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Basics ⬇

Basics

Definition

Serum chloride concentration below the lower limit of normal-dogs, <105 mEq/L; cats, <117 mEq/L (values may vary from laboratory to laboratory).

Pathophysiology

  • Chloride is the most abundant anion in the extracellular fluid.
  • Chloride concentration is controlled by electrochemical gradients resulting from the active transport of sodium.
  • In general, chloride concentration varies directly with sodium concentration and inversely with bicarbonate concentration.

Systems Affected

Depends on underlying disorder

Genetics

N/A

Incidence/Prevalence

N/A

Signalment

Species

Dog and cat

Breed Predilections

N/A

Predominant Sex

N/A

Signs

Depends on underlying disorder

Causes

  • Gastric vomiting
  • Hypoadrenocorticism
  • Metabolic alkalosis
  • Chronic respiratory acidosis
  • Salt-losing nephropathy
  • Diuretic therapy

Risk Factors

N/A

Diagnosis ⬆ ⬇

Diagnosis

Differential Diagnosis

If the degree of hypochloremia exceeds that of hyponatremia, it suggests selective chloride loss as seen in patients with gastric vomiting.

Laboratory Findings

Drugs That May Alter Laboratory Results

Furosemide, thiazides, bicarbonate, and laxatives lower the serum concentration.

Disorders That May Alter Laboratory Results

Lipemia and hyperproteinemia can falsely lower chloride concentration if ion-specific electrodes are not used.

Valid if Run in Human Laboratory?

Yes

CBC/Biochemistry/Urinalysis

  • Low chloride.
  • Other abnormalities depend on underlying disorder, possibly hyponatremia, hyperkalemia, and high bicarbonate concentration

Other Laboratory Tests

  • Measurement of urine fractional excretion of chloride may demonstrate high excretion.
  • Blood gas measurement may reveal metabolic alkalosis.

Diagnostic Procedures

N/A

Pathologic Findings

N/A

Treatment ⬆ ⬇

Treatment

Appropriate Health Care

  • Depends on underlying disorder
  • Use 0.9% NaCl if fluid administration is indicated

Nursing Care

N/A

Diet

No need to alter

Client Education

Depends on underlying disorder

Surgical Considerations

N/A

Medications ⬆ ⬇

Medications

Drug(s) Of Choice

Other fluid therapy and medication as dictated by underlying cause

Precautions

N/A

Alternative Drug(s)

N/A

Follow-Up ⬆ ⬇

Follow-Up

Patient Monitoring

Serum electrolyte concentrations as needed to ensure appropriate response.

Possible Complications

Depends on underlying disorder

Prevention/Avoidance

Depends on underlying disorder

Expected Course and Prognosis

Depends on underlying cause

Miscellaneous ⬆

Miscellaneous

Associated Conditions

Often accompanied by hyponatremia

Age-Related Factors

N/A

Pregnancy/Fertility/Breeding

N/A

See Also

Hyponatremia

Author Melinda Fleming

Consulting Editor Deborah S. Greco

Acknowledgment The author and editors acknowledge the prior contribution of Peter Kintzer.

Suggested Reading

DiBartola SP. Fluid, Electrolyte and Acid-base Disorders in Small Animal Practice, 3rd ed. Philadelphia: Saunders, 2005.

Rose DB, Post T. Clinical Physiology of Acid-base and Electrolyte Disorders, 5th ed. New York: McGraw-Hill, 2000.