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14 Δεκ 2021 · The therapeutic objective in treating chronic hypernatremia is to raise the serum [Na] no more than 8 to 12 mm/L during the first 24 hours and then continue with slow correction with close monitoring over the next 24 to 48 hours.
With salt toxicity (from homemade play dough, salt emetic ingestion, etc.), patients will develop acute hypernatremia within several hours (e.g., 140 to 180 mEq/L). Treatment should be initiated promptly and includes rapid correction of the sodium levels.
Hypernatremia is defined as a plasma or serum [Na] above the reference range and reflects the loss of water in excess of sodium, or the addition of sodium in excess of water. In healthy animals, central osmoreceptors will detect the associated increase in osmolarity and trigger water-seeking behaviors and antidiuretic hormone release.
Hypernatremia was associated with a higher case fatality rate than hyponatremia. Among the animals with moderate or severe hypernatremia, 50% of dogs and 38.5% of cats presented with community‐acquired hypernatremia, and 50% of dogs and 61.5% of cats developed hospital‐acquired hypernatremia.
Correction of hypernatremia through inappropriate fluid therapy can result in even more severe complications, ranging from cerebral edema to coma and death. This article reviews the pathophysiology, causes, classification, treatment, and prognosis of hypernatremia.
Returning of sodium concentrations to the normal range is crucial in patient management – and needs to be carried out in a careful manner, to avoid decreasing serum osmolality too rapidly. This short podcast reviews an approach to the management of a dog with hypernatraemia, with the aim of helping avoid common pitfalls of rapid sodium ...
Treatment is predominantly impacted by underlying cause, acuity versus chronicity, volume status, and need for fluid resuscitation. Address underlying cause when possible. Gradually reduce Na + to avoid osmotic injury unless change is known to be acute.
