How high blood sugar lowers sodium in diabetic dogs

Abstract

OBJECTIVE: To determine the sodium correction factor for clinical use in hyperglycemic diabetic dogs. SAMPLE: Retrospective analysis of 76 hospitalization episodes from 67 different dogs presenting to the University of Georgia Veterinary Teaching Hospital between January 1, 2015, and January 1, 2023. METHODS: For each hospitalization episode, paired blood sodium and glucose concentration measurements were recorded from the time of presentation until glucose concentration was ≤ 201 mg/dL. Therapies administered, primary diagnosis, and concurrent diseases were also recorded for each episode. A linear mixed model was used to determine the sodium correction factor per 100-mg/dL increase in glucose. Piecewise linear mixed models were also constructed for blood glucose measurements ≤ 400 mg/dL and > 400 mg/dL to explore potential correction factor differences between low and high glucose concentrations. RESULTS: A sodium correction factor of a 1.6-mEq/L (95% CI, 1.3 to 1.9 mEq/L) decrease in sodium concentration per 100-mg/dL increase in blood glucose concentration was calculated. Differences in the correction factor between conditions of low and high glucose concentrations could not be determined due to a small sample size of blood glucose values > 400 mg/dL. Most dogs received similar treatments throughout the study period, including balanced isotonic crystalloids (97% [74/76]), electrolyte supplementation (84% [64/76]), and regular insulin (97% [74/76]). Almost all patients (93% [71/76]) had 1 or more concurrent diseases. CLINICAL RELEVANCE: A sodium correction factor of 1.6 mEq/L (decrease in sodium per 100-mg/dL increase in glucose) is recommended for clinical use in hyperglycemic diabetic dogs.