Values

11/9/19 3:30 PM

Highlighted are the two main problems!

Proble Pathophysiology Etiological Agent (if known)
ms
Loose, Malabsorptive or maldigestion; infectious process happened that lead to ETEC, viral, infectious
watery diarrhea-- failure passive transfer
severe - Would be indirect cause of diarrhea — calf's immunity isn't top
diarrhe quality
a - Colostrum regulated by progesterone
Brown, Dehydration -- corneal edema and feeling shitty
dull - Hydration status
eyes ○ When you drink a lot of water, skin tends to be clear and glossy
○ Eyes are similar-- low hydration status will lower the moistness
of the eyes
Dehydr Excessive diarrhea Diarrhea
ation
Sepsis Septicemia from enterotoxin-producing bacteria ETEC or other bacterial infection
Hypoth Late decompensated to irreversible state of hypovolemic shock
ermia
Bradyc Late decompensated to irreversible state of hypovolemic shock (early
ardia compensated state of hypovolemic shock would be tachycardic with small
lapses in heart beats)
Tachyp Occurs with compensated state of hypovolemic shock
nea
Also occurs with acidosis as a compensatory mechanism to offset acid
accumulation (to offset acid accumulation, body gives off excess CO2 by
increasing depth and frequency of breaths)
Pink Dehydration
and
tacky
mucous
membr
anes
Depres Due to feeling shitty
sed
CRT 5 Dehydration
second
s
Skin Dehydration
turgor
3+
second
s
Arrhyth Depends -- perpetuation of arrhythmias is hyperkalemia
mias - So the origin of hyperkalemia is what will determine the origin of
arrhythmias

Mix of both hypoperfusion due to hypovolemic shock

Metabolic acidosis — possibly from hyperkalemia

Hypovolemic shock:
-
Enopht Dehydration
halmos
(sunke
n in
eyes)
Ears Compensatory mechanism to hypovolemic shock (blood shunting)
and - result from vasoconstriction and vasopressin secretion (the
distal vasopressin causes vasoconstriction and increased sodium & water
legs are absorption)
cold to
the
touch
Umbilic Can be due to:
us is - Septicemia — bacteria probably entered here
swollen - Local inflammatory due to bacteria proliferating there (not septic)
(ompha ○ Navel ill
litis) ○ Immunosuppressive
Muzzle Dehydration
is dry
and
crusty
Weak From feeling shitty
and
unable
to rise
Both Septicemia — neonatal joints are highly vascularized so bacteria deposit
carpi here first
are
swollen Joint ill

Moreso due to dehydrated third spacing

Spacing:
- Second-spacing: don’t worry about it
- Third-spacing: can cause the swollen carpi
Hypogl Diarrhea and calf not eating (utilizing more anaerobic metabolisms)
ycemia
Associated with cachexic
Increas Dehydration — low volume so solutes seem higher
ed PCV
Monoc Activated macrophages to fight off the septicemia/sepsis; can also be due
ytosis to stress (Stress leukogram: neutrophilia, lymphopenia, eosinopenia, and
potentially monocytosis)

Also diarrhea (because of infectious cause) can increase macrophage

recruitment

Septicemia (late stage) would have low WBCs

- Acute septicemia would have high WBCs
Hypern Dehydration — makes it seem like it's higher than it actually is.
atremia - Dehydration is caused by decreased water and increased sodium
(9 units concentrations
over) - Hypovolemic hypernatremia:
○ Same as dehydration instead the water loss is coming from
diarrhea (still loss of volume)

*** for enterotoxins (by bacteria; for example: enterotoxic E. coli) it would
cause increased Na and Cl secretion into the gut lumen (resulting in
hyponatremia and hypochloremia)

Additionally, compensatory mechanisms to hypovolemic shock:

(1) Increase in heart rate, respiratory rate, and vasoconstriction (this
is because the hypovolemic shock causes CO and BP to decrease
leading to an increase in sympathetic tone)
(2) stimulation of RAAS which means increased secretion of
aldosterone which causes an increase in sodium & water
reabsorption
(3) vasopressin release which further cause vasoconstriction and
even more reabsorption of sodium & water
Hyperk Sequestering of H+ into cells so that acidosis can be fixed. Part of
alemia sequestering H+ is that something has to replace the H+ so the cell
(increas replaced H+ with K+.
ed
potassi Will be pushing force for cations
um)
Mixed diarrhea types and dehydration lead to hyperkalemia
Hyperc With metabolic acidosis and diarrhea, body should have hypochloremia
hloremi because as a compensatory mechanism to any GI pathogen, body increases
a (12 secretion of chloride and sodium to aid in flushing out of GI pathogen.
units - Cl-/HCO3- exchanger: apical surface only-- Cl- into lumen for HCO3-
over) into cell (compensatory mechanism to help fix acidosis)
- Na+/Cl- cotransporter: secretory diarrhea (body pushes these
electrolytes into lumen to stimulate flushing of GI tract so flush out
pathogen that may be causing GI tract disturbances)

Dehydration
- Can make values seem higher than they are
○ Solution lower so solute is higher

However, Cl- can be cotransported with K+ so having hyperkalemia AND

hyperchloremia makes sense — having increased cotransportation of both
Cl- and K+
Azotem Increased BUN from glutamine metabolized by glutaminase to generate
ia NH3 and HCO3-. Cant describe origin, would need more data
- Pre-renal but we would need to confirm with a UA
○ Since Squirt is neonatal, renal or post-renal cause would be
unlikely
Hypoal Part of the protein losing enteropathy because of severe diarrhea.
bumine
mia Septicemia
- Stimulates acute phase proteins so albumin would be used more

