Fluid therapy in cattle

Question 1

main Indications for fluid therapy in cattle: (4-5)

Answer 1

dehydration and shock

diarrhea in calves

acidosis in cows

e.coli mastitis with endotoxemia

Question 2

Assessment of dehydration in cattle by

Answer 2

level of skin tenting and eye recession.

Question 3

Fluid therapy calculation for calves.

Answer 3

fluid needed = body weight (kg) x dehydration (%) + maintenance 50-80 ml/ kg

(50 kg x 0.08) * 1000 = 4,000 ml = 4L to correct dehydration

+ 50 ml/ 50kg = 2,500 ml = 2,5 L for maintenance

Question 4

Speed of fluid administration in calves maximum

Answer 4

80 ml/kg/h

Question 5

Are most cow diseases acidotic or alkalotic?
What IVFT fluid to use for acidosis?

Answer 5

acidotic mostly but some GI diseases can cause alkalosis

(except diarrhea causes acidosis; e.coli mastitis also causes acidosis)

ringer’s lactate is one good option for alkalinizing the blood (lactate is alkalotic).

Question 6

What is isotonic bicarbonate solution concentration usually?

Answer 6

1.3%

(so 13 grams of bicarbonate per liter of fluid)

hypertonic sodium bicarbonate is typically 8.4%/2000 mOsm/L

Question 7

How to calculate base deficit for CALVES?

Answer 7

Depends on how bad the animal is.

Rule of thumb:
- Recumbent calf, dehydration 12-15%, BD 15-20 mEq/l.

• Weak calf, dehydration 8-12%, BD 15 mEq/l.
• Ambulatory calf, dehydration 5-8%, BD 5 - 10 mEq/l.

If you’re unsure, just use 10 mEq/L.

Requirement for total alkalizing agent (mEq) = base deficit (mEq/l) x 0,6 x BW

(factor of 0.3 in adult cows)

Question 8

Rule of thumb for base deficit in calves based on calf condition: (3)

Answer 8

• Recumbent calf, dehydration 12-15%, BD 15-20 mEq/l.
• Weak calf, dehydration 8-12%, BD 15 mEq/l.
• Ambulatory calf, dehydration 5-8%, BD 5 - 10 mEq/l.

Question 9

Name 6 Isotonic solutions.

Answer 9

 0,9% NaCl
 1,1% KCl

 1,3% NaHCO3 (bicarbonate)
 5% dextrose

 Ringer’s solution
 Ringer’s lactate solution

Question 10

1.3% bicarbonate has how many grams in a liter?

how about 4.2% bicarbonate solution?

Answer 10

13 g bicarbonate in 1 liter fluid when 1.3%

42 g in 4.2%

Question 11

Rule of thumb for converting grams to mEq/L.

Answer 11

1 g = 12 mEq/L

(e.g. 13 g of bicarbonate in 1.3% solution x factor 12 for conversion = 156 mEq/L

and if your calf needs e.g. 300 mEq/L->

300 mEq/L divided by 156 mEq/L = 1.9

Your calf needs to get 1.9 bottles of this 1.3% bicarbonate solution.)

Question 12

Formula for base deficit in adult cows.

Answer 12

base deficit (mEq/l) x 0,3 x BW
= alkalizing agent (mEq) needed

(factor of 0.3 in adult cows, 0.6 in calves)

Question 13

At what % dehydration do calves needs IV fluid therapy?

Answer 13

8% and up

Question 14

Selection of intravenous fluids in cattle:

Answer 14

 Ideally – according to laboratory results

 In cattle, the acid-base balance and electrolyte level is associated with a certain disease so depending on your suspected disease, choose your fluid.

 Compensatory mechanisms are important as well.

Question 15

Describe Metabolic acidosis in calves.

Answer 15

Metabolic acidosis present in Calf diarrhea and dehydration, anorexia, hypothermia
(<38°C).

„Flour overfeeding“ in cows and over 1 month old calves causes lactic acidosis.

Question 16

D-lactic acidosis occurs commonly with..

Answer 16

bacterial carbohydrate fermentation, malabsorption,
excretion of hydrogen ions through kidneys,
loss of bicarbonates with feces.

„Flour overfeeding“ in cows and over 1 month old calves causes lactic acidosis.

Also, Diarrhea in adult cattle including endotoxemia (e.g E.coli mastitis).

 Fatty liver syndrome = fatty liver disease
 Ketosis

 Urogenital tract diseases
 Shock and other conditions that restrict excretion of saliva.

Question 17

Fluid therapy in case of metabolic
acidosis.

Answer 17

Use Alkalizing solutions such as bicarbonates, lactate, acetate, gluconate
and citrate – they bind hydrogen ions.

