Veterinary Guide to Metabolic Alkalosis in Dogs (2025)🐶⚠️

By Dr. Duncan Houston BVSc

🔍 Introduction

Metabolic alkalosis occurs when a dog’s blood bicarbonate (HCO₃⁻) becomes abnormally elevated, raising pH and affecting multiple systems. It’s always secondary to another issue—such as vomiting, diuretics, or kidney disease. This 2025 guide explores causes, signs, diagnosis, treatment, and prevention to help you safeguard your pet’s health. 🩺

💡 What Is Metabolic Alkalosis?

• Defined by elevated bicarbonate (>26 mmol/L) and pH >7.45, often with compensatory hypoventilation (PaCO₂ rises ~0.7 mmHg per 1 mEq/L HCO₃⁻).
• Commonly triggered by acid loss (vomiting, diuretics) or alkali gain (bicarbonate overdose).

⚠️ Causes & Predisposing Factors

• Vomiting, especially due to pyloric obstruction or GI disease—leads to H⁺/Cl⁻ loss.
• Diuretics like furosemide cause contraction and hypochloremic alkalosis.
• Excess alkali intake (bicarb, antacids, iatrogenic fluids).
• Renal or endocrine issues, e.g., hypokalemia, hypoalbuminemia, Cushing’s, hyperaldosteronism.

🚨 Signs & Clinical Effects

• Clinical signs reflect underlying illness—vomiting, dehydration, weakness, arrhythmias, ileus, muscle twitching, seizures.
• Systemic effects include hypokalemia-induced weakness, hypocalcemia with tetany, altered respiration and blood flow.

🔬 Diagnostic Approach

• History & exam: note duration of vomiting, medications (diuretics) or alkali intake.
• Labs: blood gas and serum electrolytes reveal elevated HCO₃⁻, hypochloremia, hypokalemia.
• Urine Cl⁻: low (<25 mEq/L) suggests chloride-responsive alkalosis.
• Imaging: abdominal/GI imaging if obstruction suspected; assess hydration and renal signs.
• Further tests: underlying endocrine or renal disease assessment as needed.

🛠 Treatment Strategies

• Correct volume & electrolytes: IV isotonic saline restores Cl⁻/volume; potassium supplementation as needed.
• Treat root cause: antiemetics, surgery for obstruction, adjust diuretics, discontinue alkali sources.
• Severe cases: may require acidifying fluids (ammonium chloride) under vet supervision.
• Monitor closely: repeat bloodwork, electrolytes, and blood gas until stabilized.

📈 Prognosis & Monitoring

• Excellent outcome if underlying cause addressed and fluid/electrolyte balance restored.
• Chronic diuretics or endocrine imbalances may require ongoing management and periodic labs.
• Scheduled follow-up of electrolytes, acid-base status, and renal function are vital.

🛡 Prevention & Owner Tips

• Manage vomiting early—use antiemetics and assess GI health.
• Use diuretics judiciously—monitor electrolytes regularly.
• Avoid excessive bicarbonate or antacid use without vet approval.
• Stay vigilant if the dog has endocrine or renal disease—periodic checks recommended.

🔧 Tools & Support Services

• Ask A Vet App: Real-time support for signs of alkalosis, fluid therapy & diet insights 📱

✅ Final Thoughts

Metabolic alkalosis in dogs is a red flag—though treatable, it reflects an underlying condition that must be resolved. Through accurate diagnosis, fluid and electrolyte correction, and addressing root causes, dogs typically recover fully. Preventative care and supportive tools like Ask AVet ensure long-term stability and health in 2025 and beyond. 🐾❤️

Download the Ask A Vet app today for expert guidance, hydration tracking, and personalized care for metabolic and systemic health. 📱💡