General overview to treatment of strong ion (metabolic) acidosis in neonatal calves with diarrhea
Year 2013,
Volume: 29 Issue: 3, 114 - 120, 01.09.2013
Ismail Sen
Peter D. Constable
Abstract
Diarrhea in neonatal calves is due to one or more causes. Strong
ion (metabolic) acidosis is common in diarrheic calves. Clinical
signs associated with metabolic acidosis are vague and nonspecific.
However, the calf’s age can be used to predict the severity
of metabolic acidosis, because one weak old diarrheic calves are
less acidemic than older calves despite they have similar clinical
signs. Moreover, the suckling reflex is closely associated with
base excess parameters. One of the most important factors for
decreasing mortality rates associated with diarrhea in calves is
parenteral and oral administration of appropriately formulated
electrolyte solutions. Inclusion of an alkalinizing agent is
required to correct systemic metabolic acidosis. Bicarbonatecontaining
fluids are more effective at rapidly correcting severe
acidemia, since bicarbonate reacts directly with H+
ions. Lactated
Ringers solution or Acetated Ringers solutions can be used to
correct mild to moderate acidosis.
References
- Abeysekara S, Zello GA, Lohmann KL, Alcorn J, Hamilton DL, Naylor JM, 2012. Infusion of sodium bicarbonate in experimentally induced metabolic acidosis does not provoke cerebrospinal fluid (CSF) acidosis in calves. Can J Vet Res, 76, 16-22.
- Argenzio RA, 1985. Pathophysiology of neonatal calf diarrhea. Vet Clin North Am Food Anim Pract, 1, 461-469.
- Basoglu A, Aydogdu U, 2012. Terminal atrial standstill with ventricular escape rhythm in a neonatal calf with acute diarrhea. Turk J Vet Anim Sci, (inpress).
- Başoğlu A, Sen I, Sevinç M, Simsek A, 2004. Serum concentrations of tumor necrosis factor –alpha in neonatal calves with presumed septicemia. J Vet Intern Med, 18, 238-241.
- Basoglu A, Sevinc M, Maden M,1996. Idioventricular rhythm in a calf suffering from diarrhea. Turk J Vet Anim Sci, 20, 375-377.
- Bellino C, Arnaudo F, Biolatti C, Borrelli A, Gianella P, Maurella C, Zabaldano G, Cagnasso A, D’Angelo A, 2012. Development of a diagnostic diagram for rapid field assesment of acidosis severity in diarrheic calves. J Am Vet Med Assoc, 240, 312-316.
- Berchtold J, 1999. Intravenous fluid therapy of calves. Vet Clin North Am Food Anim Pract, 15, 505-531.
- Berchtold J, 2009. Treatment of calf diarrhea: intravenous fluid therapy. Vet Clin North Am Food Anim Pract, 25, 7399.
- Buntain BJ, Selman IE, 1980. Controlled studies of various treatments for neonatal calf diarrhoea in calves of known immunoglobulin levels. Vet Rec, 107, 245–248.
- Bywater RJ, 1983. Diarrhoea treatments – fluid replacement and alternatives. Ann Rech Vet, 14, 556–560.
- Constable PD, 1999a. Hypertonic saline. Vet Clin of North Am Food Anim Pract, 15(3), 559-585.
- Constable PD, 1999b. Clinical assessment of acid-base status: Strong ion difference theory. Vet Clin North Am Food Anim Pract, 15, 447-471.
- Constable PD, 2000. Clinical assessment of acid-base status: comparison of the Henderson-Hasselbalch and strong ion approaches. Vet Clin Pathol, 29, 115-128.
- Constable PD, 2003. Fluids and electrolyte therapy in ruminants. Vet Clin North Am Food Anim Pract, 19, 1-40.
- Constable PD, Grünberg W, Carstensen L, 2009. Comparative effects of two oral rehydration solutions on milk clotting, abomasal luminal pH, and abomasal emptying rate in suckling calves. J Dairy Sci, 92, 296-312.
- Constable PD, Grünberg WA, 2013. Hyperkalemia, acidaemia, and dehydration in diarrheic calves: implications for diagnosis and treatment. Vet J, (inpress).
- Constable PD, Thomas E, Boisrame B, 2001. Comparison of two oral electrolyte solutions for the treatment of dehydrated calves with experimentally-induced diarrhoea. Vet J, 162, 129-140.
