Metabolic acidosis in neonatal calf diarrhea-clinical findings and theoretical assessment of a simple treatment protocol

Effectiveness of oral electrolyte solutions with different compositions for the treatment of neonatal calves with induced osmotic diarrhea

ABSTRACT In a randomized controlled trial, we evaluated the effects of five oral electrolyte solutions (OESs) with different compositions of water, electrolyte, and acid-base balances of diarrheal neonatal calves. Osmotic diarrhea and dehydration were induced with sucrose in milk, spironolactone, and hydrochlorothiazide for 48 h in thirty 10-day old Holstein healthy calves with 43.5 ± 3.80 kg BW who were fed with natural milk. They were allocated to five treatment groups (n=6) based on the administered OES (commercial: OES A, B, C, D; and non-commercial: OES UEL). On the day of treatment, the calves received 6L of OES in two doses apart from milk intakes. Venous blood samples were collected at -48h (start of induction), -24h, 0h (start of the treatment day), 8h, 16h, 24h, 48h, and 72h. TPP, glucose, D-lactate, L-lactate, pH, pCO2, HCO3 -, BE, Na+, K+, Cl-, SID3, SIG, AG, Atot and percentage change in plasma volume (%PV) were measured or calculated and analyzed by two-way repeated measures ANOVA. All the calves developed osmotic diarrhea, mild to moderate dehydration, hyponatremia, relative hyperchloremia, and moderate to severe metabolic acidosis. The tested OESs were well accepted by the calves and effective in reversing dehydration, electrolyte imbalances, and metabolic acidosis. OES D did not completely correct hyponatremia, and SEO B caused transient hyperglycemia. It has been concluded that all the tested OESs are safe and effective for the treatment of diarrhea in calves with moderate degrees of dehydration and metabolic acidosis, which indicates that they have proper compositions for this purpose.

Can apps be used to formulate fluid therapy plans in veterinary medicine?

BACKGROUND

Formulating sophisticated fluid therapy plans can be complicated and time consuming. Consequently, veterinarians in the field who lack experience, time, or confidence may formulate suboptimal fluid therapy plans.

OBJECTIVES

Compare conventional and app-guided fluid therapy plans for simulated cases of neonatal calf diarrhea.

PARTICIPANTS

Third and fourth year veterinary students (n = 55) from The University of Sydney.

METHODS

We developed a web app to assist fluid therapy formulation (http://calfaid.com) that was evaluated in a randomized case simulation trial. Participants were instructed to perform fluid therapy calculations and formulate an integrated fluid therapy plan for case scenarios using conventional methods and using the fluid therapy app. Responses were scored by a blinded study investigator using an a priori scoring guide and groups (conventional vs. app-guided) were compared using linear mixed models.

RESULTS

On average, total scores for app-guided fluid therapy calculations were 20.6% points higher (95% confidence interval [CI], 14.1-27.1) than calculations completed using the conventional method (88.2% vs. 67.5%, respectively). On average, total scores for app-guided integrated fluid therapy plans were 14.2% points higher (95% CI, 6.3-22.2; 65.8% vs. 51.2%). Eighty percent of respondents indicated they would prefer to use the app-guided method over the conventional method.

CONCLUSION AND CLINICAL IMPORTANCE

Our findings suggest that fluid therapy plans can be improved using apps.

Macronutrient profile in milk replacer or a whole milk powder modulates growth performance, feeding behavior, and blood metabolites in ad libitum-fed calves

