Peer-reviewed veterinary case report
Electrolyte levels and hormone changes in dog heart disease stages
By Adin, Darcy et al.·Published in Journal of veterinary internal medicine·2020·College of Veterinary Medicine, United States·View original on PubMed →
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Original publication title: Role of electrolyte concentrations and renin-angiotensin-aldosterone activation in the staging of canine heart disease.
- Species:
- dog
Plain-English summary
A group of dogs with heart disease, specifically those in advanced stages of the condition, were studied to understand how their kidney function and electrolyte levels related to their heart disease severity. The researchers found that low levels of chloride in the blood (hypochloremia) were particularly common in dogs with the most severe heart disease (stage D). They also noted that higher doses of a common diuretic medication, furosemide, did not always correlate well with its effectiveness, suggesting that some dogs may not absorb the medication properly. Treatments that suppress the renin-angiotensin-aldosterone system (RAAS) were found to be more effective in these advanced cases, helping to manage symptoms of congestive heart failure.
People also search for: dog heart disease symptoms · furosemide dosage for dogs · low chloride levels in dogs · advanced heart failure treatment for dogs
Abstract
BACKGROUND: Refractory congestive heart failure (CHF) and associated diuretic resistance are not well defined. OBJECTIVES: To characterize renal function, electrolyte concentrations, indices of diuretic efficacy, and renin-angiotensin-aldosterone system (RAAS) activation in dogs with naturally occurring heart disease (HD) in American College of Veterinary Internal Medicine stages B1, B2, C, and D and to determine their usefulness in defining HD stages. ANIMALS: Group 1:149 dogs with HD stages B1, B2, C, and D. Group 2:22 dogs with HD stages C and D. METHODS: Group 1: Renal parameters, serum and urine electrolyte and diuretic concentrations, and urine aldosterone concentrations were measured. Medication dosages and measured variables were compared among stages. Correlation of furosemide dosages to serum concentrations was explored. Group 2: Angiotensin-converting enzyme activity and RAAS components were measured and compared among CHF stages. RESULTS: Serum chloride concentration was the best differentiator of HD stage. Furosemide PO dosages (≤6 mg/kg/day) were weakly correlated with serum furosemide concentrations, whereas higher dosages were not significantly correlated. Angiotensin-converting enzyme inhibitor dosage and RAAS inhibition were greater in stage D, compared to stage C dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: Hypochloremia is a useful marker for stage D HD in dogs. Poor furosemide dosage correlation to serum concentration may indicate variable and poor absorption, especially at higher dosages, advanced disease, or both. A small number of stage D dogs met proposed criteria for diuretic resistance. Greater RAAS inhibition in stage D versus stage C indicates effectiveness of RAAS-suppressive treatments in this group of dogs with refractory CHF.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/31769114/