• 1.

    Matsuura K, Hasegawa M, Shiraishi K, et al. Mitral annular dynamics short term after mitral valve surgery. In: Proceedings of the Sixth Asian Meeting of Veterinary Medicine Specialties. Asian Meeting of Animal Medicine Specialties; 2019:243.

    • Search Google Scholar
    • Export Citation
  • 2.

    Matsuura K, Yamada S, Enokizono M, et al. Effect of hemodialysis during cardiopulmonary bypass in dogs with azotemia undergoing mitral valve plasty. J Vet Intern Med. 2018;32:2172. Abstract.

    • Search Google Scholar
    • Export Citation
  • 3.

    Kanemoto I, Masumoto T, Ohara K, Kimura Y, Machida N. Short- and long-term results of chordal reconstruction using artificial suture material (polytetrafluoroethylene and polypropylene) in the dog. Vet Sci Dev. 2017;7(1):7882.

    • Search Google Scholar
    • Export Citation
  • 4.

    van Thiel RJ, Koopman SR, Takkenberg JJ, Ten Harkel AD, Bogers AJ. Metabolic alkalosis after pediatric cardiac surgery. Eur J Cardiothorac Surg. 2005;28(2):229233.

    • Search Google Scholar
    • Export Citation
  • 5.

    Wong HR, Chundu KR. Metabolic alkalosis in children undergoing cardiac surgery. Crit Care Med. 1993;21(6):884887.

  • 6.

    Libório AB, Noritomi DT, Leite TT, et al. Increased serum bicarbonate in critically ill patients: a retrospective analysis. Intensive Care Med. 2015;41(3):479486.

    • Search Google Scholar
    • Export Citation
  • 7.

    Ha YS, Hopper K, Epstein SE. Incidence, nature, and etiology of metabolic alkalosis in dogs and cats. J Vet Intern Med. 2013;27(4):847853.

    • Search Google Scholar
    • Export Citation
  • 8.

    Robinson EP, Hardy RM. Clinical signs, diagnosis, and treatment of alkalemia in dogs: 20 cases (1982–1984). J Am Vet Med Assoc. 1988;192(7):943949.

    • Search Google Scholar
    • Export Citation
  • 9.

    Sakamoto Y, Sakai M, Sato K, Watari T. Plasma renin activity and aldosterone concentration in dogs with acquired portosystemic collaterals. J Vet Intern Med. 2020;34(1):139144.

    • Search Google Scholar
    • Export Citation
  • 10.

    DiBartola SP. Metabolic acid-base disorders. In: DiBartola SP, ed. Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice. Saunders; 2012:253286.

    • Search Google Scholar
    • Export Citation
  • 11.

    Rimmer JM, Gennari FJ. Metabolic alkalosis. J Intensive Care Med. 1987;2:137150.

  • 12.

    Gillion V, Jadoul M, Devuyst O, Pochet J-M. The patient with metabolic alkalosis. Acta Clin Belg. 2019;74(1):3440.

  • 13.

    Penman RW, Luke RG, Jarboe TM. Respiratory effects of hypochloremic alkalosis and potassium depletion in the dog. J Appl Physiol. 1972;33(2):170174.

    • Search Google Scholar
    • Export Citation
  • 14.

    Webster NR, Kulkarni V. Metabolic alkalosis in the critically ill. Crit Rev Clin Lab Sci. 1999;36(5):497510.

  • 15.

    Wang S, McDonnell EH, Sedor FA, Toffaletti JG. pH effects on measurements of ionized calcium and ionized magnesium in blood. Arch Pathol Lab Med. 2002;126(8):947950.

    • Search Google Scholar
    • Export Citation
  • 16.

    Höhne C, Krebs MO, Seiferheld M, Boemke W, Kaczmarczyk G, Swenson ER. Acetazolamide prevents hypoxic pulmonary vasoconstriction in conscious dogs. J Appl Physiol. 2004;97(2):515521.

    • Search Google Scholar
    • Export Citation
  • 17.

