Case report: Neurological abnormalities due to acute, severe hyponatremia in a kitten associated with a subcutaneous infusion of 5% dextrose in water

Objective: To describe a case of severe acute hyponatremia in a kitten, as a result of subcutaneous infusion of 5% dextrose in water. Case summary: A nine-week old male Persian kitten presented with a history of vomiting, depression and tremor of five hour duration, following subcutaneous infusion of 100 ml/kg of 5% dextrose in water (D5W). Severe hyponatremia (109 mmol/l, reference interval 145-158) as well as hyperglycemia, mild hypokalemia and glucosuria were noted. The kitten was diagnosed with feline panleukopaenia. Treatment with intravenous 0.9% and 7.5% saline led to normalization of serum sodium concentration and clinical improvement. The acute, severe, hyponatremia and hyperglycaemia were most likely due to the large subcutaneous volume of D5W which resulted in a rapid water shift into the intravascular compartment. Natriuresis and dilutional hyponataemia with subsequent hypo-osmolality are presumed to be the underlying mechanism for the neurological abnormalities. New information provided: This case report is the first documented report of an iatrogenic hyponatremia due to subcutaneous fluid administration in any animal species.