Spot urinary electrolytes are associated with decongestion and duration of hospitalization in dogs with acute left-sided congestive heart failure secondary to myxomatous mitral valve disease.

Spot urinary sodium and uNa:K after furosemide predict decongestion success and survival in dogs with acute CHF.

This multicenter retrospective study evaluated whether spot urinary electrolyte indices measured after IV furosemide administration are associated with clinical outcomes in dogs with acute left-sided congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD). Fifty client-owned dogs presenting to three referral hospitals received a single IV furosemide bolus (2 mg/kg), and urine was collected from the first spontaneous voiding within 2 hours. Urinary sodium concentration, urinary sodium-to-potassium ratio (uNa:K), and urinary sodium-to-chloride ratio were measured and correlated with clinical outcomes including radiographic pulmonary congestion score improvement, hospitalization duration, and survival to discharge. Higher urinary sodium concentration and uNa:K were significantly associated with greater radiographic improvement in pulmonary congestion and shorter hospitalization. Dogs surviving to discharge had significantly higher uNa:K compared to those that died during hospitalization. Notably, urinary electrolyte indices did not correlate with echocardiographic or radiographic measures of left atrial size, suggesting these indices reflect diuretic response rather than structural disease severity. The study concludes that spot urinary electrolyte measurements represent a practical, noninvasive method for monitoring diuretic efficacy and predicting clinical outcomes in dogs with acute CHF. These findings support potential integration of urinary electrolyte monitoring into early clinical decision-making for hospitalized cardiac patients, though prospective validation in larger cohorts is warranted.

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