Evaluation of the association between strong ion acid–base disturbances and mortality in dogs: a retrospective study

Zager, Erik; Fletcher, Daniel J.; Goggs, Robert

doi:10.1002/vms3.101

Cited by 7 publications

(6 citation statements)

References 45 publications

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“…At the same time, the sensitivity, specificity, and areas under the receiver operating characteristic (ROC) curves (AUR) were calculated to evaluate the diagnostic effect of the SUA. Determination of diagnostic cutoff point value of SUA was identified by maximizing the Youden index (J) where J = (sensitivity + specificity) -1 (23,24). Cox regression analysis was used to analyze the influencing factors of NAFLD.…”

Section: Discussionmentioning

confidence: 99%

Higher Serum Uric Acid Level Predicts Non-alcoholic Fatty Liver Disease: A 4-Year Prospective Cohort Study

Wei

Chen

et al. 2020

Front. Endocrinol.

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Background: Non-alcoholic fatty liver disease (NAFLD) has become a serious disease affecting people's health in the world. This article studies the causal relationship between NAFLD and serum uric acid (SUA) levels.Methods: During the 4 years of follow-up in a fixed cohort that was established in 2014, 2,832 follow-up subjects without NAFLD were finally included in this study. The study population was divided into four groups according to baseline SUA levels. Cox hazard regression model and Kaplan-Meier survival curves analysis were used to predict risk factors of NAFLD. The receiver operating characteristic curve analyses were used to determine SUA cutoffs for predicting NAFLD.Results: The cumulative prevalence rates of NAFLD were 33.97% (962/2,832), 38.93% (758/1,947) in males and 23.05% (204/885) in females. The results showed that males had a higher incidence of NAFLD (χ 2 = 68.412, P = 0.000). The Cox regression analysis disclosed that the hazard ratios of NAFLD [95% confidence interval (CI)] were 1.431 (95% CI, 1.123∼1.823), 1.610 (95% CI, 1.262-2.054), and 1.666 (95% CI, 1.287-2.157) across the second to the fourth quartile of SUA adjusted for other confounders. The SUA cutoffs, sensitivity, specificity, and area under the curve (AUC) (95% CI) were ≥288.5 µmol/L, 75.5, 46.5%, 0.637(0.616-0.658), respectively, for total; ≥319.5 µmol/L, 65.8%, 48.4%, 0.590 (0.564-0.615), respectively, for males; and ≥287.5 µmol/L, 51.0%, 75.6%, 0.662 (0.619-0.704), respectively, for females. Kaplan-Meier survival curves revealed that individuals with higher SUA level had an increased risk of NAFLD in comparison to lower SUA level (P = 0.000).Conclusion: Serum uric acid is positively correlated with NAFLD, and elevated SUA level can be used as an independent predictor for NAFLD.

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Section: Discussionmentioning

confidence: 99%

Higher Serum Uric Acid Level Predicts Non-alcoholic Fatty Liver Disease: A 4-Year Prospective Cohort Study

Wei

Chen

et al. 2020

Front. Endocrinol.

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“…An electronic database of blood gas and electrolyte analyses conducted in the emergency room or intensive care unit at the Cornell University Hospital for Animals between 05/31/2007 and 01/03/2017 was searched for results from dogs and cats. Some data from this database have been previously reported (12–15). The database was visually inspected and manually curated to remove samples from species other than dogs and cats, samples with missing, erroneous or untraceable case numbers, analyses from sample types other than blood (e.g., abdominal fluid) and analyses with missing data.…”

Section: Methodsmentioning

confidence: 99%

Severity of Ionized Hypercalcemia and Hypocalcemia Is Associated With Etiology in Dogs and Cats

