Hyponatremia in horses with septic pneumopathy. (23rd August 2022)

• Record Type: Journal Article
• Authors: Migliorisi, Alessandro; Barger, Anne; Austin, Scott; Foreman, Jonathan H.; Wilkins, Pamela
• Is Part Of: Journal of veterinary internal medicine. Volume 36:Number 5(2022)
• Page Start: 1820
• Page End: 1826
• Publication Date: 2022-08-23
• Subjects: antidiuretic hormone -- equine -- pneumonia -- respiratory -- sodium; Veterinary medicine -- Periodicals; 636.0896
• DOI: 10.1111/jvim.16522
• Languages: English
• ISSNs: 0891-6640

Abstract

Abstract: Background: Hyponatremia is common in horses with bacterial pleuropneumonia, but no further characterization of this abnormality has been reported. Objectives: Describe admission plasma sodium concentration ([Na]) in horses with septic pneumopathy and evaluate any association of plasma [Na] with markers of systemic inflammation. Animals: Medical records of horses >1 month of age that between 2008 and 2021 had a transtracheal aspirate (TTA) performed, abnormal TTA cytology, positive TTA culture, pulmonary disease on ultrasonography, radiography or both, and plasma [Na] assessed by direct ion‐selective‐electrode (dISE). Horses with concurrent diarrhea or azotemia were excluded. Methods: Clinical and clinicopathological variables of interest between hypo‐ and normonatremic horses were compared. Spearman correlation and Fisher exact tests were used to identify significant associations ( P < .05). Results: Twenty of 35 horses had hyponatremia (median, 132 mmol/L; 25‐75th interquartile range [IQR], 129.7‐133.1 mmol/L; reference range, 134.2‐138.4 mmol/L). A higher proportion of horses with systemic inflammatory response syndrome (SIRS) had hyponatremia ( P = .01). Hyponatremic patients had higher mean plasma fibrinogen concentration (461 ± 160.5 mg/dL; P = .01) and higher rectal temperature (38.8 ± 0.7°C; P = .02) than normonatremic horses. Negative correlations were found between plasma [Na] and fibrinogen ( P = .001; ρ = −0.57) concentrations and between plasma [Na] and rectal temperature ( P = .001; ρ = −0.51). Presence or absence of pleural effusion did not influence severity of hyponatremia. Mean duration of hospitalization was longer ( P = .04) in hyponatremic horses (9.8 ± 6.6 days). Conclusions and Clinical Importance: Hyponatremia at admission is associated with the presence of inflammation, SIRS, and with longer duration of hospitalization.