Introduction: Hypocalcemia and magnesium disturbances are linked to vasoplegia, cardiac arrhythmias, gastrointestinal ileus, and coagulopathies. In human critical care patients, these imbalances are associated with higher mortality and longer hospital stay. Little is known about such associations in companion animals. Our study assessed the prevalence of ionized calcium (iCa) and ionized magnesium (iMg) disturbances in dogs and cats with septic peritonitis at presentation, and their association with administration of antiarrhythmics, vasopressors, prokinetics, and plasma, hospitalization duration and mortality.

Methods: Medical records of patients with septic peritonitis from January 2018 to December 2023 were reviewed. Inclusion criteria were confirmed septic peritonitis and blood gas analysis with ionized calcium and magnesium values at admission. Data collected included signalment, diagnosis and cause, calcium and magnesium levels, administration of vasopressors, antiarrhythmics, prokinetics, and plasma, length of hospitalization, and survival. Comparisons were made using Chi-square, Fisher exact test, and ANOVA. Correlations were assessed with the Spearman coefficient.

Results: Sixty-one dogs and 17 cats were included. Hypocalcemia (iCa < 1.25 mmol/L in dogs; <1.10 mmol/L in cats) was diagnosed in 51.7% of dogs and 23.5% of cats. Hypomagnesemia (iMg < 0.43 mmol/L in dogs; <0.47 mmol/L in cats) was found in 13.5% of dogs and 0% of cats, and hypermagnesemia (iMg > 0.6 mmol/L in dogs; >0.7 mmol/L in cats) in 15.4% of dogs and 60% of cats. Hypocalcemia and hypermagnesemia were significantly more common in dogs and cats, respectively. Ionized hypocalcemia was associated with plasma administration in dogs (p = 0.038). No significant correlation was found between iCa and iMg disturbances and length of hospitalization in dogs (respectively p = 0.62 and p = 0.62) or cats (respectively p = 0.62 and p = 0.27). The survival rate was 50%, with no association between iCa and iMg derangements and survival in dogs (p = 0.30 and p = 0.38 respectively), nor in cats (p = 0.29 and p = 0.29 respectively). A significant difference was observed in the mean iMg values between survivors (0.49 ± 0.09 mmol/L) and non-survivors (0.55 ± 0.11 mmol/L) in dogs (p = 0.042).

Discussion: In this population with septic peritonitis, about half of the dogs and a quarter of the cats had ionized hypocalcemia. Hypo- and hypermagnesemia were rare in dogs, while hypermagnesemia was common in cats and hypomagnesemia was not seen in cats. Dogs and cats with hypocalcemia were more likely to receive plasma. Mean iMg values were lower in survived dogs than dogs that did not survive.

Keywords: calcium metabolism; critical illness; ionized hypermagnesemia; ionized hypocalcemia; ionized hypomagnesemia; septic abdomen.

Copyright © 2025 Debie, Giberto, Noel, Paepe and Gommeren.

介绍： 低钙血症和镁离子紊乱与血管麻痹、心脏心律失常、肠梗阻以及凝血障碍有关。在人类重症监护患者中，这些不平衡与较高的死亡率和更长的住院时间相关。关于伴侣动物中的此类关联知之甚少。本研究评估了患有腹膜炎的狗和猫在入院时出现游离钙（iCa）和游离镁（iMg）紊乱的情况及其与抗心律失常药、血管加压药、促动力药物以及血浆的应用，住院时间及死亡率之间的关联。

方法： 我们审查了2018年1月至2023年12月期间患有腹膜炎患者（犬猫）的医疗记录。纳入标准为确诊腹膜炎并有入院时的血液气体分析和游离钙、镁值的数据。收集的数据包括宠物的基本信息、诊断及病因，钙和镁水平，使用抗心律失常药、血管加压药物、促动力药物以及血浆的情况，住院时间和生存情况。使用卡方检验、费舍尔精确检验以及ANOVA进行比较，并用Spearman系数评估相关性。

结果： 共有61只狗和17只猫被纳入研究。低钙血症（犬：iCa 0.6 mmol/L；猫：> 0.7 mmol/L）在15.4%的狗和60%的猫中出现。低钙血症与高镁血症分别在犬和猫中显著更常见。游离态低钙血症与狗接受血浆治疗相关（p = 0.038）。未发现iCa和iMg紊乱与住院时间之间存在显著相关性，无论是犬 (分别为 p = 0.62 和 p = 0.62) 还是猫 (分别为 p = 0.62 和 p = 0.27)。生存率为50%，没有发现低钙血症和高镁血症与狗的存活率之间存在关联 (p = 0.30 和 p = 0.38 分别)，同样在猫中也未见相关性（分别为 p = 0.29 和 p = 0.29）。在犬类中，生存者和非生存者的平均iMg值之间存在显著差异 (p = 0.042)：生存者为 0.49 ± 0.09 mmol/L，而非生存者为 0.55 ± 0.11 mmol/L。

讨论： 在这个患有腹膜炎的人群中，大约一半的狗和四分之一的猫表现出游离态低钙血症。低镁血症与高镁血症在狗身上较为罕见，而在猫身上则常见高镁血症且未发现低镁血症。有低钙血症的犬猫更可能接受血浆治疗。存活下来的狗的平均iMg值低于那些没有存活下来的。

关键词： 钙代谢；重症疾病；游离态高镁血症；游离态低钙血症；游离态低镁血症；腹膜炎

Copyright © 2025 Debie, Giberto, Noel, Paepe and Gommeren.