Hyperkalemia secondary to renal hypoperfusion in a dog with third-degree atrioventricular block.

Abstract

OBJECTIVE:

To demonstrate a critical role of artificial cardiac pacing to normalize severe bradyarrhythmia-induced hyperkalemia in a dog with third-degree atrioventricular (AV) block.

CASE SUMMARY:

A dog was presented for evaluation of severe hyperkalemia and bradyarrhythmia. ECG revealed third-degree AV block with heart rate of 10-20 min, which was lower than usual ventricular escape rate. The etiology of severe hyperkalemia was considered secondary to significantly decreased renal perfusion and potassium excretion as a result of poor cardiac output caused by the AV block. Since potassium disorders may lead to life-threatening conditions such as cardiopulmonary arrest, artificial cardiac pacing was immediately pursued. Within 1 hour, serum potassium concentration was normalized, which confirmed that severe hyperkalemia occurred primarily due to third-degree AV block. The dog was then treated with permanent pacemaker implantation. A recheck evaluation 3-month post pacemaker implantation showed normal serum potassium concentration and the dog was clinically healthy.

NEW OR UNIQUE INFORMATION PROVIDED:

This report describes hyperkalemia secondary to significantly decreased cardiac output and renal hypoperfusion caused by third-degree AV block. The authors propose that artificial cardiac pacing must be considered as an emergency treatment for bradyarrhythmia-induced hyperkalemia, which ultimately restores cardiac output and renal perfusion and normalizes serum potassium concentration.

• Authors: SeungWoo Jung, Karl E Jandrey
• Journal: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) (J Vet Emerg Crit Care (San Antonio)) Vol. 22 Issue 4 Pg. 483-7 (Aug 2012) ISSN: 1476-4431 [Electronic] United States
• PMID: 22765053 (Publication Type: Journal Article)
• Copyright: © Veterinary Emergency and Critical Care Society 2012.

Topics

• Animals
• Atrioventricular Block (therapy, veterinary)
• Cardiac Pacing, Artificial (veterinary)
• Dog Diseases (blood, therapy)
• Dogs
• Female
• Hyperkalemia (blood, veterinary)
• Kidney (blood supply, physiology)
• Pacemaker, Artificial (veterinary)