or partial obstruction. Other ingested objects act as linear foreign bodies and cause plication of the small intestine.2 Animals with GI disease frequently have acid-base and electrolyte abnormalities.3 Large volumes of fluid and electrolytes are secreted and reabsorbed by the healthy GI tract daily. In a 20-kg dog, approximately 2.5 L of fluid enters the GI tract from diet and normal gastrointestinal secretions and over 98% is reabsorbed daily. 4 Experimental studies of GI obstruction in dogs have revealed that, after an obstruction has been present for over 24 hours, there is secretion of sodium, potassium, and water rather than absorption in the bowel proximal to the obstruction. Gastrointestinal function is also abnormal distal to the obstruction. 5 Thus, disturbances in normal GI tract function secondary to complete or partial obstruction can rapidly result in disturbances of fluid balance, acid-base status, and serum electrolyte concentrations. Protracted or profuse vomiting and diarrhea with reluctance to consume adequate volumes of food and fluid can also affect the intravascular volume and hydration

Linear versus non‐linear gastrointestinal foreign bodies in 499 dogs: clinical presentation, management and short‐term outcome

“…Reported survival rates of dogs undergoing surgery of the gastrointestinal tract vary from 80 to 99% (Evans et al , Boag et al , Shales et al , Hayes ), with the present study results being 96% for both groups. However, it should be noted that the current study was unable to provide follow‐up past the time of discharge for all patients, and it is therefore difficult to directly compare survival rates with other studies.…”

“…Hypochloraemia, metabolic alkalosis, hypokalaemia and hyponatraemia have been reported in dogs with various gastrointestinal foreign bodies, with LFB being more likely associated with hyponatraemia (Boag et al ). Similarly, the present study demonstrated that dogs with LFB were more likely to have lower sodium, potassium and chloride concentrations, but also demonstrated haemoconcentration, an increase in blood urea nitrogen concentrations, and higher pH than dogs with NLFB.…”

Gastrointestinal foreign bodies in dogs and cats: a retrospective study of 208 cases

“…Gastrointestinal obstruction results in disturbances of fluid balance, acid‐base status and serum electrolyte concentrations due to hypersecretion and sequestration within the gastrointestinal tract which is exacerbated by vomiting and impaired oral intake of fluid and nutrients (Boag and others 2005). Gastrointestinal foreign bodies may cause complete or partial obstruction.…”

Severe muscle fasciculations and tremor in a cat with hypochloraemic metabolic alkalosis secondary to duodenal obstruction

“…Hypochloraemic metabolic alkalosis is common in dogs with GI foreign bodies and functional pyloric outflow obstruction. 10 In a recent study examining metabolic alkalosis in dogs and cats, 87% of cats with a metabolic alkalosis were hypochloraemic. 1 In an experimental study of complete obstruction of the ileum in dogs, it was found that bowel proximal to obstruction had net water, sodium and potassium secretion (chloride was not measured), resulting in sequestration of fluid and electrolytes into the lumen of the intestine.…”