Also from septicemia (Smith's Large Animal Internal Medicine pg. 302):
- Septicemia refers to a bacterial infection of the blood associated with
adverse systemic signs.
○ If not successfully treated, this can lead to multiple organ
dysfunction, septic shock, and death.
§ Meningitis is particularly difficult to treat successfully and
therefore prevention of septicemia through good
colostrum management is essential.
- The phagocytic and bacterial killing function of neutrophils (PMN) is a
crucial component of the primary immune response against invading
pathogens.
- Despite a larger number of neutrophils in the circulation of normal
calves at birth, neutrophils from neonatal calves are functionally less
effective than adult cells.
○ Reduced Fc-receptor expression in neonatal PMNs may
contribute to impaired phagocytosis and antibody-dependent
cellular cytotoxicity
Clinical Signs of Septicemia:
- Depressed PMN bacterial killing may be related to reduced
superoxide anion and myeloperoxidase-hydrogen presence of clinical
signs including lethargy, pyrexia, diarrhea, tachypnea, polyarthritis,
uveitis, omphalitis, and meningitis, along with documented presence
of Failure of Passive Transfer (FPT), should make the clinician highly
suspicious of septicemia.
Hematology of Septicemia:
- Abnormal neutrophil count (neutrophilia and neutropenia) and
increased immature forms (bands) are frequently seen.
- Fibrinogen concentration is often elevated.
- Thrombocytopenia may be present in severe cases
- A metabolic acidosis is also frequently present in septic calves.
○ Lactic acidosis occurs as the disease progresses.
○ Some calves will develop respiratory disease (respiratory
distress syndrome) or pneumonia and will suffer from
hypoxemia and/or hypoventilation.

Hypogl Part of the protein losing enteropathy because of severe diarrhea

obuline
ma Loosing albuminemia with typically cause globulin loss as well.
Hypoca Ca2+ can be exchanged with Na+ (Ca2+/3Na+ - ATPase Exchange Pump : 3
lcemia Na+ into cell and 1 Ca2+ out of the cell & into ECF; this pump is vitamin D
dependent)

In the collecting duct, extracellular Ca2+ can regulate the excretion of acids
- Other regulators are: angiotensin II, calcium-sensing receptors
(CaSRs), pH, and pCO2.

In metabolic acidosis, albumin is usually decreased AND the acidic

pH/environment caused unbinding of certain albumin-bound molecules,
such as calcium
- So metabolic acidosis can decrease the amount of albumin-bound
calcium which leads to an increase of blood-borne calcium
(hypercalcemia)

Parathyroid hormone
Hyperp Vitamin D stimulates a Phosphate (HPO4-)/Na+ coupled transport (2Na+
hospha into enterocyte with 1 phosphate anion going into the enterocyte).
temia
Parathyroid hormone
Hypopr Severe diarrhea so proteins would not be absorbed. Consistent with
oteine hypoalbuminemia and hypoglobulinema
mia
Elevate Cachexia because of not eating and severe starvation
d CK
Elevate Because seen with elevated CK, most likely due to muscle degradation
d AST
Can also be due to liver damage — which would be due to septicemia
Elevate http://eclinpath.com/chemistry/liver/cholestasis/gamma-glutamyl-
d GGT transferase/
- High concentration of GGT in neonates is in kidney, followed by the
pancreas, liver, lung, small intestine and brain, with very little in
skeletal or cardiac muscle
- Can be high in neonates that are under 10 days old (especially with
puppies)
○ Will decrease over 4-6 weeks in calves
- Increased GGT is an indicator for effective passive transfer (~80%
sensitivity)
Decrea TCO2 is a measure of carbon dioxide which exists in several states: CO2 in
sed physical solution or loosely bound to proteins, bicarbonate (HCO3-) or
TCO2 carbonate (CO3 ) anions, and carbonic acid (H2CO3 ).
- Measurement of TCO2 as part of an electrolyte profile is useful
chiefly to evaluate HCO3 concentration.
- TCO2 and HCO3- are useful in the assessment of acid-base imbalance
(along with pH and PCO2 ) and electrolyte imbalance

Could be low because of tachypnea

Increas Signifies acidosis (doesn’t discriminate between metabolic or respiratory)
ed - Need HCO3- and CO2 levels to determine whether metabolic or
anion respiratory
gap
Paraprotein: protein found in blood only as a result of cancer or a disease.

Factors that alter anion gap:

- Accumulation of cationic paraproteins, bromide, or iodine
○ Will lower anion gap and can even make it negative
- Accumulation of anionic paraproteins
○ Can raise anion gap
- Development of hyperphosphatemia
○ Can raise anion gap
- *Most Common*: accumulation of organic or inorganic anions in
metabolic acidosis
○ Such as lactic acid or CO2

Acidosis in adult ruminants:

- Top clinical sign is bloat
Acidic Due to acidosis
pH
(7.14)
Elevate Elevated CO2 indicated acidosis and can indicate whether it is respiratory
d pCO2 or metabolic
(partial - Both acidoses will have elevated CO2 but metabolic will have lower
pressur values
e of ○ Metabolic acidosis can have normal CO2 values rarely I think
CO2)
[1.4
units
elevate
d]
Decrea Metabolic acidosis (specific NAGMA)
sed
HCO3- We have increased TCO2 which (CO2 makes stuff more acidic)
(did via - The increased TCO2 will lead the Henderson-Hasselbalch equation for
math) CO2 and HCO3- to be more acidic (will go to produce more CO2 and
less HCO3-)
○ Equation: CO2 + H2O <——> H2CO3 <——> H+ + HCO3-
- CO2 makes more acidic; HCO3- makes more basic!
Scleral Vasoconstriction?
congest - Septicemia or sepsis?
ion