Peer-reviewed veterinary case report
Correcting low chloride levels in dogs with heart failure
By Adin, Darcy et al.·Published in Journal of veterinary internal medicine·2021·University of Florida, United States·View original on PubMed →
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Original publication title: Correction of serum chloride concentration in dogs with congestive heart failure.
- Species:
- dog
Plain-English summary
A group of dogs with congestive heart failure (CHF) were studied to understand their chloride levels, which can be affected by medications like diuretics. The researchers found that dogs in the later stages of CHF had lower chloride levels compared to those in earlier stages or without heart disease. In the most severe cases, the corrected chloride levels were higher than the measured levels, suggesting these dogs were retaining too much water. This means that while some dogs showed an increase in chloride after correction, they still had low levels overall due to the effects of their heart medications.
People also search for: dog heart failure symptoms · low chloride levels in dogs · treatment for dog congestive heart failure · dog diuretics side effects
Abstract
BACKGROUND: Hypochloremia associated with congestive heart failure (CHF) in dogs is likely multifactorial. Loop diuretics cause 1:2 sodium [Na]:chloride [Cl] loss, whereas water retention causes a 1:1 [Na]:[Cl] dilution. Mathematical [Cl] correction separates these effects on [Cl]. HYPOTHESIS: We hypothesized that corrected [Cl] (c[Cl]) would not differ from measured [Cl] (m[Cl]) in dogs with controlled CHF because of loop diuretics, and dogs with refractory CHF would have higher c[Cl] than m[Cl], indicating relative water excess. ANIMALS: Seventy-one client-owned dogs with acquired heart disease, without CHF (NO-CHF), 76 with Stage C CHF and 24 with Stage D CHF. METHODS: Clinicopathological data from a previous study were retrospectively analyzed. Corrected [Cl], m[Cl], and differences were compared among NO-CHF, Stage C CHF, and Stage D CHF, using the formula: c[Cl] = (mid-reference range [Na]/measured [Na]) × m[Cl]. RESULTS: Corrected [Cl] and m[Cl] were lower in Stage D vs Stage C and NO-CHF (all P < .0001). The c[Cl] was higher than m[Cl] in Stage D (P < .0001) but not Stage C or NO-CHF. Median difference between c[Cl] and m[Cl] was higher for Stage D vs Stage C (P = .0003). No hypochloremic Stage D dogs had normal c[Cl], but 11/24 had [Cl] that was increased by >2 mmol/L. CONCLUSIONS AND CLINICAL IMPORTANCE: Serum [Cl] increased after mathematical correction in Stage D CHF dogs but not in Stage C and NO-CHF dogs. Although c[Cl] was higher than m[Cl] in Stage D dogs supportive of relative water excess, hypochloremia persisted, consistent with concurrent loop diuretic effects on electrolytes. Future study correlating c[Cl] to antidiuretic hormone concentrations is warranted.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/33305873/