19. Medical Treatment GIT 2 Flashcards
Do you use oral fluid administration in a refluxing horse?
No!
Over what period of time should each of the following fluids be administered?
Replacement Fluids:
On-going losses:
Maintenance:
Replacement Fluids: Over 8 hours
On-going losses: Continuously administered until cause stops
Maintenance: Delivered continous until horse drinking on its own
How should you monitor your fluids?
Ensure they are electrolytes
Reflux before each administration (more than 2L, cough, tube out, painful)
Check: PE, urination, defication, PCV, TP, USG, twice daily and adjust volume
What are the properties of blood that maintain fluid?
Oncotic/osmotic pressure and selective membrane permeability
-Charged proteins - albumin, globulin, fibrinogen
-Charged molecules - na, cl, k, mg, ca
-Biologic membranes
What is oncotic pressure?
pressure due to charged proteins (Albumin and globulin)
What is osmotic pressure?
Due to charged ions helping to keep fluid in the capillary bed
What happens to water when there is a large amount of charged molecules on one side of a membrane and they can not move?
Water follows over to try to equalize the concentration
What is the reflection coeffiecnt? (RC)
How readily a molecule passes through a membrane
0 = minimal selectivity (liver)
1 = maximal selectivity (brain)
What disease processes allow fluid to move from the capillary beds into the tissue, promoting edema?
Protein decreasing disease - increased consumption, increased losses, decreased production - PLE
Loss of vascular wall integrity - vasculitis
What are some diseases that decrease oncotic pressure?
Low blood protein
-PLE
-PLN
-Hepatopathy
-Peritoneal or pleural effusion
-Lack of substrate: Starvation, Malabsorption
Diseases that decrease osmotic pressure?
Electrolyte loss
-Gut inflammation
-Water overload
-Pleural or peritoneal fluid
-Ruptured bladder
-Adrenal dysfunction
What are some diseases that reduce membrane selectivity?
Vasculitis
-Endotoxemia
Infectious
Immune Mediated
Thrombosis
What are the clinical effects of hypoproteinemia, hyponatremia and vasculitis?
Petechia
Loss of definition
Pectoral, ventral and limb edema
What substrates can be used to replace oncotic pressure in blood?
Plasma and hetastrach
What are some indications for a plasma transfusion?
TP<4g/dl
Edema in limb, prepuce, pectoral or ventral region, muzzle
Harsh, wet lung sounds, increase RR
Thickened bowel (ultrasound)
How do you calculate the replacement amount of plasma?
Replacement Volume = (Desired - Measured) (0.05 x BEt) / (donor plasma protein concentration)
What is the desired protein concentration goal of a blood transfusion?
6g/dl
How much plasma protein should the donor animal have?
6g/dl
When treating a 400-500kg horse, plasma protein will increase 1 g/dl every 4L administered if it have a protein concentration of …?
6 g/dl
How much plasma does a foal need?
Normal foal low IgG; 1 L hyperimmune plasma
Sick foal low IgG: 2-3L hyperimmune plasma
Recheck 12-24hr
How do you administer plasma to a horse?
Slowly
0.5ml/kg e 30 min through plasma administration set
- Check HR, RR, Temp e 5 min for first 30min
if no reaction then increase 40ml/kg/hr
What are some signs that the horse is having a reaction to plasma?
Increase HR, Temp, agitation, muscle fasciculations
What are some alternative treatments for restoring oncotic pressure in horse?
Hetastarch
What is hetastarch and what the rate to be administered?
Amylopectin
10ml/kg
false lower PP - coagulopathies and renal disease
Cheaper than plasma
