Experimental model of hypochloremic metabolic alkalosis caused by diversion of abomasal outflow in sheep

Donald F. Smith From the Departments of Surgical Sciences (Smith, Robinson), Medical Sciences (Lunn, McGuirk) and Pathobiological Sciences (MacWilliams), School of Veterinary Medicine, and the Department of Forestry, School of Agricultural and Life Sciences (Nordheim), University of Wisconsin-Madison, Madison, WI 53706.

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D. Paul Lunn From the Departments of Surgical Sciences (Smith, Robinson), Medical Sciences (Lunn, McGuirk) and Pathobiological Sciences (MacWilliams), School of Veterinary Medicine, and the Department of Forestry, School of Agricultural and Life Sciences (Nordheim), University of Wisconsin-Madison, Madison, WI 53706.

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Gail M. Robinson From the Departments of Surgical Sciences (Smith, Robinson), Medical Sciences (Lunn, McGuirk) and Pathobiological Sciences (MacWilliams), School of Veterinary Medicine, and the Department of Forestry, School of Agricultural and Life Sciences (Nordheim), University of Wisconsin-Madison, Madison, WI 53706.

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Sheila M. McGuirk From the Departments of Surgical Sciences (Smith, Robinson), Medical Sciences (Lunn, McGuirk) and Pathobiological Sciences (MacWilliams), School of Veterinary Medicine, and the Department of Forestry, School of Agricultural and Life Sciences (Nordheim), University of Wisconsin-Madison, Madison, WI 53706.

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Erik V. Nordheim From the Departments of Surgical Sciences (Smith, Robinson), Medical Sciences (Lunn, McGuirk) and Pathobiological Sciences (MacWilliams), School of Veterinary Medicine, and the Department of Forestry, School of Agricultural and Life Sciences (Nordheim), University of Wisconsin-Madison, Madison, WI 53706.

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Peter S. MacWilliams From the Departments of Surgical Sciences (Smith, Robinson), Medical Sciences (Lunn, McGuirk) and Pathobiological Sciences (MacWilliams), School of Veterinary Medicine, and the Department of Forestry, School of Agricultural and Life Sciences (Nordheim), University of Wisconsin-Madison, Madison, WI 53706.

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SUMMARY

Hypochloremic metabolic alkalosis accompanied by hypokalemia and hyponatremia was induced experimentally in 7 adult sheep by diversion (loss) of gastric contents through an Ivan and Johnston cannula placed in the cranial part of the duodenum just distal to the pylorus. Cannula placement was easily accomplished, and cannulae were tolerated well by the sheep. Volume of effluent produced during the 60- to 120-hour period of diversion ranged from 7.7 to 14.9 L and tended to be greatest during the first 24 hours. All sheep became dehydrated, with mean pcv and plasma total protein concentration increases of 94.2 and 61.7%, respectively. Plasma chloride concentration decreased in linear fashion from a prediversion mean of 113 mEq/L (range, 111 to 117 mEq/L) to an end-point mean of 54 mEq/L (range, 45 to 65 mEq/L). Plasma sodium and potassium concentrations also decreased, though potassium concentration increased terminally. There were rapid increases in arterial blood pH and bicarbonate and base excess concentrations during the first 48 hours after diversion. However, during the final stages of diversion, sheep developed superimposed metabolic acidosis with increased plasma lactate concentration and high anion gap.

SUMMARY

Hypochloremic metabolic alkalosis accompanied by hypokalemia and hyponatremia was induced experimentally in 7 adult sheep by diversion (loss) of gastric contents through an Ivan and Johnston cannula placed in the cranial part of the duodenum just distal to the pylorus. Cannula placement was easily accomplished, and cannulae were tolerated well by the sheep. Volume of effluent produced during the 60- to 120-hour period of diversion ranged from 7.7 to 14.9 L and tended to be greatest during the first 24 hours. All sheep became dehydrated, with mean pcv and plasma total protein concentration increases of 94.2 and 61.7%, respectively. Plasma chloride concentration decreased in linear fashion from a prediversion mean of 113 mEq/L (range, 111 to 117 mEq/L) to an end-point mean of 54 mEq/L (range, 45 to 65 mEq/L). Plasma sodium and potassium concentrations also decreased, though potassium concentration increased terminally. There were rapid increases in arterial blood pH and bicarbonate and base excess concentrations during the first 48 hours after diversion. However, during the final stages of diversion, sheep developed superimposed metabolic acidosis with increased plasma lactate concentration and high anion gap.

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