- Constable PD, Walker PG, Morin DE, Foreman JH, 1998. Clinical and laboratory assessment of hydration status of neonatal calves with diarrhea. JAVMA, 212, 991-996.
- Coskun A, Sen I, Guzelbektes H, Ok M, Turgut K, Canikli S, 2010. Comparison of the effects of intravenous administration of isotonic and hypertonic sodium bicarbonate solutions on venous acid-base status in dehydrated calves with strong ion acidosis. JAVMA, 236, 1-60.
- Fayet JC, 1971. Plasma and faecal osmolality, water kinetics and body fluid compartments in neonatal calves with diarrhoea. Br Vet J, 127, 37–43.
- Fisher EW, 1967. Death in neonatal calf diarrhea. Br Vet J, 121, 132-138.
- Garcia JP, 1999. A practitioner’s views on fluid therapy in calves. Vet Clin North Am Food Anim Pract, 15,533-543.
- Groutides CP, Michell AR, 1990. Intravenous solutions for fluid therapy in calf diarrhea. Res Vet Sci, 49, 292-297.
- Grove-White DH, White DG, 1993. Diagnosis and treatment of metabolic acidosis in calves: a field study. Vet Rec, 133, 499-501.
- Guzelbektes H, Coskun A, Sen I, 2007. The relationship of dehydration degree with base excess and anion gap in dehydrated calves with diarrhea. Bull Vet Ins Pulawy, 52, 83-87.
- Health SE, Naylor JM, Guedo BL, 1989. The effects of feeding milk to diarrheic calves supplemented with oral electrolytes. Can J Vet Res, 53, 477-485.
- Iwabuchi S, Suzuki K, Abe I, Asano R, 2003. Comparison of the Effects of Isotonic and Hypertonic Sodium Bicarbonate Solutions on Acidemic Calves Experimentally Induced by Ammonium Chloride Administration. J Vet Med Sci, 65, 1369-1371.
- Jodal M, Lundgren O, 1986. Countercurrent mechanisms in the mammalian gastrointestinal tract. Gastroenterelogy, 91, 225-241.
- Kasari TR, 1999. Metabolic acidosis in calves. Vet Clin North Am Food Anim Pract, 15, 473-486.
- Kasari TR, Naylor JM, 1985. Clinical evaluation of sodium bicarbonate, sodium L-lactate, and sodium acetate for the treatment of acidosis in diarrheic calves. JAVMA, 15, 187, 392-397.
- Koch A, Kaske M, 2008. Clinical efficacy of intravenous hypertonic saline solution or hypertonic bicarbonate solution in the treatment of inappetent calves with neonatal diarrhea. J Vet Intern Med, 22, 202–211.
- Lewis LD, Phillips RW, 1972. Water and electrolyte losses in neonatal calves with acute diarrhea. A complete balance study. Cornell Vet, 62, 596-607.
- Lorenz I, 2009. D-Lactic acidosis in calves. Vet J, 179, 197203.
- Lorenz I, Klee W, 2007. Neonatal calf diarrhea-something old, something new. BCVA, 15, 146-151.
- Marshall TS, Constable PD, Crochik SS, Wittek T, 2005. Determination of abomasal emptying rate in suckling calves by use of nuclear scintigraphy and acetaminophen absorption. Am J Vet Res, 66, 364-74.
- Müller KR, Gentile A, Klee W, Constable PD, 2012. Importance of the effective strong ion difference of an intravenous solution in the treatment of diarrheic calves with naturally acquired acidemia and strong ion (metabolic) acidosis. J Vet Intern Med, 26, 674-83.
- Naylor J, 2006. Neonatal ruminant diarrhea, In: Large animal internal medicine, 2nd edition, St Louis, Mosby, USA, pp: 396-417.
- Naylor JM, 1987. Severity and nature of acidosis in diarrheic calves over and under one week of age. Can Vet J, 28, 168-173.
- Naylor JM, 1989. A retrospective study of the relationship between clinical signs and severity of acidosis in diarrheic calves. Can Vet J, 30, 577-580.
- Naylor JM, 1992. Effects of oral electrolyte solutions on clotting of milk. JAVMA, 201, 1026-1029.
- Naylor JM, 1999. Oral electrolyte therapy. Vet Clin North Am Food Anim Pract, 15, 487-504.
