Clinical use of sodium bicarbonate in small animals: indications, electrolyte changes and survival outcome.

Monitor ionized calcium closely after sodium bicarbonate administration, as hypocalcemia occurs in approximately one-third of treated animals.

This retrospective descriptive study evaluated the clinical use of sodium bicarbonate in 25 dogs and 28 cats treated at a university teaching hospital between 2019 and 2023. Kidney disease was the most common indication for sodium bicarbonate administration in both species. The median doses were 2.12 mEq/kg in dogs and 2.49 mEq/kg in cats, most commonly diluted at a 1:6 ratio with sterile water and infused over a median of 6 hours. Sodium bicarbonate administration resulted in a statistically significant increase in mean pH (7.020 pre-treatment vs. 7.128 post-treatment; N=46). However, no correlation was found between dose and changes in pH, bicarbonate, ionized calcium, sodium, or potassium. A clinically important finding was ionized hypocalcemia occurring in 33% of treated animals, warranting monitoring. Hypernatremia was rare, identified in only 2 animals. Neither sodium bicarbonate dose nor pH change was significantly associated with survival outcome. The study is limited by its retrospective design, small sample size, and heterogeneous patient population, which preclude definitive conclusions about efficacy or optimal dosing. Nevertheless, this study provides valuable real-world descriptive data on current clinical practices regarding sodium bicarbonate use in small animals, highlighting the need for electrolyte monitoring—particularly ionized calcium—following administration.

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