Milk replacers (MR) for calves usually contain more lactose and less fat than bovine whole milk (WM). There are insufficient data to determine whether these MR formulations are optimal for calves fed at high planes of nutrition. Thus, the effect of 3 MR formulations and a WM powder were evaluated on growth, feeding behavior, and blood metabolites in 96 male Holstein calves fed ad libitum and with 45.5 ± 4.30 kg (mean ± SD) BW at arrival. Calves were blocked based on arrival sequence, and randomly assigned within block to one of the 4 treatments (n = 24 calves/group): a high-fat MR (25.0% fat, dry matter basis; 22.5% protein, 38.6% lactose; 21.3 MJ/kg; HF), a high lactose MR (44.6% lactose, 22.5% protein, 18.0% fat; 19.7 MJ/kg; HL), a high protein MR (26.0% protein, 18.0% fat, 41.5% lactose; 20.0 MJ/kg; HP), and a WM powder (26.0% fat; 24.5% protein, 38.0% lactose; 21.6 MJ/kg; WP). In the first 2 wk after arrival, calves were individually housed and were fed 3.0 L of their respective liquid feed 3 times daily at 135 g/L. They were then moved to group housing and fed ad libitum until d 42 after arrival. Weaning was gradual and took place between d 43 and 70 after arrival; thereafter, calves were fed solids only. Concentrates, chopped straw, and water were available ad libitum throughout the study. Body weight was measured, and blood was collected at arrival and then weekly thereafter from wk 1 to 12. Weight gain and height were greater in HL than WP calves. In the preweaning phase, HL and HP-fed calves consumed more milk than WP, and HL-fed calves consumed more milk than HF calves. In wk 10, starter feed intakes were lower in HF calves than in the other groups. In the preweaning phase, ME intakes were the same for all treatments. This suggests that milk intakes were regulated by the energy density of the milk supplied. The percentage of calves requiring therapeutic interventions related to diarrhea was greater in WP-fed calves (29%) than HF and HL calves (4%), whereas HP (13%) did not differ with other groups. This was coupled with lower blood acid-base, blood gas, and blood sodium in WP than in MR-fed calves. Calves fed HF had greater serum nonesterified fatty acids compared with other groups, and greater serum amyloid A compared with WP and HL calves. Among the serum parameters, insulin-like growth factor-1 and lactate dehydrogenase correlated positively with MR intake and average daily gain. The high lactose and protein intakes in HL and HP calves led to greater insulin-like growth factor-1 concentrations than in WP-fed calves. Although growth differences were limited among MR groups, the metabolic profile largely differed and these differences require further investigation.

Intravenous and Oral Fluid Therapy in Neonatal Calves With Diarrhea or Sepsis and in Adult Cattle

Optimal fluid therapy protocols in neonatal calves and adult cattle are based on consideration of signalment, history, and physical examination findings, and individually tailored whenever laboratory analysis is available. Measurement of the magnitude of eye recession, duration of skin tenting in the lateral neck region, and urine specific gravity by refractometry provide the best estimates of hydration status in calves and cattle. Intravenous and oral electrolyte solutions (OES) are frequently administered to critically ill calves and adult cattle. Application of physicochemical principles indicates that 0.9% NaCl, Ringer's solution, and 5% dextrose are equally acidifying, lactated Ringer's and acetated Ringer's solution are neutral to mildly acidifying, and 1.3-1.4% sodium bicarbonate solutions are strongly alkalinizing in cattle. Four different crystalloid solutions are recommended for intravenous fluid therapy in dehydrated or septic calves and dehydrated adult cattle: (1) lactated Ringer's solution and acetated Ringer's solution for dehydrated calves, although neither solution is optimized for administration to neonatal calves or adult cattle; (2) isotonic (1.3%) or hypertonic (5.0 or 8.4%) solutions of sodium bicarbonate for the treatment of calves with diarrhea and severe strong ion (metabolic) acidosis and hyponatremia, and adult cattle with acute ruminal acidosis; (3) Ringer's solution for the treatment of metabolic alkalosis in dehydrated adult cattle, particularly lactating dairy cattle; and (4) hypertonic NaCl solutions (7.2%) and an oral electrolyte solution or water load for the rapid resuscitation of dehydrated neonatal calves and adult cattle. Much progress has been made since the 1970's in identifying important attributes of an OES for diarrheic calves. Important components of an OES for neonatal calves are osmolality, sodium concentration, the effective SID that reflects the concentration of alkalinizing agents, and the energy content. The last three factors are intimately tied to the OES osmolality and the abomasal emptying rate, and therefore the rate of sodium delivery to the small intestine and ultimately the rate of resuscitation. An important need in fluid and electrolyte therapy for adult ruminants is formulation of a practical, effective, and inexpensive OES.

Dependence of the apparent bicarbonate space on initial plasma bicarbonate concentration and carbon dioxide tension in neonatal calves with diarrhea, acidemia, and metabolic acidosis

BACKGROUND

Marked strong ion (metabolic) acidosis in neonatal diarrheic calves usually is corrected by IV administration of NaHCO₃ . The distribution space for IV-administered bicarbonate, called the apparent bicarbonate space (ABS), appears to depend on initial plasma bicarbonate concentration (cHCO₃ ) and varies considerably in calves.