 Available in the Estonian market: Ringer-lactate, 4,2% and 8,4% bicarbonate solutions, Ringer acetate.

 Isotonic bicarbonates most suitable for diarrheic calves.

e.g. 250 ml 8.4% bicarbonate solutions mixed with 5 l of isotonic solution.

 NB 8.4% bicarbonate solutions should not be administered independently! (dilute!)

 Acetate and lactate metabolize into bicarbonates.

 Ringer-lactate consists of L- and D-lactate!

 Dextrose solutions for newborn calves in case of hypothermia.

Question 18

 Acetate and lactate metabolize into

Answer 18

bicarbonates.

They are both Alkalizing.

Question 19

In metabolic acidosis, potassium levels in the blood are…?

Answer 19

hypERkalemic

Metabolic acidosis is typically associated with hyperkalemia. This occurs because, during acidosis, hydrogen ions (H⁺) accumulate in the blood.

In an effort to reduce the acidity, cells take up H⁺ ions and, in exchange, release potassium (K⁺) into the bloodstream. K⁺ is not acidotic.

However, there are some exceptions, such as diarrheal acidosis, which can cause hypokalemia (low potassium) due to potassium loss in the stool. In general, though, metabolic acidosis is more often associated with hyperkalemia.

Question 20

Describe whether there is a Need for electrolytes in case of acidosis. (3)

Answer 20

 Paradoxical hyperkalemia in blood in acidosis so No need to supplement K as hyperkalemia will resolve itself after correction of dehydration and acidosis.

 If administration is needed, then 10 mEq K/l , monitor the heart rate. Safer to administer orally into the rumen.

 Hypocalcemia especially in case of lactic rumen acidosis.

 Hyponatremia due to losses via feces.
Safer to administer orally.

 Hypoglycemia with calf diarrhea, glucose is important in transporting K+ into the cell.

Question 21

At what dehydration percentage should calves receive oral electrolytes?

Answer 21

all of them

Question 22

Alkalotic conditions include:

Answer 22

 Vagus nerve problems
 Torsion of the intestine, intussusception

 Displacement and/or torsion of the caecum
 Abomasal displacement and torsion

 Traumatic reticulitis
 Abomasal ulcers

 Peritonitis
 Renal failure

 Rumen indigestion and putrefaction, atony.
 Almost every condition associated with loss of appetite and gastrointestinal stasis.

Question 23

What electrolyte imbalances does metabolic alkalosis see?

Answer 23

Hypochloremia, hypokalemia, dehydration

Question 24

Fluid therapy in case of metabolic
alkalosis.

Answer 24

 Hypochloremia, hypokalemia, dehydration thus Administer fluids rich in chlorides and potassium.

 Fluids should contain 135-155 mEq/l Na, 150-170 mEq/l Cl and 10-20 mEq/l K.

 Ringers has: K 5,4 mEq/l, Na 131 mEq/l, Cl 112 mEq/l, Ca 1,8 mEq/l.

 Administering enough fluids and electrolytes kidneys can then correct the alkalosis.

 Can use Isotonic solutions like 0,9% NaCl or Ringers solution and you Can add KCl 20-40mEq/l to both of these solutions, though safer to administer orally.

Question 25

Hypertonic saline solutions in cattle. Solution %? Dose?

Answer 25

For treating Dehydrated cattle and calves. Is an Alternative for administering large quantities of i.v solutions. Cheaper, faster method.  Use 7,5 % saline solution (2400 mOsm/l) i.v 4-5ml/kg within 5-10 min.  After that enable to drink as much as the animal wishes!  If the cow will not start to drink, 20 litres of water should be administered via stomach tube. Mechanism of cation: Water moves from the GI tract to blood stream 60 min after administration. Cardiac output increases, arterial blood pressure increases, tissue perfusion supply will improve as well as renal perfusion.  Hyperkalemia reduces.  In order to avoid cardiovascular collapse the i.v fluid administrations should not exceed1 (ml/kg)/min.  Contraindicated in hyponatremic animals (not getting enough water, kidney failure).  Avoid perivascular administration - tissue necrosis!

Question 26

Hypertonic iv solutions are contraindicated in cattle with...

Answer 26

Contraindicated in hyponatremic animals (not getting enough water, kidney failure).

Question 27

Response to fluid therapy, the good and the bad?

Answer 27

Expected positive reactions:  Urination within 30-60 minutes, improvement of mentation and general condition. Undesirable reactions:  Dyspnea – underlying pneumonia or too fast administration of fluids (pulmonary edema).  No urination: kidney failure, paralysis or muscular spasms of bladder.  Sudden muscular weakness due to hypokalemia.  Dyspnea and tachycardia: over-administration of fluids.

