The effects of surgery and anesthesia on blood magnesium and calcium concentrations in canine and feline patients.

OBJECTIVE To demonstrate the effect of anesthesia and surgery on serum ionized magnesium and ionized calcium concentrations in clinical canine and feline patients. ANIMALS 37 client-owned dogs, ASA PS I-III and 10 client-owned cats, ASA PS I, all receiving anesthesia for elective or emergent surgery at a Veterinary Teaching Hospital. MATERIALS AND METHODS Plasma ionized and serum total magnesium, and plasma ionized calcium were measured prior to and after a group-standardized anesthetic protocol. RESULTS Regardless of pre-operative medication (hydromorphone or butorphanol), anesthetic induction (thiopental or lidocaine/hydromorphone/diazepam (LHD) and propofol combination), or type of surgical procedure (peripheral surgery or laparotomy), post-operative plasma ionized calcium concentration decreased in all groups of dogs, while post-operative plasma ionized magnesium increased in all groups, although the changes were not always significant. The dogs who were induced with an LHD and propofol technique had a greater increase in ionized magnesium (0.36 +/- 0.07 to 0.42 +/- 0.07 mmol L(-1)) than the group in which anesthesia was induced with thiopental (0.41 +/- 0.07 to 0.42 +/- 0.07 mmol L(-1), p = 0.009). The cats showed similar changes in ionized magnesium and ionized calcium, and also had a significant increase in serum total magnesium (2.17 +/- 0.20 to 2.31 +/- 0.25 mg dL(-1), p = 0.009) CONCLUSIONS, CLINICAL RELEVANCE: A post-operative decrease in ionized calcium was demonstrated in healthy animals, as well as an increase in ionized or total magnesium after various anesthetic protocols and surgeries. These changes, while statistically significant, do not appear to be clinically significant, as values remained within reference ranges at all times.

[1]  B. Horney,et al.  Validation of the Nova CRT8 for the measurement of ionized magnesium in feline serum. , 2005, Veterinary clinical pathology.

[2]  P. Schenck Fractionation of canine serum magnesium. , 2005, Veterinary clinical pathology.

[3]  H. Dralle,et al.  Monitoring of Acid-base and Regulating Variables during Abdominal Lavage , 2004, Anaesthesia and intensive care.

[4]  K. Drobatz,et al.  Evaluation of plasma-ionized magnesium concentration in 122 dogs with diabetes mellitus: a retrospective study. , 2004, Journal of veterinary internal medicine.

[5]  M. Hässig,et al.  Evaluation of an electrolyte analyzer for measurement of ionized calcium and magnesium concentrations in blood, plasma, and serum of dogs. , 2004, American journal of veterinary research.

[6]  E. Mittendorf,et al.  Post-Parathyroidectomy Hypocalcemia: Incidence, Risk Factors, and Management , 2004, The American surgeon.

[7]  K. Drobatz,et al.  Postoperative hypoxemia and hypercarbia in healthy dogs undergoing routine ovariohysterectomy or castration and receiving butorphanol or hydromorphone for analgesia. , 2003, Journal of the American Veterinary Medical Association.

[8]  J. Rush,et al.  Massive transfusion in dogs: 15 cases (1997-2001). , 2002, Journal of the American Veterinary Medical Association.

[9]  H. Erb,et al.  Prevalence and incidence of serum magnesium abnormalities in hospitalized cats. , 2002, Journal of veterinary internal medicine.

[10]  R. Washabau,et al.  Incidence and prognostic value of low plasma ionized calcium concentration in cats with acute pancreatitis: 46 cases (1996-1998). , 2001, Journal of the American Veterinary Medical Association.

[11]  M. Millar Pre‐operative assessment clinics – the last word , 2001, Anaesthesia.

[12]  S. Hedges,et al.  Prediction of degree of hypomagnesaemia during general anaesthesia , 2001, Anaesthesia.

[13]  L. Freeman,et al.  Prevalence and prognostic importance of hypomagnesemia and hypocalcemia in horses that have colic surgery. , 2001, American journal of veterinary research.

[14]  R. Sasaki,et al.  Prediction of degree of hypomagnesaemia during general anaesthesia , 2000, Anaesthesia.

[15]  J. Watkins,et al.  A case for co‐ordinated investigation and reporting of hypersensitivity‐type drug reactions in the UK , 2000, Anaesthesia.

[16]  I. M. Aguilera,et al.  Calcium and the anaesthetist , 2000, Anaesthesia.