- Naylor JM, Petrie L, Rodriguez MI, 1990. A comparison of three oral electrolyte solutions in the treatment of diarrheic calves. Can Vet J, 31,753-760.
- Nouri M, Constable PD, 2006. Comparison of two oral electrolyte solutions and route of administration on the abomasal emptying rate of Holstein-Friesian calves. J Vet Intern Med, 20, 620-626.
- Ok M, Guler L, Turgut K, Ok U, Sen I, Gunduz K, Birdane FM, Guzelbektes H, 2009. The studies on the etiology of diarrhoea in neonatal calves and determination of virulence gene markers of escherichia coli strains by multiplex PCR. J Vet Med B, 56, 94-101.
- Radostits OM, Gay CC, Hinchcliff KW, Constable PD, 2007. Veterinary Medicine. A textbook of the diseases of cattle, sheep, pigs, goats, and horses, W.B. Saunders Company, 10th edition, London, England, pp; 2156.
- Roussel AJ, 1983. Principles and mechanics of fluid therapy in calves. Compend Cont Educ Pract Vet, 5,332-336.
- Roussel AJ, Kasari TR, 1990. Using fluid and electrolyte replacement therapy to help diarrheic calves. Vet Med (Praha), 85, 303-311.
- Roussel AR, Cohen ND, Holland PS, Taliaoferro L, Green R, Benson P, Navarre CB, Hooper RN, 1998. Alterations in acid-base balance and serum electrolyte concentrations in cattle: 632 cases (1984–1994). JAVMA, 212, 1769-1775.
- Sen I, Altunok V, Ok M, Coskun A, Constable PD, 2009. Efficacy of oral rehydration therapy solutions containing sodium bicarbonate or sodium acetate for treatment of calves with naturally acquired diarrhea, moderate dehydration, and strong ion acidosis. JAVMA, 234, 926-34.
- Sen I, Constable PD, Marshall TS, 2006. Effect of suckling isotonic or hypertonic solutions of sodium bicarbonate or glucose on abomasal emptying rate in calves. Am J Vet Res, 67, 1377-1384.
- Şen İ, Güzelbekteş H, Yıldız R, 2013. Neonatal buzağı ishalleri: Patofizyoloji, epidemiyoloji, klinik, tedavi ve koruma. Türkiye Klinikleri J Vet Sci, 4, 71-78.
- Smith WG, 2009. Treatment of calf diarrhea: Oral fluid therapy. Vet Clin North Am Food Anim Pract, 25, 55-72.
- Stämpfli H, Oliver O, Pringle JK, 2012. Clinical evaluation of an oral electrolyte solution formulated based on strong ıon difference (SID) and using propionate as the organic anion in the treatment of neonatal diarrheic calves with strong ion acidosis. Open Journal of Veterinary Medicine, 2, 3439.
- Suzuki K, Abe I, Iwabuchi S, 2002a. Evaluation of isotonic sodium bicarbonate solution for alkalizing effects in conscious calves. J Vet Med Sci, 64, 699-703.
- Suzuki K, Kato T, Tsunoda G, 2002b. Effect of intravenous infusion of isotonic sodium bicarbonate solution on acidemic calves with diarrhea. J Vet Med Sci, 64, 1173-1175.
- Trefz FM, Lorch A, Feist M, Sauter-Louis C, Lorenz I, 2012. Metabolic acidosis in neonatal calf diarrhea-clinical findings and theoretical assessment of a simple treatment protocol. J Vet Intern Med, 26, 162-170.
- Walker PG, Constable PD, Morin DE, Foreman JH, Drackley JK, Thurmon JC, 1998. Comparison of hypertonic salinedextran solution and lactated Ringer’s solution for resuscitating severely dehydrated calves with diarrhea. JAVMA, 213, 113-121.
- Watt JG, 1965. The use of fluid replacement in the treatment of neonatal diseases in calves. Vet Rec, 77, 1474-1482. Weldon AD, Moise NS, Rebhun WC, 1992. Hyperkalemic atrial standstill in neonatal calf diarrhea. J Vet Intern Med, 6, 294-297.