OBJECTIVE

To determine whether ABS was associated with initial plasma cHCO₃ and other acid-base variables.

ANIMALS

Twenty-five neonatal diarrheic calves with acidemia and metabolic acidosis.

METHODS

Prospective observational study using a convenience sample. Calves received NaHCO₃ (10 mmol/kg) and glucose (1.4 mmol/kg) IV in a crystalloid solution at 25 mL/kg over 60 minutes. The ABS (L/kg) was calculated at 4 time points over 2 hours after the end of the infusion. The relationship between ABS and initial acid-base variables was characterized using nonlinear, linear, and stepwise regression.

RESULTS

The median value for ABS calculated from the initial plasma cHCO₃ increased from 0.53 L/kg (range, 0.40-0.79) at the end of IV infusion to 0.96 L/kg (range, 0.54-1.23) 120 minutes later. Data obtained at the end of infusion provided the best fit to initial plasma cHCO₃ and jugular venous blood Pco₂ , such that: ABS = 0.41 + 1.06/cHCO₃ and ABS = 0.87-0.0082 × Pco₂ .

CONCLUSIONS AND CLINICAL IMPORTANCE

The observed median value for ABS of 0.53 L/kg in our study was similar to the empirically used value of 0.6. However, ABS values varied widely and were increased in calves with severe metabolic acidosis. We therefore recommend calculating ABS using the initial plasma cHCO₃ or venous blood Pco₂ , if respective measurements are available.

Relationship between the values of blood parameters and physical status in Korean native calves with diarrhea

Dehydration, electrolyte disturbance, and acid-base imbalance are the most significant consequences of diarrhea in calves. We aimed to determine blood gas, hematological, electrolyte, and biochemical values and investigate the relationship between the physical status and blood parameters in Korean native calves (KNCs) with diarrhea. One hundred eighty KNCs with diarrhea (age < 75 days) were investigated. Blood samples were collected from the external jugular vein and analyzed using a portable clinical blood gas analyzer. The measured parameters were statistically compared according to the status of physical activity, dehydration, or prognosis. The mean values of parameters in the Calves with diarrhea showed metabolic acidosis, hyponatremia, and azotemia. The mean values of potassium, chloride, hematocrit, and hemoglobin were in the upper limit of their reference ranges. More than 75% of the calves had metabolic acidosis caused by bicarbonate loss, and 63.6% had high blood urea nitrogen (BUN) values. Moreover, BUN showed the highest correlation with the physical activity status and dehydration. pH, base excess of the extracellular fluid (BE), anion gap, potassium, hematocrit, bicarbonate, and hemoglobin were closely correlated with physical deterioration and dehydration (p < 0.001). BUN, pH, BE, and anion gap were closely correlated with physical deterioration and dehydration. These correlations between clinical symptoms and blood gas parameters can be clinically relevant in predicting the status of parameters according to clinical symptoms.

Clinical application of 2.16% hypertonic saline solution to correct the blood sodium concentration in diarrheic calves with hyponatremia

The aim of this study was to examine whether 2.16% hypertonic saline solution (HSS) is useful for the treatment of diarrheic calves with hyponatremia. Eleven of 13 female Holstein calves exhibiting moderate diarrhea and hyponatremia received 1,250 ml of 2.16% HSS over 15 min regardless of body weight. The remaining two calves that were unable to stand and had severe hyponatremia received 2,500 ml of 2.16% HSS intravenously over 30 min. As a result, hyponatremia in all diarrheic calves was significantly improved by the administration of 2.16% HSS from 122.2 ± 7.0 mEq/l at pre to 134.8 ± 3.7 mEq/l at post, which was above the threshold of 132 mEq/l for hyponatremia. Therefore, 2.16% HSS may be useful for hyponatremia in calves with diarrhea.

