Fluid Therapy

Question 1

How can we assess patient hydration status?

Answer 1

HR
Skin tent 
Blood pressure
Mucous membranes
Eye position
Pulse quality 
CRT

Question 2

What are the clinical signs of a very hypovolaemic dog?

Answer 2

High HR
Thready pulse
Pale mm
Slow CRT
Cold extremities

Question 3

What happens to the cat HR when they have hypovolaemia?

Answer 3

Bradycardia (120-160 bpm)

Question 4

Tacky mucous membranes at what percentage loss?

Answer 4

5-6%

Question 5

Increased pulse and cold extremities at what percentage loss?

Answer 5

10%

Question 6

The dog will collapse at what percentage loss?

Answer 6

15%

Question 7

Horse mucous membranes go wha colour when they are dehydrated?

Answer 7

Red

Question 8

What is daily fluid maintenance rate for an animal?

Answer 8

40-60ml/kg/day

Question 9

What types of fluid are available?

Answer 9

Crystalloids (hypotonic, isotonic, hypertonic)
Colloids
Blood products
HBOCS (hemoglobin based oxygen carrying solutions)

Question 10

What do isotonic crystalloids contain?

Answer 10

AKA hartmanns
Buffered, contains lactate as a bicarbonate precursor
Inadequate potassium for long term
Good for shock, diuresis, during anesthesia & can use for maintenance (can add other things to it)
Low levels of calcium

Question 11

What do hypertonic crystalloids do?

Answer 11

Draws water from interstitial space
Causes a pulmonary-vagal reflex
Vasoconstriction
Bypass of pulmonary circulation
Transient effect (10-15 mins)
Rapid restoration of MAP, increased myocardial contractility, CO & O2 delivery

Question 12

What are the rules of using hypertonic crystalloids?

Answer 12

4ml/kg over 10 min, don’t repeat
Must follow with isotonic fluids
‘Low volume resus’, used in severe life threatening hypovolaemia

Question 13

What do colloid fluids do?

Answer 13

Support colloid osmotic pressure

Use when support of circulating blood volume is needed

Question 14

After 45 mins how much of the colloid is still in circulation

Answer 14

1/4

Question 15

What are natural colloids?

Answer 15

Blood products – available from commercial pet blood bank

Question 16

What routes can we use for fluid administration?

Answer 16

IV
Oral
Rectal
Subcutaneous
Intraosseous
Intraperitoneal

Question 17

What is the difference between a giving set and a burette?

Answer 17

Giving set will deliver 15-20 drops per ml

Burette will deliver 60 drops per ml so is more accurate

Question 18

How quickly should you replace fluid losses?

Answer 18

Aim to replace approx ½ total deficit over first 1-2 hours then decide on a rate thereafter (over 24 or 48 hours)