5: Clinical Evaluation of Dehydration and Overhydration Flashcards
list the four dehydration degrees/categories and their dehydration range
mild (<5%)
moderate (5-8%)
marked (8-10%)
shock (10-12%)
5 severity ranges and signs of dehydration
- < 5% (1-4%) dehydration - no detectable clinical signs
- 5-6% dehydration - slight loss of skin elasticity (turgor)
- 6-8% dehydration - turgor, slightly prolonged CRT, slight sinking of eyes into orbit, slight dryness of oral mucous membranes & nostril
- 8-10% dehydration - tented skin stands, prolonged CRT sunken eyeballs, dry mucous membranes (mouth, nostril), signs of shock
- 10-12% dehydration - signs of hypovolemic shock: pale mucous membranes, weak pulse, tachycardia, death
5 methods used in physical examination of dehydration
- check skin elasticity
- check oral mucous membranes
- check the nostrils
- check the eyes
- check the capillary refill time (CRT)
checking skin elasticity:
- well hydrated animal
- dehydrated animal
well hydrated animal - skin would snap back in 1-2 seconds
dehydrated animal - takes time for skin to snap back or not at all
checking oral mucous membranes:
- well hydrated animal
- dehydrated animal
well hydrated animal - wet, slick, pink in color
dehydrated animal - dry, sticky, pale in color; thick saliva
what to check in the nostrils (evaluation of dehydration status)
should be moist and no cracks
check the eyes
- well hydrated animal
- dehydrated animal
well hydrated animal - eyes not sinking in the orbit
dehydrated animal - eyes sink into the orbit (sunken eyeballs)
!!! take note: long dolic[h]ocephalic breeds of dogs: deep set of eyes
3 types of dogs according to skull shape
dolichocephalic - long, narrow, flat stop; prone to overshot and Parrot mouth (e.g, Doberman Pincher, Poodle, Collie, Whippet)
mesaticephalic/mesocephalic - smooth, sloping stop (e.g., Beagle, Labrador Retriever, Siberian Husky)
brachycephalic - extreme, deep stop; prone to undershot bite, wry mouth, and lolling tongue (e.g., Bulldog, Pug, Charles Spaniel)
checking the capillary refill time (CRT)
- well hydrated animal
- dehydrated animal
well hydrated animal - oral membranes return to original color in 1-2 seconds after pressing
dehydrated animal - takes longer than 2 seconds for the oral membranes to return to its original color after pressing
4 clinical signs of overhydration in animals
chemosis - swelling of conjunctiva
increased serous discharge - e.g., around the eyes and nose
pulmonary edema - accumulation of fluid in the lungs
pulmonary congestion - wheezes and crackles detectable on auscultation
conjuctiva: clear, thin membrane that covers part of the front surface of the eye and the inner surface of the eyelids
serous fluid: clear to pale yellow watery fluid that is found in the body especially in the spaces between organs and the membranes which line or enclose them
auscultation: the action of listening to sounds from the heart, lungs, or other organs, typically with a stethoscope, as a part of medical diagnosis
5 clinical signs observed in animals with pulmonary edema
- coughing
- difficulty or rapid breathing
- weakness
- bluish (cyanotic) lips and tongue
- collapse
3 general types of fluids used clinically for volume replacement therapy
hypotonic solution - less osmotic concentration than plasma
- increases ICF volume
isotonic solution - same osmotic concentration of plasma
- doesn’t alter ICF volume
hypertonic solution - greater osmotic concentration than plasma
- decreases ICF volume
!!! blood plasma osmolarity: 300 mOsm/L or 0.3 Osm/L
give examples of fluids used for each type of solution
- hypotonic
- isotonic
- hypertonic
in mOsm/L:
hypotonic - dextrose in 5% water (278),
- lactated Ringer’s solution (LRS) (272)
isotonic - Normosol-R (294)
- dextrose 5% in NSS (300)
- normal saline (NSS) or 0.9% NaCl (308)
- Ringer’s solution (309)
hypertonic - dextrose 2.5% in LRS (525)
- dextrose 50% (2525)