Tonicity of oral rehydration solutions affects water, mineral and acid-base balance in calves with naturally occurring diarrhoea

Recommendations for composition of oral rehydration solutions (ORS) for calves, particularly concerning Na⁺, glucose, and their combined effect on tonicity, are not in line with guidelines for humans. Thus, this study aimed to determine the effect of ORS tonicity on water, mineral and acid–base balance. Seventy‐two calves were selected based on the severity of dehydration and blood base excess (BE) on day 0. Five calves that did not develop diarrhoea were removed post‐inclusion from the study. Calves were allocated to blocks of four animals based on blood BE on day 1. Within each block, calves were randomly assigned to one of four treatments: (a) hypotonic ORS with low Na⁺ and lactose (HYPO); (b) isotonic ORS with low Na⁺and glucose (ISO); (c) hypertonic ORS with high Na⁺ and glucose (HYPER); and (d) control consisting of warm water including 5 g/L of whey powder (CON). Treatments were administered twice daily over a 3‐day period, in which calves were offered 2.0 L of treatment at 1300 and 2100 hr. Calves were fed 2.5 L of milk replacer at 0700 and 1630 hr from day 1 to 3 and 3.0 L from day 4 to 5, and had access to water. Calves were monitored for 5 days in which measurements included intakes, BW, blood sampling and collection of faeces on day 1 and urine from day 1 to 3. All ORS treatments maintained normal serum Na⁺, whereas CON did not. Calves in the HYPER group had lower blood pH and greater faecal Na⁺ losses than HYPO and ISO. Plasma expansion relative to baseline was higher in low tonicity ORS (+4.8%) when compared with CON (+1.0%). Urine osmolality was 30% higher in HYPER calves. In this experiment, low tonicity ORS were more effective at restoring water, mineral and acid–base balance than the hypertonic ORS.

Identifying hydric, electrolytic and acid-base imbalances through traditional and quantitative approaches in dogs with hemorrhagic gastroenteritis

ABSTRACT Vomiting and diarrhea are two important clinical signs that can cause significant electrolytic and acid-base imbalances. The purposes of this study were to characterize hydric, electrolytic and acid-base disorders presented by puppies with hemorrhagic gastroenteritis and to compare the traditional and quantitative approaches to acid-base status interpretation. Sixty-one animals with a history of vomiting and/or diarrhea were used in this study and the following tests were performed: complete blood count, total plasma protein concentration and hemogasometry. Mean, standard deviation and Kappa values were calculated. The imbalances characterized by both approaches were: 42 (69%) animals without imbalance, 17 (28%) with metabolic alkalosis and 2 (3%) with metabolic acidosis by the traditional approach and 17 (28%) dogs without imbalance, 26 (43%) with metabolic alkalosis and 18 (29%) with metabolic acidosis by the quantitative approach. The agreement calculated between two approaches coincide in 28 cases, with a moderate Kappa value equivalent to 0.459. The most found imbalances were metabolic alkalosis, hypokalemia, and mild dehydration. Most of acid-base disturbances were not identified by the traditional approach, whereas by the quantitative approach, they were easily determined. Thus quantitative approach proved to be superior in identification of possible acid-base imbalances.

Plasma citrulline, arginine, nitric oxide, and blood ammonia levels in neonatal calves with acute diarrhea

Background

Plasma citrulline (CIT) concentration is considered to be a reliable marker of functional enterocyte mass, primarily in humans. However, information about CIT levels along with related metabolites, arginine (ARG), nitric oxide (NO), and ammonia in neonatal calves are lacking.

Objectives

To compare plasma CIT, ARG, NO, and whole blood ammonia concentrations in neonatal calves with acute diarrhea with those in healthy calves and to assess their possible relationships with diarrhea‐related criteria.

Animals

Seventy neonatal calves (60 with acute diarrhea and 10 healthy).

Methods

Observational case‐control study. Diarrheic calves were classified into subgroups on the basis of etiology, severity of diarrhea, degree of dehydration, and systemic inflammatory response syndrome (SIRS) status. Plasma CIT and ARG concentrations were measured by liquid chromatography/tandem mass spectrometry.

Results

Plasma CIT (median [range]: 67.5 [61.9‐75.4] vs 30.1 [15.0‐56.1] μmol/L) and ARG (170.7 [148.5‐219.5] vs 106.1 [54.4‐190.7] μmol/L) were lower and plasma NO (4.42 [3.29‐5.58] vs 6.78 [5.29‐8.92] μM) and blood ammonia concentrations (28.7 [26.1‐36.9] vs 59.8 [34.6‐99.5] μmol/L) were higher in the neonatal calves with diarrhea (P < .001). Plasma CIT (β = −0.29, P = .02), ARG (β = −0.33, P = .01), NO (β = 0.55, P < .001), and blood ammonia (β = 0.63, P <.001) were affected by SIRS status. Except for ammonia (0.52), the effects sizes for severity of diarrhea and degree of dehydration were small (ηp2 ≤ 0.45) for CIT, ARG, and NO.

