title: Incidence of ionized hypocalcemia in septic dogs and its association with morbidity and mortality: 58 cases (2006-2007).
abstract: OBJECTIVE
  To determine the incidence rate and prognostic significance of ionized hypocalcemia (iHCa) among septic dogs.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Veterinary teaching hospital.
  
  
  METHODS
  Fifty-eight septic dogs that were presented to Cornell University Hospital for Animals between January 2006 and December 2007.
  
  
  METHODS
  Cases were diagnosed with sepsis if they exhibited 2 or more criteria of the systemic inflammatory response syndrome with a concurrent documented infectious focus. Cases were excluded if diagnosed with a concurrent illness reportedly associated with calcium derangements. Lowest, mean, and highest blood ionized calcium concentrations were recorded and statistically analyzed for an association with morbidity, as measured by duration of hospitalization and number of blood product transfusions, and outcome. In addition, the incidence rate of iHCa was recorded.
  
  
  RESULTS
  Of the 58 cases included in this study, iHCa was documented in 4 of 6 (67%) patients that died, 5 of 19 (26%) euthanized patients and 5 of 33 (15%) patients that survived to discharge, with an overall incidence of 24%. Dogs that died during hospitalization had more severe iHCa than patients that were discharged or euthanized as well as significantly lower mean ionized calcium concentrations than patients who were discharged. Severity of iHCa was also associated with a longer duration of hospitalization. The highest ionized calcium concentration was not associated with outcome.
  
  
  CONCLUSIONS
  This study is the first to document the incidence of iHCa among septic dogs. Because both low mean ionized calcium and the lowest documented ionized calcium concentration are associated with poor outcome, it is likely that both the severity and duration of hypocalcemia are important in these patients. Further prospective studies investigating the prognostic significance, etiology and treatment of iHCa among septic veterinary patients are needed to better understand its role in sepsis.
authors: Department of Emergency and Critical Care, Cornell University Hospital for the Animals, Ithaca, NY 14850, USA. ml398@cornell.edu
authors: Maureen A
authors: MA
authors: Luschini
authors: Daniel J
authors: DJ
authors: Fletcher
authors: Gretchen L
authors: GL
authors: Schoeffler
mesh_terms: D000818:Animals; D002118:Calcium / Q000097:blood; D004283:Dog Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D004285:Dogs; D006996:Hypocalcemia / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000662:veterinary*; D015994:Incidence; D009518:New York / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000662:veterinary*; D016896:Treatment Outcome
chemical_list: D002118:Calcium