# Effects of an Iso‐Osmotic Chloride‐Free Solution With High Strong Ion Difference vs. Ringer's Lactate on Non‐Lactate Metabolic Acidosis in Dogs

## TL;DR

This study compares two fluid treatments for acidosis in dogs, finding a new solution more effective than the standard.

## Contribution

Demonstrates a chloride-free solution with high strong ion difference is more effective for treating non-lactate metabolic acidosis in dogs.

## Key findings

- The H-SID solution significantly increased base excess in extracellular fluid compared to Ringer's lactate at both infusion rates.
- The H-SID solution showed a superior alkalizing effect without notable adverse effects in dogs with non-lactic metabolic acidosis.

## Abstract

Metabolic acidosis is a common acid–base disorder in critically ill dogs, with fluid therapy being a key but debated treatment. Sodium bicarbonate's risks have spurred interest in safer alternatives such as sodium lactate.

To compare the efficacy of a chloride‐free, high strong ion difference solution (H‐SID) to Ringer's lactate (RL) for treating metabolic acidosis, hypothesizing the superiority of the H‐SID solution.

Forty‐six dogs with metabolic acidosis from two veterinary hospitals.

Prospective randomized multicenter study. Dogs were randomly assigned to receive either RL or H‐SID at infusion rates of 4 or 10 mL/kg/h for 4 h, based on their volume status. H‐SID was compounded with sodium (145 mmol/L), lactate (145 mmol/L), potassium (10 mmol/L), and aspartate (10 mmol/L) in sterile water for injection.

The H‐SID group showed a significant increase in BE‐ecf (mmol/L) at infusion rates of 4 mL/kg/h (p < 0.001) and 10 mL/kg/h (p < 0.001) when compared to the RL group. At the lower infusion rate, the median increase was 4.1 mmol/L (95% CI: 3.37, 6.71), whereas the RL group exhibited a variation of −0.1 (95% CI: −0.75, 2.2). At the higher infusion rate, the median increase was 11 mmol/L (95% CI: 8.16, 12.52) compared to the RL group variation of 1.3 (95% CI: 0.01, 2.96).

Our results indicate a significant alkalizing effect of the H‐SID solution in dogs with non‐lactic metabolic acidosis, demonstrating a superior effect compared to the RL solution without notable adverse effects.