Conclusions and Clinical Importance

The changes in these variables might have diagnostic, prognostic, and therapeutic value in diarrheic neonatal calves.

Temporal changes of abomasal contents and volumes in calves fed milk diluted with oral rehydration salt solution

Several manufacturers recommend to feed mixture comprising equal amounts of oral rehydration salt (ORS) solution and milk for diarrheic calves after milk withdrawal. Such a feeding method is expected to supply more nutrients and energy compared to feeding only the ORS solution. However, little is known about the effects of feeding milk diluted with ORS solution on calves' digestive process. This study examined the abomasal contents, volumes, and emptying rates in calves fed whole milk, milk diluted by 50% with ORS solution (50% ORS-milk), and ORS solution. Ultrasonography identified curds in the milk-fed calves, but not in the 50% ORS-milk-fed or the ORS-fed calves. The abomasal fluid of the 50% ORS-milk-fed calves contained not only β-lactoglobulin but also α-casein (CN), β-CN, and κ-CN, which were used for curd formation and undetectable in the milk-fed calves. Abomasal pH was relatively higher in the 50% ORS-milk-fed than that in the milk-fed calves. Abomasal emptying rates were significantly faster in the ORS-fed than in the 50% ORS-milk-fed and the milk-fed calves. These data indicate that the formation of abomasal curd is inhibited in the 50% ORS-milk-fed calves due to the resultant high abomasal pH and low κ-CN concentration. The 50% ORS-milk may not provide rehydration as quickly as the ORS solution. In conclusion, we do not recommend feeding 50% ORS-milk to calves.

Effect of Intravenous Small-Volume Hypertonic Sodium Bicarbonate, Sodium Chloride, and Glucose Solutions in Decreasing Plasma Potassium Concentration in Hyperkalemic Neonatal Calves with Diarrhea

Background

Hyperkalemia is a frequently observed electrolyte imbalance in dehydrated neonatal diarrheic calves that can result in skeletal muscle weakness and life‐threatening cardiac conduction abnormalities and arrhythmias.

Hypothesis

Intravenous administration of a small‐volume hypertonic NaHCO₃ solution is clinically more effective in decreasing the plasma potassium concentration (cK) in hyperkalemic diarrheic calves than hypertonic NaCl or glucose solutions.

Animals

Twenty‐two neonatal diarrheic calves with cK >5.8 mmol/L.

Methods

Prospective randomized clinical trial. Calves randomly received either 8.4% NaHCO₃ (6.4 mL/kg BW; n = 7), 7.5% NaCl (5 mL/kg BW; n = 8), or 46.2% glucose (5 mL/kg BW; n = 7) IV over 5 minutes and were subsequently allowed to suckle 2 L of an electrolyte solution. Infusions with NaHCO₃ and NaCl provided an identical sodium load of 6.4 mmol/kg BW.

Results

Hypertonic NaHCO₃ infusions produced an immediate and sustained decrease in plasma cK. Hypertonic glucose infusions resulted in marked hyperglycemia and hyperinsulinemia, but cK remained unchanged for 20 minutes. Between 30 and 120 minutes after initiation of treatment, the most marked decrements in cK from baseline occurred in group NaHCO₃, which were significantly (P < .05) larger during this period of time than in calves in group NaCl, but not group glucose. After 120 minutes, the mean decrease in cK from baseline was −26 ± 10%, −9 ± 8%, and −22 ± 6% in groups NaHCO₃, NaCl, and glucose, respectively.

Conclusions/Clinical Importance

Small‐volume hypertonic NaHCO₃ infusions appear to have clinical advantages for the rapid resuscitation of hyperkalemic diarrheic calves, compared to hypertonic NaCl or glucose solutions.

Risk factors for the development of hypokalemia in neonatal diarrheic calves

Background

Neonatal diarrheic calves have a clear negative potassium balance because of intestinal losses and decreased milk intake but in the presence of acidemia, they usually show normokalemic or hyperkalemic plasma concentrations.

Objectives

To assess whether marked hypokalemia occurs in response to the correction of acidemia and dehydration and to identify factors that are associated with this condition.