    López C, Alcaraz AJ, Toledo B, Cortejoso L, Gil-Ruiz MA. Acetazolamide therapy for metabolic alkalosis in pediatric intensive care patients. Pediatr Crit Care Med. 2016;17(12):e551e558. doi: 10.1097/PCC.0000000000000971

    • Search Google Scholar
    • Export Citation
  • 18.

    Perez-Valdivieso JR, Monedero P, Vives M, Garcia-Fernandez N, Bes-Rastrollo M, GEDRCC (Grupo Español de Disfunción Renal en Cirugía Cardiaca). Cardiac-surgery associated acute kidney injury requiring renal replacement therapy: a Spanish retrospective case-cohort study. BMC Nephrol. 2009;10:27. doi: 10.1186/1471-2369-10-27

    • Search Google Scholar
    • Export Citation
  • 19.

    Thakar CV, Arrigain S, Worley S, Jean-Pierre Yared, Emil P Paganini. A clinical score to predict acute renal failure after cardiac surgery. J Am Soc Nephrol. 2005;16(1):162168.

    • Search Google Scholar
    • Export Citation
  • 20.

    Mehta RH, Grab JD, O'Brien SM, et al. Bedside tool for predicting the risk of postoperative dialysis in patients undergoing cardiac surgery. Circulation. 2006;114(21):22082216.

    • Search Google Scholar
    • Export Citation
  • 21.

    Forni LG, Darmon M, Ostermann M, et al. Renal recovery after acute kidney injury. Intensive Care Med. 2017;43(6):855866.

  • 22.

    Ferenbach DA, Bonventre JV. Mechanisms of maladaptive repair after AKI leading to accelerated kidney ageing and CKD. Nat Rev Nephrol. 2015;11(5):264276.

    • Search Google Scholar
    • Export Citation

Metabolic alkalosis following mitral valvuloplasty in a dog with preoperative acute kidney injury

View More View Less
  • 1 From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.
  • | 2 From the Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan.
  • | 3 From the Laboratory of Surgery 1, School of Veterinary Medicine, Azabu University, Kanagawa, Japan.
  • | 4 From the Department of Clinical Engineering, National Cerebral and Cardiovascular Center, Osaka, Japan.

Abstract

CASE DESCRIPTION

An 11-year-old sexually intact male Shih Tzu diagnosed with acute kidney injury and left-sided congestive heart failure that had nonelective mitral valve surgery.

CLINICAL FINDINGS

Metabolic alkalosis developed postoperatively, and plasma bicarbonate concentration peaked 2 days after surgery (40.2 mmol/L; pH, 7.550).

TREATMENT AND OUTCOME

Acetazolamide administration increased the urinary excretion of bicarbonate and contributed to the improvement of the dog’s acid-base status and oxygenation capacity. Metabolic alkalosis persisted for 4 days after surgery, and no treatment was required after resolution. Plasma urea nitrogen and creatinine concentrations normalized 2 days after surgery.

CLINICAL RELEVANCE

Severe metabolic alkalosis can occur as a complication following mitral valve surgery. Acetazolamide may be suitable for the treatment of severe metabolic alkalosis.

Abstract

CASE DESCRIPTION

An 11-year-old sexually intact male Shih Tzu diagnosed with acute kidney injury and left-sided congestive heart failure that had nonelective mitral valve surgery.

CLINICAL FINDINGS

Metabolic alkalosis developed postoperatively, and plasma bicarbonate concentration peaked 2 days after surgery (40.2 mmol/L; pH, 7.550).

TREATMENT AND OUTCOME

Acetazolamide administration increased the urinary excretion of bicarbonate and contributed to the improvement of the dog’s acid-base status and oxygenation capacity. Metabolic alkalosis persisted for 4 days after surgery, and no treatment was required after resolution. Plasma urea nitrogen and creatinine concentrations normalized 2 days after surgery.

CLINICAL RELEVANCE

Severe metabolic alkalosis can occur as a complication following mitral valve surgery. Acetazolamide may be suitable for the treatment of severe metabolic alkalosis.

Contributor Notes

Address correspondence to Dr. Matsuura (k.matsuura.vet@gmail.com).