Intermittent Hemodialysis in a Dog with Chronic Kidney Disease: Electrocardiographic Aspects
World Small Animal Veterinary Association World Congress Proceedings, 2015
J.F.A. Ribeiro; M.L.G. Lourenço; A. Melchert; S.S. Geraldes; P.T.C. Guimarães-Okamoto
Veterinary Clinical Department, School of Veterinary Medicine and Animal Science, Veterinary State University of São Paulo (UNESP), Botucatu, Brazil

Introduction

Intermittent hemodialysis (IHD) is used in dogs with chronic kidney disease (CKD) for reduction of chronic progressive azotemia, hyperkalemia, and fluid overload.

Objectives

Evaluation electrocardiographic in dogs with CKD subjected to IHD and medical management.

Methods

The first dog was submitted to intravenous fluid with Ringer's lactate twice a week at a rate of 5 ml/kg/h, and the other to IHD twice a week, 3 h/session, blood flow of 5 ml/kg/min, dialysate flow rate of 500 ml/min, ultrafiltration 5 ml/kg/h and 50 IU/kg/h of heparin.

Results

The dog submitted to fluid, despite electrolyte abnormalities having a normal ECG, with ST-segment depression (0.11 ± 0.078 mV) and T-wave amplitude of 0.6 ± 0.39 mV. After fluid, there was a reduction of ionized calcium (from 0.95 ± 0.16 to 0.73 ± 0.12 mmol/L) and phosphorus (6.38 ± 1.21 to 5.95 ± 0.12 mg/dl) and a raise of potassium (3.78 ± 0.61 to 3.91 ± 0.45 mEq/L) and sodium (136.8 ± 9.7 to 137.4 ± 9.17 mEq/L). There was a heart rate (HR) average increase (159.9 ± 18.05 to 171.7 ± 14.89 bpm) and a decrease of T-wave amplitude (0.5 ± 0.24 mV), ST-segment depression (0.10 ± 0.07 mV) and QT interval (0.18 ± 0.02 to 0.17 ± 0.03 s). The dog submitted to IHD had hyperphosphatemia (13.35 ± 2.62 mEq/L), hyperkalemia (6.05 ± 0.07 mEq/L) and hypocalcemia (1.00 ± 0.12 mmol/L), normal ST-segment and T-wave amplitude of 0.17 ± 0.05 mV. With the decrease of phosphorus (7.9 ± 2.97 mEq/L) and potassium (3.45 ± 0.07 mEq/L) after IHD, it was observed an increase in HR average (138.5 ± 4.95 for 168.5 ± 12.02 bpm), decreased QT interval (0.2 ± 0 to 0.18 ± 0.02 s) and T-wave amplitude (0.14 ± 0.05 mV).

Conclusions

These findings suggest the HDI in DRC cause electrocardiographic changes such as HR increased and T-wave amplitude decreased resulting from electrolyte disturbances. Grant: FAPESP: 2013/02932-8.

  

Speaker Information
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M.L.G. Lourenço
Veterinary Clinical Department
School of Veterinary Medicine and Animal Science
Veterinary State University of São Paulo (UNESP)
Botucatu, Brazil


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