Hypothermia in Uremic Dogs and Cats

Abstract

BackgroundThe prevalence of uremic hypothermia (UH) and the effects of improving uremia on body temperature have not been determined in veterinary patients.ObjectivesTo determine the prevalence of UH and correlations between uremia and body temperature in patients undergoing intermittent hemodialysis (IHD).AnimalsUremic dogs (n = 122) and cats (n = 79) treated by IHD at the Bobst Hospital of the Animal Medical Center from 1997 to 2013.MethodsRetrospective review of medical records.ResultsThe prevalence of hypothermia was 38% in azotemic cats and 20.5% in azotemic dogs. Statistically significant temperature differences were observed between uremic and nonuremic dogs (nonuremic: mean, 100.8°F; range, 91.2–109.5°F; uremic: mean, 99.9°F; range, 95.6–103.8°F; P < .0001) and cats (nonuremic: mean, 100.6°F; range, 94.0–103.8°F; uremic: mean, 99.3°F; range, 92.3–103.4°F; P < .0001). In dog dialysis patients, significant models included (1) timing (pre‐dialysis versus post‐dialysis) with weight class (small [P < .0001], medium [P = .016], and large breed [P = .033] dogs), (2) timing with serum creatinine concentration (P = .021), and (3) timing with BUN concentration (P < .0001). In cat dialysis patients, there was a significant interaction between timing and weight as a categorical variable (<5 kg and ≥5 kg).Conclusions and Clinical ImportanceUremic hypothermia appears to be a clinical phenomenon that occurs in cats and dogs. Uremic patients are hypothermic compared to ill nonuremic patients and body temperatures increase when uremia is corrected with IHD in dogs and in cats >5 kg. In cats, UH seems to be a more prevalent phenomenon driven by uremia. Uremic hypothermia does occur in dogs, but body weight is a more important predictor of body temperature.

A retrospective study of 157 hospitalized cats with pancreatitis in a tertiary care center: Clinical, imaging and laboratory findings, potential prognostic markers and outcome

“…The occurrence of fever at presentation was unexpectedly more common in survivors. This finding potentially was related to the increased frequency of azotemia in nonsurvivors, which previously has been associated with hypothermia in cats, and the increased frequency of fever in non‐azotemic cats. The higher frequency of hypoglycemia and severe lethargy in the nonsurvivors is another possible explanation.…”

Machine-learning algorithm as a prognostic tool in non-obstructive acute-on-chronic kidney disease in the cat

“…7,9,16 The aetiology of uraemic hypothermia is poorly understood, but it is speculated that uraemic toxins may cause cellular hypometabolism. 17 Digestive signs (ie, vomiting and, less frequently, diarrhoea) are also common in azotaemic cats, even if other causes may coexist in an individual patient. In addition to respiratory signs and ataxia, vomiting was also associated with survival in a study on AKI in cats.…”

Evaluation of and the prognostic factors for cats with big kidney‐little kidney syndrome

“…In the present study among UO cats, the BT of the nonsurvivor group was significantly lower than that of the survivor group. Although the mechanism of a lower BT in these cats with renal disease remains unclear, accumulating evidence based on human and veterinary studies has pointed out there is an increasing prevalence of hypothermia in uremic animals 34 . This means that core BT might be able to serve as a prognostic index, 28,35 and this could lead to longer veterinary hospital stays for hypothermic cats with urethral obstruction 36 …”