Animals

Eighty‐three calves with a clinical diagnosis of neonatal diarrhea.

Methods

Prospective cohort study. Calves were treated according to a clinical protocol using an oral electrolyte solution and commercially available packages of 8.4% sodium bicarbonate, 0.9% saline and 40% dextrose infusion solutions.

Results

The proportion of hypokalemic calves after 24 hours of treatment (19.3%) was twice as great as it was on admission to the hospital. Plasma K⁺ after 24 hours of treatment was not significantly correlated to venous blood pH values at the same time but positively correlated to venous blood pH values on admission (r = 0.51, P < .001). Base excess on admission (Odds ratio [OR] = 0.81, 95% confidence interval [CI] = 0.70–0.94), duration of diarrhea (OR = 1.37, 95% CI = 1.05–1.80), milk intake during hospitalization (OR = 0.54, 95% CI = 0.37–0.79) and plasma sodium concentrations after 24 hours (OR = 1.12, 95% CI = 1.01–1.25) were identified to be independently associated (P < .05) with a hypokalemic state after 24 hours of treatment.

Conclusions and Clinical Importance

Findings of this study suggest that marked depletion of body potassium stores is evident in diarrheic calves that suffered from marked metabolic acidosis, have a low milk intake and a long history of diarrhea.

Quantitative physicochemical analysis of acid-base balance and clinical utility of anion gap and strong ion gap in 806 neonatal calves with diarrhea

BACKGROUND

Acid-base abnormalities in neonatal diarrheic calves can be assessed by using the Henderson-Hasselbalch equation or the simplified strong ion approach which use the anion gap (AG) or the strong ion gap (SIG) to quantify the concentration of unmeasured strong anions such as D-lactate.

HYPOTHESIS/OBJECTIVES

To determine and compare the clinical utility of AG and SIG in quantifying the unmeasured strong anion charge in neonatal diarrheic calves, and to examine the associations between biochemical findings and acid-base variables by using the simplified strong ion approach. We hypothesized that the SIG provides a more accurate prediction of unmeasured strong anions than the AG.

ANIMALS

Eight hundred and six neonatal diarrheic calves admitted to a veterinary teaching hospital.

METHODS

Retrospective study utilizing clinicopathologic findings extracted from medical records.

RESULTS

Hyperphosphatemia was an important predictor of venous blood pH. Serum inorganic phosphorus and plasma D-lactate concentrations accounted for 58% of the variation in venous blood pH and 77% of the variation in AG and SIG. Plasma D- and total lactate concentrations were slightly better correlated with SIG (rs = -0.69; -0.78) than to AG (rs = 0.63; 0.74).

CONCLUSIONS AND CLINICAL IMPORTANCE

Strong ion gap is slightly better at quantifying the unmeasured strong anion concentration in neonatal diarrheic calves than AG. Phosphorus concentrations should be included as part of the calculation of Atot when applying the simplified strong ion approach to acid-base balance to critically ill animals with hyperphosphatemia.

Acid-base disorders in calves with chronic diarrhea

The aim of this study was to analyze disorders of acid-base balance in calves with chronic diarrhea caused by mixed, viral, bacterial and Cryptosporydium parvum infection. We compared results ob- tained with the classic model (Henderson-Hasselbalch) and strong ion approach (the Steward model). The study included 36 calves aged between 14 and 21 days. The calves were allocated to three groups: I - (control) non-diarrheic calves, group II - animals with compensated acid-base imbalance and group III calves with compensated acid-base disorders and hypoalbuminemia. Plasma concentrations of Na+, K+, Cl-, C12+, Mg2+, P, albumin and lactate were measured. In the classic model, acid-base balance was determined on the basis of blood pH, pCO2, HCO3-, BE and anion gap. In the strong ion model, strong ion difference (SID), effective strong anion difference, total plasma concentration of nonvolatile buffers (A(Tot)) and strong ion gap (SIG) were measured. The control calves and the animals from groups II and III did not differ significantly in terms of their blood pH. The plasma concentration of HCO3-, BE and partial pressure of CO2 in animals from the two groups with chronic diarrhea were significantly higher than those found in the controls. The highest BE (6.03 mmol/l) was documented in calves from group II. The animals from this group presented compensation resulted from activation of metabolic mechanisms. The calves with hypoal- buminemia (group III) showed lower plasma concentrations of albumin (15.37 g/L), Cl (74.94 mmol/L), Mg2+ (0.53 mmol/L), P (1.41 mmol/L) and higher value of anion gap (39.03 mmol/L). This group III presented significantly higher SID3 (71.89 mmol/L), SID7 (72.92 mmol/L) and SIG (43.53 mmol/L) values than animals from the remaining groups (P < 0.01), whereas A(Tot) (6.82 mmol/L) were significantly lower. The main finding of the correlation study was the excellent relationship between the AGcorr and SID3, SID7, SIG. In conclusion, chronic diarrhea leads to numerous water-electrolyte disorders. Characterization of acid-base disturbance in these cases suggests that classic model have some limitations. This model can not be recommended for use whenever serum albumin or phosphate concentrations are markedly abnormal.

