Retrospective evaluation of acute hyperkalemia of unknown origin during general anesthesia in dogs

BackgroundCardiac catheterizations in horses are mainly performed in the right heart, as access to the left heart traditionally requires an arterial approach. Transseptal puncture (TSP) has been adapted for horses but data on follow‐up and closure of the iatrogenic atrial septal defect (iASD) are lacking.Hypothesis/ObjectivesTo perform TSP and assess postoperative complications and iASD closure over a minimum of 4 weeks.AnimalsEleven healthy adult horses.MethodsTransseptal puncture was performed under general anesthesia. Serum cardiac troponin I concentrations were measured before and after puncture. Weekly, iASD closure was monitored using transthoracic and intracardiac echocardiography. Relationship between activated clotting time and anti‐factor Xa activity during postoperative enoxaparin treatment was assessed in vitro and in vivo.ResultsTransseptal puncture was successfully achieved in all horses within a median duration of 22 (range, 10‐104) minutes. Balloon dilatation of the puncture site for sheath advancement was needed in 4 horses. Atrial arrhythmias occurred in 9/11 horses, including atrial premature depolarizations (N = 1), atrial tachycardia (N = 5), and fibrillation (N = 3). Serum cardiac troponin I concentrations increased after TSP, but remained under the reference value in 10/11 horses. Median time to iASD closure was 14 (1‐35) days. Activated clotting time correlated with anti‐factor Xa activity in vitro but not in vivo.Conclusions and Clinical ImportanceTransseptal puncture was successfully performed in all horses. The technique was safe and spontaneous iASD closure occurred in all horses. Clinical application of TSP will allow characterization and treatment of left‐sided arrhythmias in horses.

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Hyperkalemia During Prolonged Anesthesia in a Greyhound

O’Neill

2024

Case Reports in Veterinary Medicine

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Case Report: A 3‐year‐old female neutered greyhound presented for a dental procedure under general anesthesia. At the time of presentation, the dog was clinically well, with no health concerns from the client except for halitosis. The dog underwent general anesthesia with 13 teeth extracted and was stable until a severe, acute bradycardia was noticed at 2 h and 20 min postinduction. Venous blood analysis revealed a marked hyperkalemia. The dog was treated with calcium gluconate, an intravenous fluid bolus, glucose, and atropine. Serum potassium levels returned to within normal reference range at 60 min posttreatment. The dog developed ventricular tachycardia in recovery which responded to two lignocaine boluses. The dog was discharged from hospital in a stable condition.Conclusions: Unanticipated hyperkalemia during anesthesia was treated in an otherwise healthy greyhound undergoing a dental procedure.

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Retrospective evaluation of acute hyperkalemia of unknown origin during general anesthesia in dogs

Cited by 4 publications

References 29 publications

Anesthetic Emergencies, Resuscitation, and Adverse Events

Anesthetic Emergencies, Resuscitation, and Adverse Events

Intracardiac ultrasound‐guided transseptal puncture in horses: Outcome, follow‐up, and perioperative anticoagulant treatment

Hyperkalemia During Prolonged Anesthesia in a Greyhound

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