Fluid Therapy Flashcards
Define hypovolaemia.
A state of decreased intravascular volume.
Define dehydration.
Excessive loss of body water from the extravascular compartment.
What is the other term for shock?
Tissue hypoperfusion.
What parameters are affected by hypovolaemia?
HR, pulse quality, MM colour, CRT, BP and mentation
What are normal canine parameters?
HR = 60-120
Pink MMs
CRT = <2 secs
Systolic BP = >90
What parameters are affected by dehydration?
MM moistness, skin turgor, weight, globe position
What is the advantage of isotonic crystalloids and give two examples of solutions?
Mimic intravascular electrolyte concentration (high Na, low K)
0.9% NaCl, Hartmann’s
What makes colloids different to crystalloids?
Colloids contain large molecules (either natural or artificial) that increase colloid osmotic pressure.
What is the potential advantage of colloids?
They stay in the intravascular space for longer, so a smaller volume of fluid can be used for volume resuscitation.
What conditions need to be considered before prescribing fluid therapy?
Cardiac disease/heart failure
Renal failure
Respiratory disease
What are the symptoms of volume overload?
Pulmonary oedema (tachypnoea, dyspnoea, crackles)
Venous engorgement
Peripheral oedema formation / chemosis
Cavitary effusions
Name the 5 routes of fluid administration.
Per os Subcutaneous Intravenous Central venous access Intraosseous
What components make up the minimum database?
PVC, TS, urea, glucose, lactate, blood smear
How do we interpret PCV and TS readings?
Should be interpreted together and in context of the clinical findings
Changes in PCV and TS are not diagnostic!
What do high and low urea readings indicate in the minimum database?
Increases may be pre-renal, renal or post-renal
Low urea can be due to severe hepatic dysfunction
In what patients should we check blood glucose?
Patients with altered mentation Patients experiencing seizures Patients with distributive shock Paediatric patients Patients with history compatible with diabetes mellitus
If a patient presents with high blood glucose, which measurement would be added to the minimum database?
Serum or urine ketones.
What can lactate levels indicate about a patient?
Levels increase when a patient is in shock - a marker of tissue hypoxia
What are we looking for in a blood smear examination?
Regenerative/non-regenerative anaemia RBC morphology changes] Circulating white blood cell numbers Platelet numbers Blood-borne parasites?
What are the common causes of hyperkalaemia (increased potassium)?
Urethral obstruction
Uroabdomen
Hypoadrenocorticism
Renal failure
What is the treatment for hyperkalaemia (increased potassium)?
IVFT - an isotonic crystalloid
Calcium gluconate
Glucose +/- soluble insulin
What are the common causes of hypokalaemia (decreased potassium)?
Vomiting and diarrhoea CKD, post-obstructive diuresis, diuretics Fluids containing insulin/glucose Anorexia/inappetence Long-term IVFT with low K concentration
How do we treat hypokalaemia (decreased potassium)?
Potassium supplementation
IV in saline / Hartmann’s (never bolus)
Oral supplementation for chronic disease
How are chloride and sodium levels related and how do we determine if a change in chloride level is significant?
Should be in a 1:1 ratio
Chloride needs to be ‘corrected’ to determine if changes are proportionate or disproportionate
What are the causes of corrected hyperchloraemia?
May be artifact
Iatrogenic
Associated with acid-base disturbances
What are the causes of hypochloraemia?
Iatrogenic
Loss of chloride in excess of sodium (e.g. pure gastric vomiting or excessive sweating in horses)
What are the clinical signs and treatment of hypocalcaemia?
Tetany, panting, hyperthermia, facial pruritus
Treatment = calcium gluconate IV
What are the clinical signs and treatment of hypercalcaemia?
PUPD, anorexia, lethargy, depression, shivering, twitching, vomiting
Treatment = directed at underlying cause and correction of dehydration (severe = salmon calcitonin or bisphosphonates considered)
