Urine sodium concentration after intravenous furosemide in dogs with acute congestive heart failure and correlation with treatment efficacy

Background: Poor natriuresis is a potential marker of diuretic resistance in dogs with acute congestive heart failure (CHF) but little is known about the relationship between urine sodium concentration (uNa) and frequency of successful decongestion. Supplemental O-2 is a common treatment in dogs with severe CHF. The time from start to discontinuation of supplemental O-2 therapy (DCSO2) typically reflects the time course and ease of decongestion.Hypothesis/Objectives: Urine Na concentration after IV administration of furosemide will be correlated with duration of treatment with supplemental O-2 (timeO(2)) and the cumulative frequency of successful DCSO2 during hospitalization.Animals: Fifty-one dogs with acute CHF.Methods: Retrospective observational single center study.Results: Dogs with low uNa had significantly longer mean time(O2) than dogs with high uNa (uNa <87 mmol/L, 24.2 +/- 2.6 hours vs uNa >= 87 mmol/L, 16.6 +/- 1.7 hours; P = .02). Low uNa was correlated with lower cumulative frequency of DCSO2 (12 hour, 28%; 24 hour, 42%; 36 hour, 73%) compared to high uNa (12 hour, 28%; 24 hour, 88%; 36 hour, 96%; P = .005). History of PO loop diuretics, low serum chloride concentration (sCl), and high PCV were associated with low uNa. Urine Na concentration outperformed other metrics of diuretic responsiveness including weight loss.Conclusions and Clinical Importance: Urine Na concentration after IV furosemide predicted timeO(2) and cumulative frequency of DCSO2 in dogs with acute CHF, which likely reflects important aspects of diuretic responsiveness. Urine Na can assess diuretic responsiveness and treatment efficacy in dogs with CHF.