Metabolic Derangements

Question 1

What’s a stress leukogram?

Answer 1

Neutrophilia
Lymphopenia
Eosinopenia
(monocytosis)

Question 2

What leukocyte parameters have a poor prognosis?

Answer 2

persistant neutrophila
degenerative left shift
severe persistent leukocytosis

Question 3

Tell me the parameters of pH disturbances (metabolic/resp alkalosis/acidosis)

Answer 3

Resp acidosis: low pH, high bicarb
resp alkalosis: high pH, low bicarb

metabolic acidosis: low pH, low bicarb
metabolic alkalosis: high pH, high bicarb

metabolic = pH and bicarb saME
resp = pH and bicarb REverse

Question 4

What is the most common acid/base derangement in cows?

Answer 4

metabolic alkalosis

Question 5

cows in metabolic alkalosis display compensatory ____ ____. how does this manifest?

Answer 5

respiratory acidosis

hypoventilation = increase PCO2

Question 6

cows in metabolic acidosis display compensatory _____ _____. how does this manifest?

Answer 6

respiratory alkalosis

hyperventilation = decrease PCO2

Question 7

when do we usually see metabolic alkalosis in cows?

Answer 7

digestive disturbances!
excessive H+ loss, HCO3 retention, sequestration of fluids high in Na and Cl

Question 8

cows in metabolic alkalosis have ____ urine.

Answer 8

acidic

aciduria

Question 9

Why is there paradoxic aciduria in a cow with metabolic alkalosis?

Answer 9

low Cl from dz process –> Cl not really resorbed in prox tubules –> high Na in tubules –> Na leaves tubules via H+ or K+ –> H+ in urine = aciduria

GI dz = HCl stuck in abomasum –> H+ trades w/ K+ = K+ & Cl- in abomasum

H+ comes from abomasum to kidney and trades places with Na+ in the kidney

Question 10

cows with respiratory alkalosis will have compensatory _____ _____. how does this manifest?

Answer 10

metabolic acidosis

decrease HCO3

Question 11

when do we see respiratory alkalosis in cows?

Answer 11

hyperventilation, hypoxemia, CHF, severe anemia

we don’t see this too often

Question 12

cows with respiratory acidosis will have compensatory _____ _____. how does this manifest?

Answer 12

metabolic alkalosis

increase HCO3

Question 13

when do we see respiratory acidosis in cows?

Answer 13

upper resp obstruction

Question 14

when do we see metabolic acidosis in cows?

Answer 14

calves with diarrhea

lactic acidosis, hyperketonemia
choke, diarrhea, renal failure

Question 15

a 3 week old calf comes in almost comatose and scouring. what acid base values do you expect to see?

Answer 15

metabolic acidosis

low pH, low HCO3, normal pCO2

Question 16

a cow comes in and you hear a pinging on the L side of abdomen. You diagnose a LDA. What acid base values do you expect?

Answer 16

metabolic alkalosis

high pH, high HCO3, normal pCO2

Question 17

what is more common in cows, hypo or hyper natremia?

Answer 17

hyponatremia

Question 18

when do we see hyponatremia in cows?

Answer 18

fluid loss, 3rd space problem, mastitis

Question 19

when do we see hypernatremia in cows?

Answer 19

H2O deprivation, H2O loss exceeds electrolyte loss, salt tox

Question 20

what is more common in cows, hypo or hyper kalemia?

Answer 20

hypokalemia

Question 21

when do we see hypokalemia in cows?

Answer 21

redistribution from ECF to ICF (acute alkalosis), gut immobility/torsion, diarrhea, metabolic alkalosis

Question 22

when do we see hyperkalemia in cows?

Answer 22

metabolic acidosis

Question 23

what causes hypochloremia in cows?

Answer 23

excess H2O loss, sequestration of fluid (ex. torsion), hypochloremic metabolic alkalosis

Question 24

what causes hyperchloremia in cows?

Answer 24

H2O deprivation, H2O exceeds electrolyte loss, salt tox

Question 25

what is the most common electrolyte derangement in adult cattle? what causes it?

Answer 25

hypochloremic metabolic alkalosis

loss of chloride-rich fluids or sequestration of fluids in abomasum and forestomachs

Question 26

how do you calculate % dehydration in cows? general

Answer 26

eyeball recession + skin tent duration

Question 27

how do you calculate the fluid loss of a cow due to dehydration?

Answer 27

BW x dehydration % = loss

Question 28

tell me the specifics of measuring eyeball recession and skin-tent duration to assess dehydration status.

Answer 28

% dehydration: recession (mm), skin-tent (s)

0%: 0mm, 2s
2%: 1mm, 3s
4%: 2mm, 4s
6%: 3mm, 5s
8%: 4mm, 6s
10%: 6mm, 7s
12%: 7mm, 8s
14%: 8mm, 10s

Question 29

what is the normal reference range for pH?

Answer 29

7.45

Question 30

what is the normal reference range for pCO2?

Answer 30

35-45

Question 31

what is the normal reference range for HCO3?

Answer 31

24-28

Question 32

what is the normal reference range for PO2?

Answer 32

80

Question 33

what is the normal reference range for saturated O2?

Answer 33

95%