Question 28

Requirements for oral rehydration solution (ORS).

Answer 28

Enough Na (90-130 mmol/l) to increase the volume of extracellular fluid.  Cl 40-80 mEq/l  K 10-30 mmol/l Substances that promote absorption of Na and water (such as glucose, citrate, acetate, propionate or glycine).  Dextrose (mmol/l) and Na (mmol/l) ratio 1:1 to 3:1. Alkalinizing substance 50-80 mmol/l (acetate, propionate or bicarbonate) in order to correct metabolic acidosis. Energy: Presence of glucose determines the osmolality of the solution (hyperosmotic solutions 500-600 mOsm/l).

Question 29

Fluid therapy with ORS (oral rehydration solutions).

Answer 29

Its Essential to evaluate the function of rumen before administration into it.  Exclude rumen acidosis! (atony!)  Always use ORS when calf has a suckle reflex and her condition is stable.  Keep time gap of 2-4 hours between feeding milk and giving ORS.  ORS with acetate or propionate are more suitable when calves are fed milk.

Question 30

The range of fluid deficit that can be identified is

Answer 30

between 5 per cent (a mild deficit) and 12 per cent (which is severe).

Question 31

Dehydration is much less quantifiable than hypovolemia, and is identified by: (4)

Answer 31

Increased skin tent (which is best assessed using the upper eyelid in cattle) Enophthalmos (sunken eyes) Decreased mentation Dry mucous membranes

Question 32

Two forms of lactate contribute to acid–base derangements: what are they? How are they formed?

Answer 32

L-lactate and D-lactate. L-lactate is produced by mammalian cells usually secondarily to cellular hypoperfusion and hypoxia, although other rarer causes include hepatic failure, increased glucose metabolism, hyperventilation and blood contaminated with lactated Ringer’s solution. D-lactate is a by-product of bacterial metabolism and is produced in the gastrointestinal tract in calves that have diarrhea, from where it enters the bloodstream. The D isomer cannot be metabolised, can accumulate in both the rumen and large intestine, and is absorbed.

Question 33

In ORS, the highest content electrolyte is

Answer 33

sodium then, chloride and then potassium

Question 34

Plasma osmolality

Answer 34

275 to 295 mOsm/kg H2O

Question 35

compounds that are metabolised to bicarbonate in the liver and have been shown to have a similar alkalinising affect to bicarbonate (3)

Answer 35

acetate, citrate and propionate They also have the advantage that they provide an energy source for the animals as well as facilitating the co-transport of sodium and water out of the small intestine.

Question 36

what % of hypertonic saline can be used iv in cattle

Answer 36

7.5% hypertonic saline (2400 mOsm/L)

Question 37

Describe Plasma transfusion to calves.

Answer 37

A sick calf may benefit from receiving plasma (usually administered as blood) that has been taken from either its mother or other animals on the farm. Bovine blood will not spontaneously separate and often it is not practical to spin it when required in the field. A normal-sized calf needs two litres of plasma, which means that a minimum of four litres of blood should be administered over several hours.

Question 38

Replacement fluid (L) =

Answer 38

dehydration (%) x body weight (kg)

Question 39

A negative BE indicates

Answer 39

metabolic acidosis and a positive BE indicates metabolic alkalosis. Plasma HCO3 and TCO2 are decreased in acidosis and increased in alkalosis.

Question 40

It is well documented that, unlike calves, most mature cattle with dehydration are not

Answer 40

acidotic. Dehydrated mature cattle were about twice as likely to have metabolic alkalosis than metabolic acidosis.

Question 41

Gastrointestinal tract stasis and small intestinal or pyloric obstruction lead to accumulation of chloride ions in the gastrointestinal tract, resulting in

Answer 41

systemic alkalosis. Therefore, cattle with abomasal displacement or volvulus, vagal indigestion, and cecal displacement or torsion are usually alkalotic.

Question 42

name 4 conditions of mature cattle whereby metabolic acidosis is more commonmthan metabolic alkalosis

Answer 42

Carbohydrate engorgement, urinary tract disease, small intestinal strangulation/obstruction, and enteritis/diarrhea

Question 43

when skin pinched on the neck takes 6 seconds to return to normal, this indicates

Answer 43

8% dehydration

Question 44

Total mEq of base required =

Answer 44

BD x 0.3 x BW (kg) = Total mEq of base required When laboratorydata is not available, and there is a strong probability that moderate or severe acidosis exists, a BD of 10 mEq/L may be used without substantial risk as an estimate in the formula for initial therapy. If the cow in fact had a normal acid-base balance, creating a BE of 10 is unlikely to cause significant deterioration in the clinical status of the cow.