Page 173 - Basic Monitoring in Canine and Feline Emergency Patients

Table 8.2. Diseases associated with hypercalcemia or hypocalcemia.

VetBooks.ir Hypercalcemia a Hypocalcemia
Hyperparathyroidism
Hypoparathyroidism
Addison’s disease (hypoadrenocorticism)
Renal disease Hypoalbuminemia
Chronic renal failure
D – Hypervitaminosis D Hypovitaminosis D
Idiopathic hypercalcemia Pancreatitis
Osteomyelitis (caused by bacterial or fungal Eclampsia
disease of the bone) Starvation
Neoplastic disease (especially lymphoma, Ethylene glycol intoxication
anal sac apocrine gland adenocarcinoma) Administration Ca binders such as phosphate enemas or bicarbonate
Intestinal malabsorption
Cellular breakdown (e.g. rhabdomyolysis, tumor lysis syndrome)

a Mnemonic for differentials for hypercalcemia: HARD ION.
Table 8.3. Common diseases causing hypophosphatemia or hyperphosphatemia.
Hyperphosphatemia Hypophosphatemia
Renal failure Renal diuresis (e.g. furosemide)
Hypoparathyroidism Hyperparathyroidism
Hyperthyroidism Eclampsia
Increased intake of dietary phosphorus Decreased dietary intake
Vitamin D intoxication (e.g. rodenticide) Vitamin D deficiency
Phosphate enema Malabsorption
Release of phosphorus from other cells: Phosphate binders
● Tumor lysis syndrome Translocation into cells
● Rhabdomyolysis ● Treatment diabetic ketoacidosis
● Hemolysis ● Insulin administration
Metabolic acidosis (shifting out of cells to follow hydrogen ions) ● Respiratory alkalosis
● Hypothermia

Potassium
every 12–24 hours while treating the underlying dis-
Potassium levels are commonly altered in sick ani- ease and/or supplementing potassium. However, if
mals. Low potassium results from gastrointestinal potassium levels are less than 2.5 mEq/L, the author
losses (vomiting and diarrhea) or (rarely) chroni- will test potassium levels every 4–6 hours during sup-
cally decreased potassium intake (anorexia). In plementation until the potassium levels are close to
addition, diseases affecting the kidney and its abil- 3.0 mEq/L or above. This is both to ensure that sup-
ity to reabsorb potassium can lead to hypokalemia plementation of potassium is improving the levels as
including renal failure as well as any other diuresis- well as to be able to identify when to lessen the
inducing disorder such as post-obstructive diuresis degree of supplementation. If potassium levels are
or diabetes mellitus. On the other hand, high potas- greater than 7 or 7.5 mEq/L, actions are typically
sium most commonly results from renal failure or taken to reduce the potassium levels, and potassium
an inability to excrete potassium in the urine as is rechecked until it is consistently dropping toward
seen with urethral obstruction. See Table 8.4 for a normal or is at least below 6 mEq/L. See Section 8.4
list of the most common diseases that lead to for general information on how to supplement low
hyperkalemia and hypokalemia. potassium or decrease high potassium levels and case
If potassium levels are mildly to moderately ele- study 2 for an example of managing hyperkalemia;
vated (<7.5 mEq/L) or mildly to moderately decreased the interested reader is urged to consult additional
(>2.5 mEq/L), potassium levels can be monitored resources related to treating electrolyte abnormalities

Electrolyte Monitoring 165