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Definition

Abnormal blood concentrations of magnesium (reference range 0.6–0.8 mmol/L), phosphorus (reference range 0.7–1.3 mmol/L) and calcium (reference range 2.9–3.3 mmol/L). Ionized calcium is more relevant than total calcium, as total calcium might be low due to hypoalbuminemia, whereas the concentration of ionized Ca is not affected by protein levels (ionized Ca reference range: 1.0–1.7 mmol/L).

Risk factors

 Prolonged anorexia (low concentrations of all electrolytes)

 Reflux and diarrhea

 Renal disease

Pathogenesis

Prolonged fluid therapy and/or anorexia, as well as various primary diseases (e.g. renal disease, diarrhea, reflux and sepsis), can lead to abnormal levels of calcium, phosphorus and magnesium. The reader is referred to a more comprehensive review for further details (Torribio (2011) Vet. Clin. N. Am. Equine Pract; Stewart (2011) Vet. Clin. N. Am, Equine Pract,).

Prevention

To avoid electrolyte depletion while on fluid therapy, maintenance fluids should contain additional electrolytes other than sodium, chloride and potassium. If fluid therapy is anticipated for more than 48 hours, a maintenance solution should be used or electrolytes added to the replacement fluid. When fluid therapy is administered for more than 48 hours, electrolyte concentrations should be monitored daily, particularly in animals with diarrhea, reflux or renal disease.

Diagnosis

Diagnosis is based on clinical signs and measuring blood concentrations of electrolytes. Hypocalcemia can lead to abnormal muscle contractions evidenced by diaphragmatic flutter, intestinal hypomotility and weakness. Clinical signs of low phosphorus are variable but can include weakness. Clinical signs of hypomagnesemia are variable but can include weakness.

Treatment

The reader is referred to a more comprehensive review for further details (Toribio et al. (2011) Vet. Clin. N. Am.; Stewart (2011) Vet. Clin. N. Am.).