İshalli neonatal buzağılarda strong (metabolik) ion asidozisin tedavisine genel bakış
Year 2013,
Volume: 29 Issue: 3, 114 - 120, 01.09.2013
Ismail Sen
Peter D. Constable
Abstract
Neonatal buzağı ishallerine bir veya birden daha fazla etken
neden olabilir. İshalli buzağılarda strong ion (metabolic)
asidozis yaygın olarak gözükür. Strong ion asidozisle ilişkili
klinik semptomlar spesifik olmayıp belirsizdir. Fakat strong ion
asidozisin şiddetinin tahmininde buzağının yaşı göz önünde
bulundurulabilir. Çünkü aynı klinik bulgulara sahip buzağılardan
yaşamının ilk haftasındaki buzağılar, bir haftalıktan büyük
buzağılara kıyasla daha az asidemiktir. Ayrıca emme refleksi ile
baz açığı değeri arasında yakın ilişki bulunmaktadır. Buzağılarda
ishalle ilişkili ölümün azaltılmasında en önemli faktörlerden biri
uygun oral veya intravenöz sıvıların kullanılmasıdır. Sistemik
metabolik asidozisisi düzeltmek için uygun alkalize ajanların
kullanılması gerekmektedir. Bikarbonat kandaki H+
iyonu
ile direk reaksiyona girdiğinden dolayı, bikarbonat içeren
intravenöz sıvılar şiddetli asideminin düzeltilmesinde oldukça
etkilidir. Laktatlı ringer veya asetatlı ringer solüsyonlar ise hafiforta
derecede metabolik asidozisi düzeltmede tercih edilir.
References
- Abeysekara S, Zello GA, Lohmann KL, Alcorn J, Hamilton DL, Naylor JM, 2012. Infusion of sodium bicarbonate in experimentally induced metabolic acidosis does not provoke cerebrospinal fluid (CSF) acidosis in calves. Can J Vet Res, 76, 16-22.
- Argenzio RA, 1985. Pathophysiology of neonatal calf diarrhea. Vet Clin North Am Food Anim Pract, 1, 461-469.
- Basoglu A, Aydogdu U, 2012. Terminal atrial standstill with ventricular escape rhythm in a neonatal calf with acute diarrhea. Turk J Vet Anim Sci, (inpress).
- Başoğlu A, Sen I, Sevinç M, Simsek A, 2004. Serum concentrations of tumor necrosis factor –alpha in neonatal calves with presumed septicemia. J Vet Intern Med, 18, 238-241.
- Basoglu A, Sevinc M, Maden M,1996. Idioventricular rhythm in a calf suffering from diarrhea. Turk J Vet Anim Sci, 20, 375-377.
- Bellino C, Arnaudo F, Biolatti C, Borrelli A, Gianella P, Maurella C, Zabaldano G, Cagnasso A, D’Angelo A, 2012. Development of a diagnostic diagram for rapid field assesment of acidosis severity in diarrheic calves. J Am Vet Med Assoc, 240, 312-316.
- Berchtold J, 1999. Intravenous fluid therapy of calves. Vet Clin North Am Food Anim Pract, 15, 505-531.
- Berchtold J, 2009. Treatment of calf diarrhea: intravenous fluid therapy. Vet Clin North Am Food Anim Pract, 25, 7399.
- Buntain BJ, Selman IE, 1980. Controlled studies of various treatments for neonatal calf diarrhoea in calves of known immunoglobulin levels. Vet Rec, 107, 245–248.
- Bywater RJ, 1983. Diarrhoea treatments – fluid replacement and alternatives. Ann Rech Vet, 14, 556–560.
- Constable PD, 1999a. Hypertonic saline. Vet Clin of North Am Food Anim Pract, 15(3), 559-585.
- Constable PD, 1999b. Clinical assessment of acid-base status: Strong ion difference theory. Vet Clin North Am Food Anim Pract, 15, 447-471.
- Constable PD, 2000. Clinical assessment of acid-base status: comparison of the Henderson-Hasselbalch and strong ion approaches. Vet Clin Pathol, 29, 115-128.
- Constable PD, 2003. Fluids and electrolyte therapy in ruminants. Vet Clin North Am Food Anim Pract, 19, 1-40.
- Constable PD, Grünberg W, Carstensen L, 2009. Comparative effects of two oral rehydration solutions on milk clotting, abomasal luminal pH, and abomasal emptying rate in suckling calves. J Dairy Sci, 92, 296-312.
- Constable PD, Grünberg WA, 2013. Hyperkalemia, acidaemia, and dehydration in diarrheic calves: implications for diagnosis and treatment. Vet J, (inpress).
