Is Bicarbonate Therapy Useful?

Vet Clin North Am Small Anim Pract. 2017 Mar;47(2):343-349. doi: 10.1016/j.cvsm.2016.09.005. Epub 2016 Nov 18.


Despite concerns about the negative effects of metabolic acidosis, there is minimal evidence that sodium bicarbonate administration is an effective treatment. In addition, sodium bicarbonate therapy is associated with many adverse effects, including paradoxic intracellular acidosis, hypokalemia, hypocalcemia, hypernatremia, and hyperosmolality. Definitive recommendations regarding bicarbonate therapy are challenging as there is little high-quality evidence available. In most clinical scenarios of metabolic acidosis, treatment efforts should focus on resolution of the underlying cause, and sodium bicarbonate therapy should be used with caution, if at all. An exception to this is kidney disease, wherein sodium bicarbonate therapy may have a valuable role.

Keywords: Diabetic ketoacidosis; Ionized calcium; Kidney disease; Lactic acidosis; Metabolic acidosis; Potassium.

Publication types

  • Review

MeSH terms

  • Acid-Base Imbalance / drug therapy*
  • Animals
  • Cardiopulmonary Resuscitation / methods
  • Renal Insufficiency, Chronic / drug therapy
  • Sodium Bicarbonate / pharmacology*


  • Sodium Bicarbonate