{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:47:47Z","timestamp":1784008067376,"version":"3.55.0"},"reference-count":54,"publisher":"American Veterinary Medical Association (AVMA)","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"sc_a1\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To assess the association between serum chloride concentration (s[Cl\n                      <jats:sup>\u2212<\/jats:sup>\n                      ]) and survival outcomes in cats with stable congestive heart failure (CHF).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a2\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single-institution retrospective study. Medical record reviews of 178 client-owned cats from 2014 through 2024 identified 84 cats meeting inclusion criteria of stable CHF at least 1 week after hospitalization. Cats with significant gastrointestinal disease were excluded. Biochemical parameters, medications, and survival were analyzed using Kaplan-Meier methods. Forward stepwise Cox proportional hazards regression was used to identify independent predictors of death risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Hypochloremia was defined as s[Cl\n                      <jats:sup>\u2212<\/jats:sup>\n                      ] &lt; 112 mEq\/L (the lower limit of the reference range). Fifteen cats were hypochloremic, and 69 cats were normochloremic. Hypochloremia was independently associated with a higher risk of death (hazard ratio, 2.82), and survival was shorter for cats with s[Cl\n                      <jats:sup>\u2212<\/jats:sup>\n                      ] &lt; 112 mEq\/L (159 days) compared to cats with s[Cl\n                      <jats:sup>\u2212<\/jats:sup>\n                      ] &gt; 112 mEq\/L (392 days). Diuretic dose was significantly higher in the hypochloremic group but was not an independent predictor of outcome in multivariable modeling. Two other confounders independently predicted outcome in the multivariable model (higher death risk with pimobendan use; hazard ratio, 1.96; lower death risk with normal BUN &lt; 28 mg\/dL; hazard ratio, 0.45).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a4\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort of cats with stable CHF, hypochloremia was independently associated with significantly shorter survival and increased mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sc_a5\">\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>\n                      Efforts to normalize s[Cl\n                      <jats:sup>\u2212<\/jats:sup>\n                      ] in cats with CHF merit consideration.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2460\/ajvr.26.01.0023","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T17:07:47Z","timestamp":1772471267000},"source":"Crossref","is-referenced-by-count":1,"title":["Hypochloremia is negatively associated with outcomes in cats with stable congestive heart failure"],"prefix":"10.2460","volume":"87","author":[{"given":"Corine","family":"Lavigne","sequence":"first","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0972-0365","authenticated-orcid":true,"given":"Darcy B.","family":"Adin","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Gurdyal","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2329-3905","authenticated-orcid":true,"given":"Autumn N.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL"},{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"3","key":"B1","series-title":"J Vet Intern Med","first-page":"1062","article-title":"ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats","author":"Luis Fuentes V","year":"2020","unstructured":"Luis Fuentes V, Abbott J, Chetboul V, et al. 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J Feline Med Surg. 2021;23(11):1009\u20131027. doi:10.1177\/1098612X211021819"},{"issue":"3","key":"B4","series-title":"Vet Sci","first-page":"289","article-title":"Clinical-diagnostic and therapeutic advances in feline hypertrophic cardiomyopathy","author":"Gaia de Sousa F","year":"2025","unstructured":"Gaia de Sousa F, Mendes ACR, Carvalho LP, Beier SL. Clinical-diagnostic and therapeutic advances in feline hypertrophic cardiomyopathy. Vet Sci 2025;12(3):289. doi:10.3390\/vetsci12030289"},{"issue":"1","key":"B5","series-title":"J Vet Intern Med","first-page":"e17254","article-title":"Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats","author":"Rogg S","year":"2025","unstructured":"Rogg S, Mochel JP, Kundu D, et al. Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats. 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Toward quantification of loop diuretic responsiveness for congestive heart failure. J Vet Intern Med. 2023;37(1):12\u201321. doi:10.1111\/jvim.16590"},{"key":"B25","series-title":"J Vet Cardiol","first-page":"15","article-title":"Antidiuretic hormone concentrations in dogs with heart disease and relationship to serum chloride","author":"Harris AN","year":"2025","unstructured":"Harris AN, Hanner C, Cooper A, Castro RA, Adin DB. Antidiuretic hormone concentrations in dogs with heart disease and relationship to serum chloride. J Vet Cardiol. 2025;59:15\u201323. doi:10.1016\/j.jvc.2025.01.007"},{"issue":"5","key":"B26","series-title":"J Am Vet Med Assoc","first-page":"534","article-title":"Case-control study of the effects of pimobendan on survival time in cats with hypertrophic cardiomyopathy and congestive heart failure","author":"Reina-Doreste Y","year":"2014","unstructured":"Reina-Doreste Y, Stern JA, Keene BW, et al. 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