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    The document discusses the differential diagnoses for hyponatremia in pets. It separates the potential causes into three categories based on blood osmolality: normal osmolality, low osmolality, and high osmolality. For low osmolality, potential causes include renal failure, GI fluid loss, severe dietary sodium restriction, iatrogenic factors like diuretics, third-space losses such as from pancreatitis, and inappropriate antidiuretic hormone secretion. High osmolality may be due to diabetes mellitus or iatrogenic administration of mannitol. The suggested reading provides further information on fluid, electrolyte, and acid-base disorders in small animals.

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    DDx_Hyponatremia

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    The document discusses the differential diagnoses for hyponatremia in pets. It separates the potential causes into three categories based on blood osmolality: normal osmolality, low osmolality, and high osmolality. For low osmolality, potential causes include renal failure, GI fluid loss, severe dietary sodium restriction, iatrogenic factors like diuretics, third-space losses such as from pancreatitis, and inappropriate antidiuretic hormone secretion. High osmolality may be due to diabetes mellitus or iatrogenic administration of mannitol. The suggested reading provides further information on fluid, electrolyte, and acid-base disorders in small animals.

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    2 views1 page

    DDX Hyponatremia

    Uploaded by

    john
    The document discusses the differential diagnoses for hyponatremia in pets. It separates the potential causes into three categories based on blood osmolality: normal osmolality, low osmolality, and high osmolality. For low osmolality, potential causes include renal failure, GI fluid loss, severe dietary sodium restriction, iatrogenic factors like diuretics, third-space losses such as from pancreatitis, and inappropriate antidiuretic hormone secretion. High osmolality may be due to diabetes mellitus or iatrogenic administration of mannitol. The suggested reading provides further information on fluid, electrolyte, and acid-base disorders in small animals.

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    DIFFERENTIAL DIAGNOSIS  h  INTERNAL MEDICINE  h  PEER REVIEWED

    Hyponatremia
    Marie Chartier, DVM, DACVIM
    BluePearl Pet Hospital
    Charlestown, Massachusetts

    Following are differential diagnoses for patients


    presented with decreased blood sodium level.
    Normal osmolality (290-310 mOsm/kg)
    h Pseudohyponatremia (eg, hypertriglyceridemia, hyperproteinemia)

    Low osmolality (<290 mOsm/kg)


    h Polyuric renal failure
    h GI fluid loss (eg, vomiting, diarrhea, regurgitation, severe ileus with
    “pooled” insensible fluid losses)
    h Hookworm infection

    h Severe dietary sodium restriction

    h Iatrogenic (eg, hypotonic fluids, diuretics)

    h Third-space loss

    • Pancreatitis
    • Peritonitis
    • Pleural or peritoneal effusion
    • Uroabdomen
    h Hypoadrenocorticism

    h Edematous disorders

    • Congestive heart failure


    • Liver failure
    • Nephrotic syndrome
    h Syndrome of inappropriate antidiuretic hormone secretion

    h Psychogenic polydipsia

    High osmolality (>310 mOsm/kg)


    h Diabetes mellitus (ie, secondary to hyperglycemia)
    h Iatrogenic (ie, mannitol administration) n

    Suggested Reading
    DiBartola SP, ed. Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice. 4th ed.
    Saunders Elsevier; 2012.

    14    cliniciansbrief.com    September 2021

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