Inorganic Constituents of Blood and Urine in Dogs with Pancreatic Fistula

Several studies on the effects of drainage of pancreatic juice have appeared during the last few years, verifying and extending Pawlow's original observations. Elman and McCaughan 1 demonstrated that drainage of the pancreatic juice through a fistula will cause death in a short time. Gamble and McIver 2 showed that the symptoms and death were due principally to a loss of fixed base and chloride, which resulted in dehydration of the blood. The fixed base and chloride of the plasma progressively diminished and water was lost while the plasma protein increased quite markedly. Hartman and Elman 3 confirmed the findings of Gamble and McIver and alleviated the symptoms and prolonged life by the injection of salt solutions.

Our own work on pancreatic fistulas, having initially a different objective, dates back to 1927. Observations were made on total base of serum, pancreatic juice and urine (methods of Stadie and Ross 4 ), specific conductivity of serum (Kohlrausch) serum protein (refractometer), chloride and bicarbonate. Chlorides and creatinin were also determined in urine. Depression of freezing point of the pancreatic juice was also done in a large number of samples.

The results were as follows: A series of over 20 dogs was studied. The dogs on a diet containing salt showed a mean survival time of 15 days, or else failed to show any evidence of dehydration. The dogs on a diet without salt showed a survival time of 8 or 9 days. All dogs injected with NaCl or NaCl + NaHCO₃ after dehydration had begun, showed a response to treatment. The initial dehydration could be entirely overcome by the injection of electrolyte in quantities a little more than equivalent to the juice secreted. In dog 29, the rise and fall of total base in the serum was followed at intervals of a few days throughout 53 days of intermittent injections.