Effects of alkalinization and rehydration on plasma potassium concentrations in neonatal calves with diarrhea

Background

Increased plasma potassium concentrations (K⁺) in neonatal calves with diarrhea are associated with acidemia and severe clinical dehydration and are therefore usually corrected by intravenous administration of fluids containing sodium bicarbonate.

Objectives

To identify clinical and laboratory variables that are associated with changes of plasma K⁺ during the course of treatment and to document the plasma potassium‐lowering effect of hypertonic (8.4%) sodium bicarbonate solutions.

Animals

Seventy‐one neonatal diarrheic calves.

Methods

Prospective cohort study. Calves were treated according to a clinical protocol using an oral electrolyte solution and commercially available packages of 8.4% sodium bicarbonate (250–750 mmol), 0.9% saline (5–10 L), and 40% dextrose (0.5 L) infusion solutions.

Results

Infusions with 8.4% sodium bicarbonate solutions in an amount of 250–750 mmol had an immediate and sustained plasma potassium‐lowering effect. One hour after the end of such infusions or the start of a sodium bicarbonate containing constant drip infusion, changes of plasma K⁺ were most closely correlated to changes of venous blood pH, plasma sodium concentrations and plasma volume (r = −0.73, −0.57, −0.53; P < .001). Changes of plasma K⁺ during the subsequent 23 hours were associated with changes of venous blood pH, clinical hydration status (enophthalmos) and serum creatinine concentrations (r = −0.71, 0.63, 0.62; P < .001).

Conclusions and Clinical Importance

This study emphasizes the importance of alkalinization and the correction of dehydration in the treatment of hyperkalemia in neonatal calves with diarrhea.

Advances in prevention and therapy of neonatal dairy calf diarrhoea: a systematical review with emphasis on colostrum management and fluid therapy

Neonatal calf diarrhoea remains the most common cause of morbidity and mortality in preweaned dairy calves worldwide. This complex disease can be triggered by both infectious and non-infectious causes. The four most important enteropathogens leading to neonatal dairy calf diarrhoea are Escherichia coli, rota- and coronavirus, and Cryptosporidium parvum. Besides treating diarrhoeic neonatal dairy calves, the veterinarian is the most obvious person to advise the dairy farmer on prevention and treatment of this disease. This review deals with prevention and treatment of neonatal dairy calf diarrhoea focusing on the importance of a good colostrum management and a correct fluid therapy.

Contribution of unmeasured anions to acid-base disorders and its association with altered demeanor in 264 calves with neonatal diarrhea

Background

The quantitative effect of strong electrolytes, unmeasured anions (UAs), pCO₂, and plasma protein concentrations in determining plasma pH and bicarbonate (HCO₃⁻) can be demonstrated using the physicochemical approach. Demeanor of calves with diarrhea is associated with acidemia, dehydration, and hyper‐d‐lactatemia.

Hypothesis

Unmeasured anions are a major factor influencing changes in plasma pH and HCO₃⁻ of calves with diarrhea and UAs and strong UAs, estimated by anion gap (AG) and strong ion gap (SIG), respectively, are more strongly associated with alteration of demeanor compared to other acid–base variables.

Animals

A total of 264 calves with diarrhea from two data sets (DS1 and DS2).

Methods

Retrospective study. Forward stepwise regression was performed to determine the relationship between measured pH or HCO₃⁻, and physicochemical variables. A two‐way ANOVA was performed to investigate the association between acid–base variables and attitude (bright, obtunded, and stuporous), posture (standing, sternal or lateral recumbency), and strength of suckling reflex (strong, weak, or absent).