- Constable PD, Thomas E, Boisrame B, 2001. Comparison of two oral electrolyte solutions for the treatment of dehydrated calves with experimentally-induced diarrhoea. Vet J, 162, 129-140.
- Constable PD, Walker PG, Morin DE, Foreman JH, 1998. Clinical and laboratory assessment of hydration status of neonatal calves with diarrhea. JAVMA, 212, 991-996.
- Coskun A, Sen I, Guzelbektes H, Ok M, Turgut K, Canikli S, 2010. Comparison of the effects of intravenous administration of isotonic and hypertonic sodium bicarbonate solutions on venous acid-base status in dehydrated calves with strong ion acidosis. JAVMA, 236, 1-60.
- Fayet JC, 1971. Plasma and faecal osmolality, water kinetics and body fluid compartments in neonatal calves with diarrhoea. Br Vet J, 127, 37–43.
- Fisher EW, 1967. Death in neonatal calf diarrhea. Br Vet J, 121, 132-138.
- Garcia JP, 1999. A practitioner’s views on fluid therapy in calves. Vet Clin North Am Food Anim Pract, 15,533-543.
- Groutides CP, Michell AR, 1990. Intravenous solutions for fluid therapy in calf diarrhea. Res Vet Sci, 49, 292-297.
- Grove-White DH, White DG, 1993. Diagnosis and treatment of metabolic acidosis in calves: a field study. Vet Rec, 133, 499-501.
- Guzelbektes H, Coskun A, Sen I, 2007. The relationship of dehydration degree with base excess and anion gap in dehydrated calves with diarrhea. Bull Vet Ins Pulawy, 52, 83-87.
- Health SE, Naylor JM, Guedo BL, 1989. The effects of feeding milk to diarrheic calves supplemented with oral electrolytes. Can J Vet Res, 53, 477-485.
- Iwabuchi S, Suzuki K, Abe I, Asano R, 2003. Comparison of the Effects of Isotonic and Hypertonic Sodium Bicarbonate Solutions on Acidemic Calves Experimentally Induced by Ammonium Chloride Administration. J Vet Med Sci, 65, 1369-1371.
- Jodal M, Lundgren O, 1986. Countercurrent mechanisms in the mammalian gastrointestinal tract. Gastroenterelogy, 91, 225-241.
- Kasari TR, 1999. Metabolic acidosis in calves. Vet Clin North Am Food Anim Pract, 15, 473-486.
- Kasari TR, Naylor JM, 1985. Clinical evaluation of sodium bicarbonate, sodium L-lactate, and sodium acetate for the treatment of acidosis in diarrheic calves. JAVMA, 15, 187, 392-397.
- Koch A, Kaske M, 2008. Clinical efficacy of intravenous hypertonic saline solution or hypertonic bicarbonate solution in the treatment of inappetent calves with neonatal diarrhea. J Vet Intern Med, 22, 202–211.
- Lewis LD, Phillips RW, 1972. Water and electrolyte losses in neonatal calves with acute diarrhea. A complete balance study. Cornell Vet, 62, 596-607.
- Lorenz I, 2009. D-Lactic acidosis in calves. Vet J, 179, 197203.
- Lorenz I, Klee W, 2007. Neonatal calf diarrhea-something old, something new. BCVA, 15, 146-151.
- Marshall TS, Constable PD, Crochik SS, Wittek T, 2005. Determination of abomasal emptying rate in suckling calves by use of nuclear scintigraphy and acetaminophen absorption. Am J Vet Res, 66, 364-74.
- Müller KR, Gentile A, Klee W, Constable PD, 2012. Importance of the effective strong ion difference of an intravenous solution in the treatment of diarrheic calves with naturally acquired acidemia and strong ion (metabolic) acidosis. J Vet Intern Med, 26, 674-83.
- Naylor J, 2006. Neonatal ruminant diarrhea, In: Large animal internal medicine, 2nd edition, St Louis, Mosby, USA, pp: 396-417.
- Naylor JM, 1987. Severity and nature of acidosis in diarrheic calves over and under one week of age. Can Vet J, 28, 168-173.
- Naylor JM, 1989. A retrospective study of the relationship between clinical signs and severity of acidosis in diarrheic calves. Can Vet J, 30, 577-580.
