Fluid Therapy 2 Flashcards
What is the recommended target fluid amount in 24 hrs?
80% within first 24 hrs
What is the formula for fluid replacement?
% dehydration X BW (kg)= liters of fluid
Concurrent losses should be added to what aspect of fluid replacement calculation?
Should be added to other losses/maintenance instead of immediate fluid replacement amount
What is the typical fluid rate in equine?
10-20 ml/kg/hr (5-10 L/hr)
What size catheter is recommended in a severely dehydrated patient?
10-12 G
What size catheter is recommended in a moderately dehydrated patient?
12-14 G
What size catheter is recommended in a miniature horse and weanlings with moderate dehydration?
14-16 G
Define resuscitation
Replace estimated deficits rapidly within 1-2 hrs
What is the rate that should be administered to a neonate in septic shock?
20 ml/kg over 10-20 minutes
What is the maintenance fluid rate?
50-60 ml/Kg/day
What is a situation where we would want to overhydrate the equine patient?
impaction, liquefaction of respiratory secretions
What is the main source of K in a equine patient?
daily diet- ingest high quantity-excrete high quantities
What do you see in terms of potassium when a horse is anorexic or in a state of colic?
Total body depletion of K
Hypokalemia in horses is associated with what?
Alkalosis, decreased intake, sequestration loss, elevated plasma insulin
What are the clinical effects of hypokalemia?
Arrhythmias, weakness, decreased intestinal motility
What could cause hyperkalemia?
Hyperkalemic periodic paralysis, acidosis, uroabdomen, acute oliguric renal failure
What is the rate of IV administration for K?
0.5 mEq/kg/hr
Calcium is highly bound to what?
Proteins-mostly albumin
What form of Ca are we most concerned about?
Ionized calcium
T/F: Decreased in proteins can cause a decrease in total calcium while ionized calcium remains constant
TRUE
What is seen in terms of Ca levels in an anorexic horse?
Total body depletion of Ca
What is a major contributor to the development of synchronous diaphragmatic flutter?
Hypocalcemia
SDF is associated with hyperresponsiveness of what nerve?
Phrenic nerve
What are other disturbances seen with SDF?
Hypokalemia and metabolic alkalosis along with hypocalcemia
What is the classic patient scenario of a horse with SDF?
endurance horse
What are the clinical effects seen with hypocalcemia?
Muscle paresis, tremors, excitability, cramping, behavior changes, decreased myocardial contractility, hypotension
What patients will you see hypercalcemia in?
Renal failure patients- chronic and oliguric acute renal failure
If Ca supplementation is given too rapidly what is our main concern?
cardiotoxic effects- bradycardia
What do sodium values represent?
water balance of the patient
What is the most significant clinical sign seen with sodium imbalance?
Neurologic signs
Define the following:
Hypertonic fluid loss
Hypotonic fluid loss
Isotonic fluid loss
Hypertonic loss: loss of electrolytes in excess of water
Hypotonic loss: loss of water in excess of electrolytes
Isotonic loss: loss of electrolytes in same ratio as serum
What is the normal type of dehydration seen in exercise horses and what is seen if excessive dehydration is sustained?
Isotonic losses typically
Sweat becomes hypertonic after a point of dehydration met
How should you treat acute sodium disturbances?
rapid restoration to normal Na status recommended
If an animal has chronic sodium disturbances with CS how would you correct this?
correct slowly over days to one week to bring to normal
If an animal has chronic sodium disturbances with no CS how would you correct this?
Likely patient is still within compensated range and therapy should be undertaken to slowly restore serum/Na values over a week
What happens if there is rapid restoration of chronic hypernatremia?
Increase CNS intracellular volume significantly resulting in brain edema leading to herniation, permanent neurologic deficits and lysis of myelin
What is the standard method of acid base interpretation?
Carbinocentric model
What is the treatment of metabolic acidosis?
alkalinizing solution-typically lactate
can undergo cystosolic gluconeogenesis in liver and mitochondrial oxidative metabolism in liver
What is the most common cause of lactic acidosis?
Tissue hypoxia
At what point should you administer bicarbonate solution to treat acidosis?
17-18 mEq/L
What factors of bicarbonate distribution would you use for a conservative, typical and younger animal?
conservative: 0.3
typical: 0.4
younger: 0.5
How should bicarbonate be administered if it were to be used?
Traditionally half of deficit given over 60 minutes as isotonic solution
What is a major contraindication to administration of bicarbonate?
Presence of respiratory compromise-hypoventilation
What is a situation where metabolic alkalosis occurs?
Endurance racing-sweat losses or high GIT disease
Endurance horses typically show a loss in what electrolytes?
Na & Cl resulting in retention of HCO3 and metabolic alkalosis
