Retrospective Evaluation of the Prognosis and Prevalence of Hyperchloremia in Dogs and Cats

TL;DR

This study found that high chloride levels in dogs and cats are common and linked to higher death rates, especially when the condition develops in the hospital.

Contribution

The study provides new insights into the prevalence and mortality risk of hyperchloremia in veterinary patients.

Findings

Hyperchloremia was found in 21.1% of dogs and 9.1% of cats.

Hospital-acquired hyperchloremia in dogs had a higher case-fatality rate than prehospital cases.

Various diseases like neurological and urological disorders were associated with hyperchloremia.

Abstract

To determine the prevalence, case‐fatality rate, and primary disease processes associated with high corrected chloride concentration (hyper[Cl−]) in dogs and cats.

Single‐center retrospective study.

Electrical medical records were reviewed to identify dogs and cats with at least one chloride and sodium concentration measured simultaneously during a 60‐month period.

A total of 17,120 dogs and 4197 cats presented to a veterinary teaching hospital.

None.

Measured hyper[Cl−] was diagnosed in 18.1% (3092/17,120) dogs and 9.4% (396/4197) cats. Corrected hyper[Cl−] was diagnosed in 21.1% (3607/17,120) dogs and 9.1% (384/4197) cats. The case‐fatality rates were higher in animals with corrected hyper[Cl−] than in those with normal corrected [Cl−] (p < 0.0001). The case‐fatality rate was higher in dogs with measured hyper[Cl−] than in those with corrected hyper[Cl−] (p = 0.011). Of the dogs and cats with corrected hyper[Cl−], a total of 50.9% (1835/3607) dogs and 38.3% (147/384) cats were categorized as prehospital corrected hyper[Cl−], whereas a total of 39.5% (1424/3607) dogs and 48.7% (187/384) cats with corrected hyper[Cl−] were categorized as hospital‐acquired corrected hyper[Cl−]. The case‐fatality rate of dogs and cats with hospital‐acquired corrected hyper[Cl−] was higher than that of prehospital corrected hyper[Cl−] in dogs (p < 0.0001) but not in cats (p = 0.9). Various primary disease processes, including neurologic and urologic diseases, were identified in animals with corrected hyper[Cl−].

Corrected hyper[Cl−] was a common electrolyte abnormality identified in dogs and cats, and it was associated with higher case‐fatality rates than normal corrected [Cl−]. Hospital‐acquired corrected hyper[Cl−] was less common but was associated with a higher case‐fatality rate than prehospital corrected hyper[Cl−] in dogs. Further investigation of corrected hyper[Cl−] in association with its morbidity and mortality and the role of therapy to target normal [Cl−] is warranted.

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