{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:47:37Z","timestamp":1784008057151,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":1678,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypochloremia is a strong negative prognostic factor in humans with congestive heart failure (CHF), but the implications of electrolyte abnormalities in small animals with acute CHF are unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To document electrolyte abnormalities present upon admission of small animals with acute CHF, and to assess the relationship between electrolyte concentrations and diuretic dose, duration of hospitalization and survival time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>Forty-six dogs and 34 cats with first onset of acute CHF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective study. The associations between electrolyte concentrations and diuretic doses were evaluated with Spearman rank correlation coefficients. Relationship with duration of hospitalization and survival were assessed by simple linear regression and Cox proportional hazard regression, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The most commonly encountered electrolyte anomaly was hypochloremia observed in 24% (9\/46 dogs and 10\/34 cats) of cases. In dogs only, a significant negative correlation was identified between serum chloride concentrations at admission (median 113\u2009mmol\/L [97-125]) and furosemide doses both at discharge (median 5.2\u00a0mg\/kg\/day [1.72-9.57]; r\u00a0=\u2009\u22120.59; P\u00a0&amp;lt;\u2009.001) and at end-stage heart failure (median 4.7\u00a0mg\/kg\/day [2.02-7.28]; r\u00a0=\u2009\u22120.62; P\u00a0=\u2009.005). No significant hazard ratios were found for duration of hospitalization nor survival time for any of the electrolyte concentrations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Clinical Importance<\/jats:title>\n                    <jats:p>The observed association between serum chloride concentrations and diuretic doses suggests that hypochloremia could serve as a marker of disease severity and therapeutic response in dogs with acute CHF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jvim.16187","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T15:26:56Z","timestamp":1623166016000},"page":"1652-1662","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Clinical relevance of serum electrolytes in dogs and cats with acute heart failure: A retrospective study"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5117-0638","authenticated-orcid":false,"given":"Marine","family":"Roche-Catholy","sequence":"first","affiliation":[{"name":"Faculty of Veterinary Medicine, Ghent University Small Animal Department, ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Van Cappellen","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary Medicine, Ghent University Small Animal Department, ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Locquet","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary Medicine, Ghent University Small Animal Department, ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6742-3911","authenticated-orcid":false,"given":"Bart J. G.","family":"Broeckx","sequence":"additional","affiliation":[{"name":"Genetics and Ethology, Faculty of Veterinary Medicine, Ghent University Department of Nutrition, ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Paepe","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary Medicine, Ghent University Small Animal Department, ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascale","family":"Smets","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary Medicine, Ghent University Small Animal Department, ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,7,1]]},"reference":[{"issue":"4","key":"2026020922175790700_jvim16187-bib-0001","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.3949\/ccjm.73.Suppl_2.S2","article-title":"Sodium and water retention in heart failure and diuretic therapy: basic mechanisms","volume":"73","author":"Sica","year":"2006","journal-title":"Cleve Clin J Med"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0002","first-page":"667","article-title":"The role of sodium and chloride in heart failure: does it take two to tango?","volume":"66","author":"O'Connor","year":"2015","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0003","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1093\/eurjhf\/hfs099","article-title":"Relationship of serum sodium concentration to mortality in a wide spectrum of heart failure patients with preserved and with reduced ejection fraction: an individual patient data meta-analysis: Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC)","volume":"14","author":"Rusinaru","year":"2012","journal-title":"Eur J Heart Fail"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0004","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1093\/eurheartj\/ehl542","article-title":"Relationship between admission serum sodium concentration and clinical outcomes in patients hospitalized for heart failure: an analysis from the OPTIMIZE-HF registry","volume":"28","author":"Gheorghiade","year":"2007","journal-title":"Eur Heart J"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0005","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0124105","article-title":"Moderate hyponatremia is associated with increased risk of mortality: evidence from a meta-analysis","volume":"8","author":"Corona","year":"2013","journal-title":"PLoS One"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0006","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/j.1534-6935.2004.00118.x","article-title":"Association of hyponatremia and hyperglycemia with outcome in dogs with congestive heart failure","volume":"14","author":"Brady","year":"2004","journal-title":"J Vet Emerg Crit Care (San Antonio)"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0007","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.jacc.2015.06.007","article-title":"Prognostic role of serum chloride levels in acute decompensated heart failure","volume":"66","author":"Grodin","year":"2015","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0008","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1253\/circj.CJ-17-0938","article-title":"Serial change in serum chloride during hospitalization could predict heart failure death in acute decompensated heart failure patients","volume":"82","author":"Kondo","year":"2018","journal-title":"Circ J"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0009","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1002\/ejhf.477","article-title":"Hypochloraemia is strongly and independently associated with mortality in patients with chronic heart failure","volume":"18","author":"Testani","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2026020922175790700_jvim16187-bib-0010","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.ijcard.2016.03.081","article-title":"Hypochloraemia as a predictor of developing hyponatraemia and poor outcome in acute heart failure patients","volume":"212","author":"Radulovi\u0107","year":"2016","journal-title":"Int J Cardiol"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0011","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.ejim.2011.11.013","article-title":"Chloride: the queen of electrolytes?","volume":"23","author":"Berend","year":"2012","journal-title":"Eur J Intern Med"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0012","article-title":"Hypochloremia and diuretic resistance in heart failure: mechanistic insights","volume":"9","author":"Hanberg","year":"2016","journal-title":"Circ Heart