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Water Intoxication

Johanna L. Watson • Gary P. Carlson

Massive water intake may produce marked hypotonicity of body fluids, with subsequent intravascular hemolysis of erythrocytes.6 This problem has been described as a naturally occurring entity in milk-reared calves when they are first given access to unlimited quantities of water.7,8 Severe neurologic signs may be seen (e.g., depression, convulsions, coma).

Respira­tory distress, hemoglobinuria, and death losses occur in some cases. Clinicopathologic features include hemolytic anemia, hypoproteinemia, hyponatremia, hypochloremia, hyposmolality, hemoglobinuria, and hyposthenuria. A sudden decrease in serum osmolality is believed to result in osmotic lysis of erythrocytes.9 Erythrocytes are most susceptible to osmotic shock when calves are between 4 and 5 months of age. Treat­ment is primarily a matter of temporarily restricting water and providing supportive care. Calves with marked hyponatremia (sodium of 110 mmol/L) that are manifesting neurologic signs may benefit from hypertonic saline, mannitol, and corticoster­oids. The goal of treatment is restoring serum sodium to 120 to 125 mmol/L without overcorrection. Death losses can occur in as little as 2 hours, but most calves recover without long-term adverse effects.

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Source: Smith Bradford P., Van Metre David C., Pusterla Nicola (eds.). Large Animal Internal Medicine. Part 2. 6th edition. — Elsevier,2020. — 2279 p.. 2020

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