Results

Increased strong UAs estimated by SIG was the most important contributor to changes in measured pH and HCO₃⁻ (DS1: r² 66 and 59%, DS2: 39 and 42%, P < .0001). SIG and AG were correlated to deteriorating calf demeanor for all three clinical scoring categories: attitude, posture, and suckle reflex (P < .0001).

Conclusion and Clinical Relevance

Elevated concentrations of strong UAs were the primary cause of acidemia and had an important influence on the demeanor of calves with diarrhea. These findings emphasize the importance of the calculation of UAs when evaluating acid–base abnormalities in calves.

Construction and validation of a decision tree for treating metabolic acidosis in calves with neonatal diarrhea

BACKGROUND

The aim of the present prospective study was to investigate whether a decision tree based on basic clinical signs could be used to determine the treatment of metabolic acidosis in calves successfully without expensive laboratory equipment. A total of 121 calves with a diagnosis of neonatal diarrhea admitted to a veterinary teaching hospital were included in the study. The dosages of sodium bicarbonate administered followed simple guidelines based on the results of a previous retrospective analysis. Calves that were neither dehydrated nor assumed to be acidemic received an oral electrolyte solution. In cases in which intravenous correction of acidosis and/or dehydration was deemed necessary, the provided amount of sodium bicarbonate ranged from 250 to 750 mmol (depending on alterations in posture) and infusion volumes from 1 to 6.25 liters (depending on the degree of dehydration). Individual body weights of calves were disregarded. During the 24 hour study period the investigator was blinded to all laboratory findings.

RESULTS

After being lifted, many calves were able to stand despite base excess levels below -20 mmol/l. Especially in those calves, metabolic acidosis was undercorrected with the provided amount of 500 mmol sodium bicarbonate, which was intended for calves standing insecurely. In 13 calves metabolic acidosis was not treated successfully as defined by an expected treatment failure or a measured base excess value below -5 mmol/l. By contrast, 24 hours after the initiation of therapy, a metabolic alkalosis was present in 55 calves (base excess levels above +5 mmol/l). However, the clinical status was not affected significantly by the metabolic alkalosis.

CONCLUSIONS

Assuming re-evaluation of the calf after 24 hours, the tested decision tree can be recommended for the use in field practice with minor modifications. Calves that stand insecurely and are not able to correct their position if pushed require higher doses of sodium bicarbonate, if there is clinical evidence of a marked D-lactic acidosis. In those calves, determining the degree of loss of the palpebral reflex was identified as a useful decision criterion to provide an additional amount of 250 mmol sodium bicarbonate. This work demonstrates the clinical relevance of the discovery that D-lactate is responsible for most of the clinical signs expressed in neonatal diarrheic calves suffering from metabolic acidosis.

Scientific Opinion on the welfare of cattle kept for beef production and the welfare in intensive calf farming systems

Information given in previous Opinions "Welfare of cattle kept for beef production" (SCAHAW, 2001) and "The risks of poor welfare in intensive calf farming systems" (EFSA, 2006) is updated and recent scientific evidence on the topics reviewed. Risks of poor welfare are identified using a structured analysis, and issues not identified in the SCAHAW (2001) beef Opinion, especially effects of housing and management on enteric and respiratory diseases are reviewed. The Opinion covers all systems of beef production, although the welfare of suckler cows or breeding bulls is not considered. The Chapter on beef cattle presents new evidence and recommendations in relation to heat and cold stress, mutilations and pain management, digestive disorders linked to high concentrate feeds and respiratory disorders linked to overstocking, inadequate ventilation, mixing of animals and failure of early diagnosis and treatment. Major welfare problems in cattle kept for beef production, as identified by risk assessment, were respiratory diseases linked to overstocking, inadequate ventilation, mixing of animals and failure of early diagnosis and treatment, digestive disorders linked to intensive concentrate feeding, lack of physically effective fibre in the diet, and behavioural disorders linked to inadequate floor space, and co-mingling in the feedlot. Major hazards for white veal calves were considered to be iron-deficiency anaemia, a direct consequence of dietary iron restriction, enteric diseases linked to high intakes of liquid feed and inadequate intake of physically effective fibre, discomfort and behavioural disorders linked to inadequate floors and floor space.