Risk factors for the development of hypokalemia in neonatal diarrheic calves.

Abstract

BACKGROUND: Neonatal diarrheic calves have a clear negative potassium balance because of intestinal losses and decreased milk intake but in the presence of acidemia, they usually show normokalemic or hyperkalemic plasma concentrations. OBJECTIVES: To assess whether marked hypokalemia occurs in response to the correction of acidemia and dehydration and to identify factors that are associated with this condition. ANIMALS: Eighty-three calves with a clinical diagnosis of neonatal diarrhea. METHODS: Prospective cohort study. Calves were treated according to a clinical protocol using an oral electrolyte solution and commercially available packages of 8.4% sodium bicarbonate, 0.9% saline and 40% dextrose infusion solutions. RESULTS: The proportion of hypokalemic calves after 24&#xa0;hours of treatment (19.3%) was twice as great as it was on admission to the hospital. Plasma K(+) after 24&#xa0;hours of treatment was not significantly correlated to venous blood pH values at the same time but positively correlated to venous blood pH values on admission (r&#xa0;=&#xa0;0.51, P&#xa0;<&#xa0;.001). Base excess on admission (Odds ratio [OR]&#xa0;=&#xa0;0.81, 95% confidence interval [CI]&#xa0;=&#xa0;0.70-0.94), duration of diarrhea (OR&#xa0;=&#xa0;1.37, 95% CI&#xa0;=&#xa0;1.05-1.80), milk intake during hospitalization (OR&#xa0;=&#xa0;0.54, 95% CI&#xa0;=&#xa0;0.37-0.79) and plasma sodium concentrations after 24&#xa0;hours (OR&#xa0;=&#xa0;1.12, 95% CI&#xa0;=&#xa0;1.01-1.25) were identified to be independently associated (P&#xa0;<&#xa0;.05) with a hypokalemic state after 24&#xa0;hours of treatment. CONCLUSIONS AND CLINICAL IMPORTANCE: Findings of this study suggest that marked depletion of body potassium stores is evident in diarrheic calves that suffered from marked metabolic acidosis, have a low milk intake and a long history of diarrhea.