ﯾﺎﻓﺘﻪﻫﺎي آزﻣﺎﯾﺸﮕﺎﻫﯽ اﺧﺘﻼل ﻫﺎﯾﭙﻮﻧﺎﺗﺮﻣﯽ در ﯾﮏ ﻗﻼده روﺑﺎه ﻗﺮﻣﺰ (Vulpes vulpes) ﺑﺎ دررﻓﺘﮕﯽ ﻣﻔﺼﻞ ﺗﺎﻟﻮﮐﺮورال

Laboratory findings of hyponatremia in a red fox (vulpes vulpes) with talocrural joint dislocation

ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ آنﮐﻪ اﺧﺘﻼﻻت ﺳﺪﯾﻢ ﭘﺪﯾﺪه اي ﺣﺎﺋﺰ اﻫﻤﯿﺖ ﻣﺤﺴﻮب ﻣﯽ ﺷﻮد، ﺑﺎﯾﺪ ﺑﻪ ﺳﺮﻋﺖ ﺗﺸﺨﯿﺺ داده ﺷ ﻮد و ﻣﺘﻌﺎﻗﺒﺎً اﻗﺪاﻣﺎت درﻣﺎﻧﯽ ﻣﺮﺑﻮط اﻧﺠﺎم ﭘﺬﯾﺮد. ﻫﺮﮔﻮ ﻧﻪ ﻏﻔﻠﺖ در اﯾﻦ اﻣﺮ ﻣﯽﺗﻮاﻧﺪ در ﺷﺮاﯾﻂ ﺑﺤﺮاﻧﯽ ﻣﻨﺠﺮ ﺑﻪ اﯾﺠﺎد ﺻﺪﻣﺎت ﺑﺮﮔﺸﺖ ﻧﺎﭘﺬﯾﺮ ﻋﺼﺒﯽ ﺷﻮد، ﻫﻤﭽﻨﯿﻦ در ﺗﻤﺎم ﺣﯿﻮاﻧﺎت ﺑﺴﺘﺮي، ﺑﻪ ﺧﺼﻮص ﻣﻮارد ﮐﺎﻧﺪﯾﺪ اي ﻣﺎﯾﻊدرﻣﺎﻧﯽ، ﺑﺎﯾﺪ ﻣﯿﺰان اﻟﮑﺘﺮوﻟﯿﺖﻫﺎي ﺳﺮم و ﺑﻪوﯾﮋه ﻏﻠﻈﺖ ﺳﺪﯾﻢ ﺑﻪ ﻃﻮر ﻣﺮﺗﺐ ﭘﺎﯾﺶ ﺷﻮد. ﯾﮏ ﻗﻼده روﺑﺎه ﻧﺮ ﻗﺮﻣﺰ )Vulpes vulpes( ﺑﺎ ﺳﺎﺑﻘﻪ اﺳﺘﻔﺮاغ، ﺿﻌﻒ و ﺑﯽﺣﺎﻟﯽ ﺷﺪﯾﺪ، آﺗﺎﮐﺴﯽ، رﯾﺰش ﻣﻮي ﺷﺪﯾﺪ و وﺿﻌﯿﺖ ﻋﻤﻮﻣﯽ ﻧﺎﻣﻨﺎﺳﺐ ﺑﻪ ﮐﻠﯿﻨﯿﮏ داﻧﺸﮑﺪه داﻣﭙﺰﺷﮑﯽ داﻧﺸﮕﺎه رازي ﮐﺮﻣﺎﻧﺸﺎه ارﺟﺎع ﺷﺪ. ﺑﺮاي ارزﯾﺎﺑﯽ وﺿﻌﯿﺖ ﺑﯿﻤﺎر و آﻏﺎز ﻣﺎﯾﻊدرﻣﺎﻧﯽ ﻧﻤﻮﻧﻪ ﺧﻮن ورﯾﺪي اﺧﺬ ﮔﺮدﯾﺪ و ﭘﺲ از ﺑﺮرﺳﯽ رادﯾﻮﮔﺮاﻓﯽ و ﺗﺸﺨﯿﺺ دررﻓﺘﮕﯽ ﻣﻔﺼﻞ ﺗﺎﻟﻮﮐﺮورال، اﻗﺪام ﺑﻪ ﺟﺎ اﻧﺪازي ﺑﻪروش ﺑﺴﺘﻪ و ﮔﭻ ﮔﺮﻓﺘﻦ ﻋﻀﻮ درﮔﯿﺮ ﺷﺪ. ﻧﺘﺎﯾﺞ ﺑﻪ دﺳﺖ آﻣﺪه از آﻧﺎﻟﯿﺰ ﺑﯿﻮﺷﯿﻤﯿﺎﯾﯽ ﺣﺎﮐﯽ از ﻫﺎﯾﭙﻮﻧﺎﺗﺮﻣﯽ ﺷﺪﯾﺪ ﺑﻮد. ﺑﺮرﺳﯽﻫﺎي ﺑﯿﺸﺘﺮ ﻫﯿﭙﻮاﺳﻤﻮﻻﻟﯿﺘﯽ ﻧﺎﺷﯽ از ﮐﺎﻫﺶ ﺣﺠﻢ ﺧﻮن و آﻟﮑﺎﻟﻮز ﻣﺘﺎﺑﻮﻟﯿﮏ ﻣﺘﻌﺎﻗﺐ اﺳﺘﻔﺮاغ را ﻧﺸﺎن داد و ﺑﺮ اﯾﻦ اﺳﺎس اﻗﺪاﻣﺎت درﻣﺎﻧﯽ ﻻزم ﺻﻮرت ﮔﺮﻓﺖ. ﻋﺪم ﺗﻔﺮﯾﻖ ﻫﺎﯾﭙﻮﻧﺎﺗﺮﻣﯽ ﮐﺎذب از ﻣﻮارد ﺣﻘﯿﻘﯽ و در ﻧﺘﯿﺠﻪ اﺗﺨﺎذ روش درﻣﺎﻧﯽ ﻧﺎﻣﻨﺎﺳﺐ ﻣﻨﺠﺮ ﺑﻪ ورود ﺑﯿﺶ از ﺣﺪ و ﺳﺮﯾﻊ ﺳﺪﯾﻢ ﺑﻪ ﻣﺎﯾﻊ ﻣﯿﺎن ﺑﺎﻓﺘﯽ ﻣﯽﺷﻮد و ادم ﻣﻐﺰي و ﺗﺸﻨﺞ را ﺑﻪ ﻫﻤﺮاه دارد، از اﯾﻦرو ارزﯾﺎﺑﯽ دﻗﯿﻖ ﻋﻠﻞ ﻫﺎﯾﭙﻮﻧﺎﺗﺮﻣﯽ ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ اﺻﻮل اﺳﺎﺳﯽ ﻓﯿﺰﯾﻮﻟﻮژﯾﮏ و دﺳﺖﯾﺎﺑﯽ ﺑﻪ ﯾﺎﻓﺘﻪﻫﺎﯾﯽ ﮐﻪ ﺑﺎ ﻓﺮﺿﯿﺎت ﺗﺸﺨﯿﺼﯽ ﺳﺎزﮔﺎر ﺑﺎﺷﺪ، ﺑﺮاي ﻣﺪﯾﺮﯾﺖ ﻣﻮﺛﺮ اﯾﻦ ﭼﺎﻟﺶِ ﻣﻬﻢ، ﺿﺮوري اﺳﺖ.

Disorder of the serum Na is an important phenomenon; it should be diagnosed as soon as possible and the patient should be treated promptly. Any delay in treatment can cause some irreversible neurological damages. In all hospitalized patients, especially those are candidate for fluid therapy, serum electrolyte, especially Na concentration should be monitored regularly. A red fox (Vulpes vulpes) with the history of vomiting, weakness and lethargy, ataxia, alopecia and a bad general condition was referred to the clinic of the faculty of veterinary medicine of Razi University. For assessing the patient’s condition and starting fluid therapy venous blood was taken and sent for hematology and biochemistry. Radiographic study of the right hind limb showed talocrural joint dislocation. It was managed by reducing and casting. The blood biochemical analysis showed severe hyponatremia, hypo-osmolality and metabolic alkalosis. Though, treatment was done based on these findings. Incorrect differentiation between false and true hyponatremia can lead to inappropriate treatment that can cause entrance of excessive Na to the interstitial tissues that can result in brain edema and convulsion. Though, careful assessment of the cause and type of hyponatremia based on physiological principles and in accordance with our suppositions is necessary for correct management of this important challenge.