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

Katsuhiro Matsuura From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.
From the Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan.

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Tomohiko Yoshida From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.
From the Department of Veterinary Surgery, Tokyo University of Agriculture and Technology, Tokyo, Japan.

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Takuya Uehara From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.
From the Laboratory of Surgery 1, School of Veterinary Medicine, Azabu University, Kanagawa, Japan.

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Shusaku Yamada From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.

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Hideki Yotsuida From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.
From the Department of Clinical Engineering, National Cerebral and Cardiovascular Center, Osaka, Japan.

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Mizuki Hasegawa From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.
From the Laboratory of Surgery 1, School of Veterinary Medicine, Azabu University, Kanagawa, Japan.

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Sakie Katayose From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.
From the Laboratory of Surgery 1, School of Veterinary Medicine, Azabu University, Kanagawa, Japan.

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Kurumi Yamada From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.

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Youta Yaginuma From the VCA Japan Shiraishi Animal Hospital, Saitama, Japan.

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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.

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