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Effect of continuous intravenous administration of a 50% dextrose solution on phosphorus homeostasis in dairy cows

Walter Grünberg Dr med vet1, Dawn E. Morin DVM, MS, DACVIM2, James K. Drackley PhD3, Anne M. Barger DVM, MS, DACVP4, and Peter D. Constable BVSc, PhD, DACVIM5
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  • 1 Department of Veterinary Clinical Medicine, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, Urbana, IL 61802
  • | 2 Department of Veterinary Clinical Medicine, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, Urbana, IL 61802
  • | 3 College of Veterinary Medicine, and the Department of Animal Sciences, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, Urbana, IL 61802
  • | 4 Department of Pathobiology, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, Urbana, IL 61802
  • | 5 Department of Veterinary Clinical Medicine, College of Agricultural, Consumer and Environmental Sciences, University of Illinois, Urbana, IL 61802.

Abstract

Objective—To determine the effect of continuous IV administration of 50% dextrose solution on phosphorus homeostasis in lactating dairy cows.

Design—Clinical trial.

Animals—4 multiparous Jersey cows.

Procedures—Cows were administered 50% dextrose solution IV (0.3 g/kg/h [0.14 g/lb/h]) for 5 days. Plasma concentrations of glucose, immune-reactive insulin (IRI), and phosphorus were determined before, during, and for 72 hours after dextrose infusion. Phosphorus intake and losses of phosphorus in urine, feces, and milk were determined. Each cow received a sham treatment that included instrumentation and sampling but not administration of dextrose.

Results—Plasma glucose, IRI, and phosphorus concentrations were stable during sham treatment. Plasma phosphorus concentration decreased rapidly after onset of dextrose infusion, reaching a nadir in 24 hours and remaining less than baseline value for 36 hours. Plasma phosphorus concentration increased after dextrose infusion was stopped, peaking in 6 hours. Urinary phosphorus excretion did not change during dextrose infusion, but phosphorus intake decreased because of reduced feed intake, followed by decreased fecal phosphorus loss and milk yield. Rapid changes in plasma phosphorus concentration at the start and end of dextrose infusion were temporally associated with changes in plasma glucose and IRI concentrations and most likely caused by compartmental shifts of phosphorus.

Conclusions and Clinical Relevance—Hypophosphatemia developed in response to hyperglycemia or hyperinsulinemia in dairy cows administered dextrose via continuous IV infusion. Veterinarians should monitor plasma phosphorus concentration when administering dextrose in this manner, particularly in cows with decreased appetite or preexisting hypophosphatemia.

Abstract

Objective—To determine the effect of continuous IV administration of 50% dextrose solution on phosphorus homeostasis in lactating dairy cows.

Design—Clinical trial.

Animals—4 multiparous Jersey cows.

Procedures—Cows were administered 50% dextrose solution IV (0.3 g/kg/h [0.14 g/lb/h]) for 5 days. Plasma concentrations of glucose, immune-reactive insulin (IRI), and phosphorus were determined before, during, and for 72 hours after dextrose infusion. Phosphorus intake and losses of phosphorus in urine, feces, and milk were determined. Each cow received a sham treatment that included instrumentation and sampling but not administration of dextrose.

Results—Plasma glucose, IRI, and phosphorus concentrations were stable during sham treatment. Plasma phosphorus concentration decreased rapidly after onset of dextrose infusion, reaching a nadir in 24 hours and remaining less than baseline value for 36 hours. Plasma phosphorus concentration increased after dextrose infusion was stopped, peaking in 6 hours. Urinary phosphorus excretion did not change during dextrose infusion, but phosphorus intake decreased because of reduced feed intake, followed by decreased fecal phosphorus loss and milk yield. Rapid changes in plasma phosphorus concentration at the start and end of dextrose infusion were temporally associated with changes in plasma glucose and IRI concentrations and most likely caused by compartmental shifts of phosphorus.

Conclusions and Clinical Relevance—Hypophosphatemia developed in response to hyperglycemia or hyperinsulinemia in dairy cows administered dextrose via continuous IV infusion. Veterinarians should monitor plasma phosphorus concentration when administering dextrose in this manner, particularly in cows with decreased appetite or preexisting hypophosphatemia.

Contributor Notes

Dr. Constable's present address is Department of Veterinary Clinical Science, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

Supported by Illinois Department of Agriculture Cattle Research Funds.

Presented in part as an abstract at the 23rd Annual American College of Veterinary Internal Medicine Forum, Baltimore, June 2005.

Address correspondence to Dr. Morin.