Fail"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0013","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.amjcard.2016.09.014","article-title":"Implications of serum chloride homeostasis in acute heart failure (from ROSE-AHF)","volume":"119","author":"Grodin","year":"2017","journal-title":"Am J Cardiol"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0014","article-title":"Hypochloremia, diuretic resistance, and outcome in patients with acute heart failure","volume":"9","author":"Ter Maaten","year":"2016","journal-title":"Circ Heart Fail"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0015","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1111\/jvim.15662","article-title":"Role of electrolyte concentrations and renin-angiotensin-aldosterone activation in the staging of canine heart disease","volume":"34","author":"Adin","year":"2020","journal-title":"J Vet Intern Med"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0016","doi-asserted-by":"crossref","first-page":"666","DOI":"10.2460\/javma.250.6.666","article-title":"Accuracy of point-of-care lung ultrasonography for the diagnosis of cardiogenic pulmonary edema in dogs and cats with acute dyspnea","volume":"250","author":"Ward","year":"2017","journal-title":"J Am Vet Med Assoc"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0017","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.cvsm.2013.03.011","article-title":"The use of ultrasound for dogs and cats in the emergency room: AFAST and TFAST","volume":"43","author":"Boysen","year":"2013","journal-title":"Vet Clin North Am Small Anim Pract"},{"key":"2026020922175790700_jvim16187-bib-0018","first-page":"302","article-title":"Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice","author":"De Morais","year":"2012","edition":"4"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0019","first-page":"91","article-title":"User's guide to correlation coefficients","volume":"18","author":"Agokul","year":"2018","journal-title":"Turk J Emerg Med"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0020","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/j.1476-4431.2010.00524.x","article-title":"Evaluation of acute congestive heart failure in dogs and cats: 145 cases (2007-2008)","volume":"20","author":"Goutal","year":"2010","journal-title":"J Vet Emerg Crit Care (San Antonio)"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0021","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1002\/ejhf.1229","article-title":"Perturbations in serum chloride homeostasis in heart failure with preserved ejection fraction: insights from TOPCAT","volume":"20","author":"Grodin","year":"2018","journal-title":"Eur J Heart Fail"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0022","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1002\/ehf2.12221","article-title":"The association between high-dose loop diuretic use at discharge and cardiovascular mortality in patients with heart failure","volume":"5","author":"Okabe","year":"2018","journal-title":"ESC Heart Fail"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0023","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1159\/000047397","article-title":"Diuretic therapy and resistance in congestive heart failure","volume":"96","author":"Ellison","year":"2001","journal-title":"Cardiology"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0024","doi-asserted-by":"crossref","first-page":"650","DOI":"10.2215\/CJN.03590319","article-title":"Mechanistic insights into loop diuretic responsiveness in heart failure","volume":"14","author":"Ellison","year":"2019","journal-title":"Clin J Am Soc Nephrol"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0025","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1002\/ejhf.546","article-title":"Serum chloride in heart failure: a salty prognosis","volume":"18","author":"Vaduganathan","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"2026020922175790700_jvim16187-bib-0026","doi-asserted-by":"crossref","first-page":"817","DOI":"10.7326\/0003-4819-98-5-817","article-title":"Effect of chloride on renin and blood pressure responses to sodium chloride","volume":"98","author":"Kotchen","year":"1983","journal-title":"Ann Intern Med"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0027","first-page":"41","article-title":"Chloride sensing by WNK1 involves inhibition of autophosphorylation","volume":"7","author":"Piala","year":"2014","journal-title":"Sci Signal"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0028","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1038\/sj.ki.5001634","article-title":"WNK kinases regulate sodium chloride and potassium transport by the aldosterone-sensitive distal nephron","volume":"70","author":"Subramanya","year":"2006","journal-title":"Kidney Int"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0029","doi-asserted-by":"crossref","first-page":"8458","DOI":"10.1073\/pnas.0802966105","article-title":"Regulation of NKCC2 by a chloride-sensing mechanism involving the WNK3 and SPAK kinases","volume":"105","author":"Ponce-Coria","year":"2008","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0030","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1681\/ASN.2011070720","article-title":"It is chloride depletion alkalosis, not contraction alkalosis","volume":"23","author":"Luke","year":"2012","journal-title":"JASN"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0031","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1073\/pnas.1017494108","article-title":"Loss-of-function DNA sequence variant in the CLCNKA chloride channel implicates the cardio-renal axis in interindividual heart failure risk variation","volume":"108","author":"Cappola","year":"2011","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0032","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1053\/j.ajkd.2016.08.027","article-title":"Diuretic Resistance","volume":"69","author":"Hoorn","year":"2017","journal-title":"Am J Kidney Dis"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0033","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12245-017-0143-x","article-title":"Markers of diuretic resistance in emergency department patients with acute heart failure","volume":"10","author":"Doering","year":"2017","journal-title":"Int J Emerg Med"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0034","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1111\/jvim.15488","article-title":"ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs","volume":"33","author":"Keene","year":"2019","journal-title":"J Vet Intern Med"},{"issue":"4","key":"2026020922175790700_jvim16187-bib-0035","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jvc.2015.09.007","article-title":"Management of acute heart failure in cats","volume":"17","author":"Ferasin","year":"2015","journal-title":"J Vet Cardiol"}],"container-title":["Journal of Veterinary Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvim.16187","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jvim.16187","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/35\/4\/1652\/66651991\/jvim16187.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jvim\/article-pdf\/35\/4\/1652\/66651991\/jvim16187.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T03:29:28Z","timestamp":1770694168000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jvim\/article\/35\/4\/1652\/8446976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,1]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,7,1]]}},"URL":"https:\/\/doi.org\/10.1111\/jvim.16187","relation":{},"ISSN":["1939-1676"],"issn-type":[{"value":"1939-1676","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,7]]},"published":{"date-parts":[[2021,7,1]]},"assertion":[{"value":"2020-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}