The effect of potassium levels on electrocardiographic data in calves with neonatal diarrhea

Abstract

Objective: The objective of the current study was to assess the potassium levels and electrocardiographic (ECG) data in a cohort of 40 calves (age < 30 days) diagnosed with newborn diarrhea, originating from dairy farms located in Ankara, Turkey. Materials and Methods: This study was conducted on a dairy farm located in Ankara, involving a population of 500 dairy animals. The calves were divided into two groups: one group with normal potassium levels (n=24) and another group with hyperkalemia (n=16) due to neonatal diarrhea. After the initial clinical examination was conducted on the farm, electrocardiographic investigations were carried out utilizing an ECG equipment. The biochemical analysis of blood samples that were collected in red and dry collecting tubes was carried out with the assistance of an automated analyzing machine Results: The findings indicate that there were no statistically significant differences observed across all ECG variables between the two groups. Conclusion: Acidemia and metabolic acidosis are commonly observed in calves suffering from hyperkalemic diarrhea, as documented in previous investigations, often accompanied by heart rhythm problems. In contrast, the current investigation revealed that neonatal calves with diarrhea and hyperkalemia had just a deepening of the T wave, without any additional abnormalities. Nevertheless, it is important to note that acidemia and metabolic acidosis were not of a severe nature. The implementation of Holter monitoring is indicated for calves experiencing hyperkalemia in conjunction with diarrhea.

Keywords

• calf
• diarrhea
• electrocardiography

References

1. Başoğlu A, Aydoğdu U. Terminal atrial standstill with ventricular escape rhythm in a neonatal calf with acute diarrhea. Turk J Vet Anim Sci. 2013; 37(3):362-365.
2. Bergman EN, Sellers AF. Studies on intravenous administration of calcium, potassium, and magnesium to dairy calves. II. Some cardiac and respiratory effects. Am J Vet Res. 1954; 15(54):25-35.
3. Constable PD. Hypertonic saline. Vet Clin North Am Food Anim Pract. 1999; 15(3):559-585.
4. Constable PD. Treatment of calf diarrhea: antimicrobial and ancillary treatments. Vet Clin North Am Food Anim Pract. 2009; 25(1): 101-120.
5. Constable PD, Stämpfli HR, Navetat H, Berchtold J and Schelcher F. Use of a Quantitative Strong Ion Approach to Determine the Mechanism for Acid—Base Abnormalities in Sick Calves with or without Diarrhea. Journal of Veterinary Internal Medicine. 2005; 19(4): 581-589.
6. Diercks DB, Shumaik GM, Harrigan RA, Brady WJ and Chan TC. Electrocardiographic manifestations: electrolyte abnormalities. J Emerg Med. 2004; 27(2): 153-160.
7. Elliott TL, Braun M. Electrolytes: Potassium Disorders. FP Essent. 2017; 459: 21-28.
8. Ewaschuk JB, Naylor JM and Zello GA. Anion gap correlates with serum D- and DL-lactate concentration in diarrheic neonatal calves. J Vet Intern Med. 2003; 17(6): 940-942.

9. Ewaschuk JB, Naylor JM and Zello GA. D-lactate in human and ruminant metabolism. J Nutr. 2005; 135(7): 1619-1625.
10. Lewis L, Phillips R. Diarrheic induced changes in intracellular and extracellular ion concentrations in neonatal calves. Annales de recherches vétérinaires. 1973.
11. Lorenz I. Influence of D-lactate on metabolic acidosis and on prognosis in neonatal calves with diarrhoea. J Vet Med A Physiol Pathol Clin Med. 2004; 51(9-10): 425-428.
12. Lorenz I. Investigations on the influence of serum D-lactate levels on clinical signs in calves with metabolic acidosis. Vet J. 2004; 168(3): 323-327.
13. Lorenz I. D-Lactic acidosis in calves. Vet J. 2009; 179(2): 197-203.
14. Mattu A, Brady WJ and Robinson DA. Electrocardiographic manifestations of hyperkalemia. Am J Emerg Med. 2000; 18(6): 721-729.
15. Montague BT, Ouellette JR and Buller GK. Retrospective review of the frequency of ECG changes in hyperkalemia. Clin J Am Soc Nephrol. 2008; 3(2): 324-330.
16. Naseri A, Sen I, Turgut K, Guzelbektes H and Constable PD. Echocardiographic assessment of left ventricular systolic function in neonatal calves with naturally occurring sepsis or septic shock due to diarrhea. Res Vet Sci. 2019; 126: 103-112.
17. Özkan C, Altuğ N, Yüksek N, Kaya A and Akgül Y. Assessment of electrocardiographic findings, serum nitric oxide, cardiac troponins and some enzymes in calves with hyperkaliemia related to neonatal diarrhoea. Revue Méd Vét. 2011; 162(4): 171-176.
18. Pohanka M. D-Lactic Acid as a Metabolite: Toxicology, Diagnosis, and Detection. Biomed Res Int. 2020; 2020: 3419034.
19. Trefz FM, Constable PD and Lorenz I. Quantitative physicochemical analysis of acid-base balance and clinical utility of anion gap and strong ion gap in 806 neonatal calves with diarrhea. J Vet Intern Med. 2015; 29(2): 678-687.
20. Trefz FM, Lorch A, Feist M, Sauter-Louis C and Lorenz I. Metabolic acidosis in neonatal calf diarrhea-clinical findings and theoretical assessment of a simple treatment protocol. J Vet Intern Med. 2012; 26(1): 162-170.
21. Trefz FM, Lorenz I and Constable PD. Electrocardiographic findings in 130 hospitalized neonatal calves with diarrhea and associated potassium balance disorders. Journal of Veterinary Internal Medicine. 2018; 32(4): 1447-1461.
22. Weldon AD, Moise NS and Rebhun WC. Hyperkalemic atrial standstill in neonatal calf diarrhea. J Vet Intern Med. 1992; 6(5): 294-297.
23. Wrenn KD, Slovis CM and Slovis BS. The ability of physicians to predict hyperkalemia from the ECG. Ann Emerg Med. 1991; 20(11): 1229-1232.