Acute subtraction alkalosis from gastric juice loss in dogs

¹ University of Kansas Medical Center, Kansas City, Kansas

The clinical syndrome of acute metabolic alkalosis secondary to pyloric obstruction and vomiting was simulated in 50 dogs by draining gastric juice through a cannula gastrostomy. This study was designed to quantify changes in body electrolyte and water utilizing radioisotope-dilution methods. Total body chloride decreased 43% with good correlation between the decrease in plasma chloride concentration and the decrease in total body chloride. Body sodium decreased 21% with no change in plasma sodium concentration. Body potassium decreased 20% but was not significantly related to the decrease in plasma potassium concentration. A highly significant correlation was obtained between plasma potassium and the product of blood hydrogen and intracellular potassium content. Intracellular pH (DMO) did not change significantly. Body water decreased 16% with isotonic loss of 169 mEq Na + K per liter body water. Sodium chloride solution alone corrected the alkalosis and acidified the urine. Potassium administration was necessary to prevent hypokalemia and aggravation of the cellular potassium deficit during rehydration. This study helps clarify the differences in body composition between the acute alkalosis of gastric juice loss and the alkalosis resulting from prolonged potassium depletion, sodium loading, and excess adrenocorticosteroid administration.

Key Words: body water • electrolytes • extracellular fluid • dehydration • plasma volume • intracellular pH • potassium deficiency • chloride deficiency • sodium deficiency • vomiting • body composition

Submitted on November 22, 1963