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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. See FIGURE 2 for an algorithm of the management of the hypernatremic patient.
Treatment should be initiated promptly and includes rapid correction of the sodium levels. We can drop the sodium levels rapidly by resuscitating or hydrating the patient with a low-sodium fluid. VETgirl’s general rule? Hydrate the patient first with a lower-sodium fluid such as LRS or Plasmalyte-A.
When evaluating hypernatraemia, it is vitally important to assess a patient’s volume status on physical examination (heart rate, pulse quality, mucous membrane colour, capillary refill time) to compose a differential diagnoses list and instigate effective treatment. The following is an example of a differential diagnoses list:
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.
In contrast, chronic hypernatremia (i.e., lasting for >24 hours) is often well tolerated because it triggers the production of osmotically active chemicals (“idiogenic” osmoles) within neurons.11 These prevent the efflux of water and maintain normal cellular volume. However, rapid correction of established hypernatremia can be
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 ...
Mild hypernatremia is common in dogs from being dehydrated or overheated, but it can be life threatening if the sodium reaches an amount high enough (over 170 mEq/L) to cause symptoms.