[17]  R. Nelson,et al.  Serum total and ionized magnesium concentrations and urinary fractional excretion of magnesium in cats with diabetes mellitus and diabetic ketoacidosis. , 1999, Journal of the American Veterinary Medical Association.

[18]  P. Constable,et al.  Hemodynamic effects of ionized calcium in horses anesthetized with halothane or isoflurane. , 1999, American journal of veterinary research.

[19]  M. Dagenais,et al.  Hypocalcemia induced during major and minor abdominal surgery in humans. , 1999, The Journal of clinical endocrinology and metabolism.

[20]  W. Fawcett,et al.  Magnesium: physiology and pharmacology. , 1999, British journal of anaesthesia.

[21]  T. Okuda,et al.  [Changes in ionized magnesium concentrations during general anesthesia]. , 1999, Masui. The Japanese journal of anesthesiology.

[22]  C. Gregory,et al.  Ionized and total serum magnesium concentrations in feline renal transplant recipients. , 1999, Veterinary surgery : VS.

[23]  P. J. Armstrong,et al.  Hypomagnesemia in 188 dogs: a hospital population-based prevalence study. , 1998, Journal of veterinary internal medicine.

[24]  T. Wallner,et al.  Magnesium Sulfate Reduces Intra- and Postoperative Analgesic Requirements , 1998, Anesthesia and analgesia.

[25]  J. Proulx,et al.  Hypocalcemia and hypomagnesemia. , 1998, The Veterinary clinics of North America. Small animal practice.

[26]  P. Hebert,et al.  Reference interval for whole blood ionized magnesium in a healthy population and the stability of ionized magnesium under varied laboratory conditions. , 1996, Clinical biochemistry.

[27]  Courtney W. Brown,et al.  Hypomagnesemia in Postoperative Spine Fusion Patients , 1996, Spine.

[28]  D. R. Cook,et al.  Ionized hypomagnesemia in patients undergoing orthotopic liver transplantation: a complication of citrate intoxication. , 1996, Liver transplantation and surgery : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[29]  M. Palta,et al.  Fluctuations in serum magnesium levels during total intravenous anaesthesia with propofol. , 1996, Magnesium research.

[30]  D. Kapusta,et al.  OPIOID MECHANISMS CONTROLLING RENAL FUNCTION , 1995, Clinical and experimental pharmacology & physiology.

[31]  J. Niemela,et al.  Analyzer-dependent differences in results for ionized calcium, ionized magnesium, sodium, and pH. , 1995, Clinical chemistry.

[32]  I. Mcconachie,et al.  Peri‐operative effect of major gastrointestinal surgery on serum magnesium , 1994, Anaesthesia.

[33]  T. Hackett,et al.  Abnormalities of Serum Magnesium in Critically III Dogs: Incidence and Implications , 1994 .

[34]  R. McLean Magnesium and its therapeutic uses: a review. , 1994, The American journal of medicine.

[35]  D. Terrar Structure and function of calcium channels and the actions of anaesthetics. , 1993, British journal of anaesthesia.

[36]  H. Matsuoka,et al.  Torsade de pointes induced by hypocalcemia in a postoperative patient with thyrotoxicosis. , 1992, Japanese heart journal.

[37]  L. Aglio,et al.  Hypomagnesemia is common following cardiac surgery. , 1991, Journal of cardiothoracic and vascular anesthesia.

[38]  A. Shakoor,et al.  Prospective study of changes in serum calcium after diethyl-ether anaesthesia. , 1990, The Indian journal of medical research.

[39]  J. Chelly,et al.  Cardiovascular effects of acute changes in extracellular ionized calcium concentration induced by citrate and CaCl2 infusions in chronically instrumented dogs, conscious and during enflurane, halothane, and isoflurane anesthesia. , 1990, Anesthesiology.

[40]  C. Coté Depth of Halothane Anesthesia Potentiates Citrate‐induced Ionized Hypocalcemia and Adverse Cardiovascular Events in Dogs , 1987, Anesthesiology.

[41]  A. Zaritsky,et al.  Hypomagnesemia is a common complication of aminoglycoside therapy. , 1984, Surgery, gynecology & obstetrics.

[42]  F. Spencer,et al.  Variations in total and ionized calcium during cardiac surgery. , 1983, The Journal of cardiovascular surgery.

[43]  F. Cavaliere,et al.  Changes of serum magnesium ions in open heart surgery. , 1983, Resuscitation.