Introduction

Dysmagnesemia has been recently reported to be associated with in-hospital mortality in critically ill human patients. The objectives of this study were to describe the prevalence of dysmagnesemia in a population of canine critically ill patients and assess its association with clinical complications and in-hospital mortality.

Methods

A prospective observational study was performed with dogs admitted to the intensive care unit of a university teaching hospital between November 2020 and December 2021. Dogs fulfilling two or more criteria for systemic inflammatory response syndrome (SIRS) who had their ionized magnesium measured on admission were included. APPLE full score was calculated retrospectively for patients on admission. Dysmagnesemia was defined as an ionized magnesium level under 0.43 mmol/L or over 0.7 mmol/L as previously described in veterinary literature. Clinical complications associated to dysmagnesemia such as arrhythmias, gastrointestinal ileus, neuromuscular signs and mortality among others were recorded during hospitalization. Associations between dysmagnesemia and the APPLE score, clinical complications and mortality were assessed using chi-square tests of independence and unpaired two-sample Wilcoxon test, with a statistical significance set at a p-value ≤0.05.

Results

In this study, sixty-seven dogs fulfilled criteria for inclusion. The APPLE full score could be calculated in fifty-five animals and the median was 35 (IQR=17.5). Dysmagnesemia on admission was detected in 24% of patients (16/67). Hypermagnesemia presented more frequently (13/16) than hypomagnesemia (3/16 dogs). Overall, mortality rate was 31% (21/67). No significant correlations were found between dysmagnesemia and mortality (p=0.54) nor between dysmagnesemia at admission and the probability of developing clinical complications (p=0.34). APPLE full score did not show significant statistical correlation with mortality (p=0.38) or dysmagnesemia (p=0.17).

Conclusions

Dysmagnesemia occurred in approximately one-fourth of dogs with SIRS, being hypermagnesemia more common than hypomagnesemia. This study did not find an association between dysmagnesemia and outcome, APPLE score or significant clinical complications. The small number of animals with dysmagnesemia included, particularly with hypomagnesemia, could have limited the study results. Further studies including more animals are warranted.

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