- Naylor JM, 1992. Effects of oral electrolyte solutions on clotting of milk. JAVMA, 201, 1026-1029.
- Naylor JM, 1999. Oral electrolyte therapy. Vet Clin North Am Food Anim Pract, 15, 487-504.
- Naylor JM, Petrie L, Rodriguez MI, 1990. A comparison of three oral electrolyte solutions in the treatment of diarrheic calves. Can Vet J, 31,753-760.
- Nouri M, Constable PD, 2006. Comparison of two oral electrolyte solutions and route of administration on the abomasal emptying rate of Holstein-Friesian calves. J Vet Intern Med, 20, 620-626.
- Ok M, Guler L, Turgut K, Ok U, Sen I, Gunduz K, Birdane FM, Guzelbektes H, 2009. The studies on the etiology of diarrhoea in neonatal calves and determination of virulence gene markers of escherichia coli strains by multiplex PCR. J Vet Med B, 56, 94-101.
- Radostits OM, Gay CC, Hinchcliff KW, Constable PD, 2007. Veterinary Medicine. A textbook of the diseases of cattle, sheep, pigs, goats, and horses, W.B. Saunders Company, 10th edition, London, England, pp; 2156.
- Roussel AJ, 1983. Principles and mechanics of fluid therapy in calves. Compend Cont Educ Pract Vet, 5,332-336.
- Roussel AJ, Kasari TR, 1990. Using fluid and electrolyte replacement therapy to help diarrheic calves. Vet Med (Praha), 85, 303-311.
- Roussel AR, Cohen ND, Holland PS, Taliaoferro L, Green R, Benson P, Navarre CB, Hooper RN, 1998. Alterations in acid-base balance and serum electrolyte concentrations in cattle: 632 cases (1984–1994). JAVMA, 212, 1769-1775.
- Sen I, Altunok V, Ok M, Coskun A, Constable PD, 2009. Efficacy of oral rehydration therapy solutions containing sodium bicarbonate or sodium acetate for treatment of calves with naturally acquired diarrhea, moderate dehydration, and strong ion acidosis. JAVMA, 234, 926-34.
- Sen I, Constable PD, Marshall TS, 2006. Effect of suckling isotonic or hypertonic solutions of sodium bicarbonate or glucose on abomasal emptying rate in calves. Am J Vet Res, 67, 1377-1384.
- Şen İ, Güzelbekteş H, Yıldız R, 2013. Neonatal buzağı ishalleri: Patofizyoloji, epidemiyoloji, klinik, tedavi ve koruma. Türkiye Klinikleri J Vet Sci, 4, 71-78.
- Smith WG, 2009. Treatment of calf diarrhea: Oral fluid therapy. Vet Clin North Am Food Anim Pract, 25, 55-72.
- Stämpfli H, Oliver O, Pringle JK, 2012. Clinical evaluation of an oral electrolyte solution formulated based on strong ıon difference (SID) and using propionate as the organic anion in the treatment of neonatal diarrheic calves with strong ion acidosis. Open Journal of Veterinary Medicine, 2, 3439.
- Suzuki K, Abe I, Iwabuchi S, 2002a. Evaluation of isotonic sodium bicarbonate solution for alkalizing effects in conscious calves. J Vet Med Sci, 64, 699-703.
- Suzuki K, Kato T, Tsunoda G, 2002b. Effect of intravenous infusion of isotonic sodium bicarbonate solution on acidemic calves with diarrhea. J Vet Med Sci, 64, 1173-1175.
- Trefz FM, Lorch A, Feist M, Sauter-Louis C, Lorenz I, 2012. Metabolic acidosis in neonatal calf diarrhea-clinical findings and theoretical assessment of a simple treatment protocol. J Vet Intern Med, 26, 162-170.
- Walker PG, Constable PD, Morin DE, Foreman JH, Drackley JK, Thurmon JC, 1998. Comparison of hypertonic salinedextran solution and lactated Ringer’s solution for resuscitating severely dehydrated calves with diarrhea. JAVMA, 213, 113-121.
- Watt JG, 1965. The use of fluid replacement in the treatment of neonatal diseases in calves. Vet Rec, 77, 1474-1482. Weldon AD, Moise NS, Rebhun WC, 1992. Hyperkalemic atrial standstill in neonatal calf diarrhea. J Vet Intern Med, 6, 294-297.