A 6 year, castrated male Bichon mix is presented with a 3 day history of vomiting brown liquid. On exam he is stuporous, has cool extremities, slow shallow respiration, and thready femoral pulses.
T 98.7FP 140R 12mm paleCRT >3s BCS 4/9Weight 6.9kg BP will not read
This patient’s bicarbonate is high, which is a metabolic alkalosis. The PCO2 is high, which is respiratory acidosis. So what is the primary disturbance?
This dog probably has (at least) two primary problems. He has been vomiting for 3 days which is probably driving the metabolic alkalosis. His breathing is slow and shallow with elevated pCO2 – he is hyperventilating – which is the probable source of respiratory acidosis. He is also in shock which is usually associated with a metabolic acidosis, and indeed his lactate is elevated.
While it’s tempting to say that the respiratory acidosis is compensation for the metabolic alkalosis, or vice versa, remember that compensation does not completely correct, or over-correct the pH. So this patient has a mixed acid-base status.
