equine fluid therapy

Question 1

what is the total body water fluid distribution in adult horses

Answer 1

60%

Question 2

what is the total body water fluid distribution in foals

Answer 2

80%

Question 3

what makes up TBW

Answer 3

extracellular fluid (1/3) 
intracellular fluid (2/3)

Question 4

what are the major electrolytes in ECF and the components of ECF

Answer 4

sodium and chloride

components being: plasma volume, interstitial fluid, transcellular fluid

Question 5

what are the major electrolytes in ICF

Answer 5

potassium and phosphorous

Question 6

T/F fluid exchange mainly occurs between ICF spaces

Answer 6

false occurs between ECF

Question 7

what are the osmotic forces in ECF

Answer 7

sodium and chloride, they create a strong gradient across membranes. ( due to water traveling from a low to high concentration)

Question 8

what creates a strong force for maintaining fluid with in a space.

Answer 8

albumin ( this is oncotic force)

Question 9

what opposes water leaving the intravascular space

Answer 9

hydrostatic forces

Question 10

when you are severely dehydrated what will happen?

Answer 10

water moves from intracellular to extracellular, causing cells to shrivel up

Question 11

what are the goals of fluid therapy

Answer 11

• restoration and maintenance of hydration
  correction of electrolyte and acid/base abnormalities
  delivery of specialized fluid
  improvement of cardiovascular parameters

Question 12

what are some indications for fluid therapy

Answer 12

dehydration, decrease water intake, NPO conditions
Inability to consume water (dysphagia)
GI abnormalities
Hemorrhage Diuresis/renal failure
pleuropneumonia/peritonitis
heat exhaustion Shock
replace electrolytes and correct acid base disturbances

Question 13

when developing a fluid plan what must you consider (5)

Answer 13

volume, type, route(IV or enteral in horses), rate, reassess

Question 14

what must volume determination account for

Answer 14

restoration of hydration
ongoing losses
maintenance fluid requirements

Question 15

what is maintenance fluid in horses derived from?

Answer 15

the amount a horse will drink to maintain adequate hydration

Question 16

what is the maintenance fluid rate for adult horses? ( include units!)

Answer 16

60ml/kg/day

this is the same for IV and enteral fluids

Question 17

what is the dehydration and perfusion determined by?

Answer 17

physical exam

it is supported by clin path

Question 18

T or F it is ok to have a horse be 15% dehydration and you can’t detect anything less than 10% dehydration.

Answer 18

false.

if greater than 15% it is not compatible with life and anything less than 5% is undetectable

Question 19

what are the clinical signs of a horse that is 5-7% dehydrated?

Answer 19

lethargy, dry MM, increased CRT, decreased urine production

Question 20

what are the clinical signs of a horse that is 8-10% dehydrated

Answer 20

weak pulse, prolonged jugular filling decreased skin turgor/prolonged skin tent, tachycardia
will also see: lethargy, dry MM, increased CRT, decreased urine production

Question 21

what are the clinical signs of a horse that is >10% dehydrated

Answer 21

cold extremities , may be recumbent, depressed, sunken eyes
Also:weak pulse, prolonged jugular filling decreased skin turgor/prolonged skin tent, tachycardia,lethargy, dry MM, increased CRT, decreased urine production

Question 22

what are some lab test that can support your diagnosis of dehydration

Answer 22

increased PCV/HCT
increased TP/ total solids concentration
Increased USG
Increased serum creatinine concentration

Question 23

what could falsely increase PCV without an increase in TP

Answer 23

splenic contraction

Question 24

if a horse is dehydrated what would cause the PCV and TP to be normal

Answer 24

anemia or hypoproteinemia

Question 25

T or F TP concentration can be increased with neoplasia or infection

Answer 25

true

Question 26

what is the calculation for determining the volume required to restore hydration

Answer 26

(BW in kg) x (%dehydration) = volume in L

Question 27

what are some causes of internal fluid loses in horses

Answer 27

pleural effusion
peritoneal effusion
GI sequestration

Question 28

the type of fluid you choose is based on what?

Answer 28

your assessment of the patient and the necessity to correct for electrolyte derangements
ned to also choose one that can be given in the volume needed safely

Question 29

what are the most common types of fluids and what do we administer them for

Answer 29

isotonic crystalloids

for restoration and maintenance or hydration, delivery of electrolytes, etc.

Question 30

which fluids have an osmolality similar to plasma

Answer 30

isotonic crystalloids ( around 300mOsm/L)

Question 31

what are some types of crystalloid fluids

Answer 31

lactated ringers
normosol -R
plasma-lyte A
0.9% NaCl

Question 32

what questions do you need to ask yourself when choosing a type of crystalloid fluids

Answer 32

does the horse need particular electrolytes or do any need to be avoided
does the horse need a fluid that is buffered or acidifying

Question 33

what type of fluid must be followed by a large volume of isotonic crystalloid fluids and why?

Answer 33

Hypertonic saline

it draws fluids into the vascular compartment for 60 minutes

Question 34

when would you give glucose supplementation in horses

Answer 34

in neonatal foals if glucose is <60mg/dL

rare in adults, but most common cause is hepatic lipidosis

Question 35

glucose solutions greater than 5% are hypertonic and can cause what

Answer 35

thrombophlebitis

Question 36

T or F glucose cannot supply a foals complete energy needs

Answer 36

true

Question 37

in order to give fluids enteral what must you have and what can the horse not be doing

Answer 37

must have a functioning GI tract

cannot be refluxing