Hyponatremia and hyperkalemia associated with idiopathic or experimentally induced chylothorax in four dogs

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A 6-year-old female Australian Shepherd Dog (No.1) weighing 15 kg had diagnosis of chylothorax (fluid cholesterol concentration, 99 mg/ dl; fluid triglycerides concentration, 1,235 mg/dl; serum triglycerides concentration, 60 mg/dl; and fluid cholesterol-to-triglycerides ratio , 0.08).Initial laboratory data documented normal serum sodium (145 mEqlL; reference value, 138 to 152 mEq/L), potassium (5.1 mEq/L; reference value, 3.4 to 5.1 mEqlL) , and chloride concentrations, as well as normal BUN and serum phosphorus concentrations (serum creatinine concentration was not determined).Platelet numbers were estimated to be increased on the basis of examination of a blood smear while performing the differential WBC count.Treatment consisted of intermittent drainage through an indwelling thoracic tube for 13 days, and administration of cefazoline (4 to 8 mg/kg of body weight, PO, q 8 h) , low-fat diet,a and medium chain triglyceride oil, during which body weight decreased to 11.4 kg.After the first day, 77 to 330 ml of chyle was removed daily, with amounts decreasing toward the end of the 13 days .Hyponatremia (134 mEq/L) and hyperkalemia (6 .9mEq/ L) were observed on the fifth day of thoracic drainage (Fig 1) despite normal serum total protein, glucose, phosphorus, and BUN concentrations.Platelet numbers were estimated to be normal.Urine specific gravity was 1.024, with normal quantitative and qualitative urine analysis results.An adrenocorticotropic hormone (ACTH ) stimulation test documented normal plasma cortisol concentration, but high plasma aldosterone concentration before and after ACTH administration (> 1,200 pg/ml, each; reference values, 36 to 143 pg/ml baseline and 71 to 758 pg/ml stimulated b ) .