2019

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Background: Calcium disorders are common in small animals, but few studies have investigated the etiology of ionized hypercalcemia and hypocalcemia in large populations. This study aimed to determine the incidence of ionized calcium disorders in dogs and cats treated at a tertiary referral clinic and to describe the associated diseases. Methods: An electronic database of electrolyte analyses conducted at the Cornell University Hospital for Animals from 2007 to 2017 was searched. Dogs and cats with ionized hypercalcemia or hypocalcemia were identified based on institution reference intervals. Duplicate case entries were removed. Medical records were reviewed to identify the cause of the calcium abnormality. Chi-squared analysis with Bonferroni adjustment was performed to compare frequencies of disease processes between mild and moderate-severe disturbances. Results: The database included 15,277 dogs and 3,715 cats. Hypercalcemia was identified in 1,641 dogs and 119 cats. The incidence of canine and feline hypercalcemia was 10.7 and 3.2%, respectively. Hypocalcemia was identified in 1,467 dogs and 450 cats. The incidence of canine and feline hypocalcemia was 9.6% and 12.1%, respectively. The most common pathologic causes of hypercalcemia in dogs were malignancy-associated (12.9%), parathyroid-dependent (4.6%) and hypoadrenocorticism (1.7%). In cats, malignancy-associated hypercalcemia (22.7%), kidney injury (13.4%) and idiopathic hypercalcemia (12.6%) were most common. Dogs presenting with moderate-severe hypercalcemia vs. mild hypercalcemia were significantly more likely to have hyperparathyroidism, malignancy-associated hypercalcemia or hypervitaminosis D, whereas cats were significantly more likely to have malignancy-associated hypercalcemia or idiopathic hypercalcemia. The most common pathologic causes of hypocalcemia in dogs were critical illness (17.4%), kidney injury (10.4%) and toxicity (7.5%). In cats, kidney injury (21.6%), urethral obstruction (15.1%), and critical illness (14.7%) were most frequent. Dogs presenting with moderate-severe hypocalcemia were significantly more likely to have hypoparathyroidism, kidney injury, eclampsia or critical illness, whereas cats were significantly more likely to have kidney injury, soft tissue trauma or urethral obstruction. Conclusions: Mild calcium disturbances are most commonly associated with non-pathologic or transient conditions. Malignancy-associated hypercalcemia is the most common cause of ionized hypercalcemia in dogs and cats. Critical illness and kidney injury are frequent causes of ionized hypocalcemia in both species.

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“…Increased UA correlates with death in humans but in 1 retrospective study in dogs none of the acid‐base perturbations, including elevated UA, were considered to confer a prognostic advantage. The purpose of the present study was to describe the acid‐base changes in PE using both the HH and SIM models, and to compare and contrast the findings.…”

Section: Introductionmentioning

confidence: 99%

Role of electrolyte abnormalities and unmeasured anions in the metabolic acid‐base abnormalities in dogs with parvoviral enteritis

Burchell

Gal

Friedlein

et al. 2020

Veterinary Internal Medicne

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Background The strong ion model (SIM) is an alternative paradigm in the characterization of acid‐base disturbances particularly in complex disorders. Hypothesis/Objectives To compare the acid‐base changes in dogs with parvoviral enteritis (PE) using the Henderson‐Hasselbalch (HH) approach, with 2 strong ion approaches. Animals Forty‐four dogs with PE, and 16 age‐matched control dogs. Methods Prospective controlled observational study. Acid‐base status was evaluated using the HH model, Fencl‐Stewart (FS) approach and a validated strong ion model (VDM). The acid‐base changes according to each model were classified and compared. Statistical correlations between pH, CO2, and various SIM variables were performed, as well as between the sum of effects (SOE) of the SIM and the individual variables comprising the SOE. Results The HH model identified acid‐base disorders in 31/44 cases of which 16/31 were mixed with metabolic acidosis and concurrent respiratory alkalosis the most common (10/31). Using the FS approach, metabolic changes were present 36/42 cases, with changes in free water (FW), chloride, and unmeasured anions (UA) being the most prevalent. Both FW and UA correlated well with pH; however, UA were most consistently abnormal in severe acidemia. Similarly to the HH, the VDM detected acid‐base disturbances in 28/44 cases. Major contributors to the acid‐base changes were hyponatremia, hypochloremia, and Atot acidosis because of elevated globulins and increased UA. Conclusions and Clinical Importance Acid‐base changes are common and complex in dogs with PE, and were easier to understand using a SIM paradigm. Increases in UA have not been documented in PE in dogs.

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Evaluation of the association between strong ion acid–base disturbances and mortality in dogs: a retrospective study

Cited by 7 publications

References 45 publications

Higher Serum Uric Acid Level Predicts Non-alcoholic Fatty Liver Disease: A 4-Year Prospective Cohort Study

Higher Serum Uric Acid Level Predicts Non-alcoholic Fatty Liver Disease: A 4-Year Prospective Cohort Study

Severity of Ionized Hypercalcemia and Hypocalcemia Is Associated With Etiology in Dogs and Cats

Role of electrolyte abnormalities and unmeasured anions in the metabolic acid‐base abnormalities in dogs with parvoviral enteritis

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