Fluid Tx Pediatrics. Cohn et al. 2022. Vet Clin North Am Flashcards
Why do pediatric patients have higher fluid requirements?
- increased extracellular fluid
- decreased renal ability to conserve water
- large surface area/body weight ratio
- larger fluid losses through the skin
What age refers “pediatric” to?
first 6 months of life
what age refers neonate, infant, and juvenile to?
neonate: 0-2 weeks
infant: 2-6 weeks
juvenile: 6-12 weeks
At what age start maternal antibodies to wane?
juvenile period of 6-12 weeks
What is the body water content in percentage in neonatal dogs and cats compared to adults?
neonatal body water content is 80% compared to 60% in adults
Why are pediatric patients not able to compensate for hypovolemia as well as adults?
pediatrics lack compensatory mechanisms to increase heart rate to maintain CO
- neonates cannot increase cardiac contractility → only 30% of fetal cardiac muscle is made up of contractile elements
- puppies have fewer sympathetic nerve fibers supplying the myocardium compared to adults
At 2 months of age how does renal function in puppies differ from adult dogs?
at 2 months of age puppies have a higher glomerular filtration rate, higher daily urine volume, greater fractional excretion of phosphorous than adult dogs
limited autoregulatin or renal blood flow to changes in arterial blood pressure/hypovolemia
limited ability to respond to rapid changes in sodium or water loads
conflicting data regarding urine-concentrating ability in uppies
- traditionally USG > 1.030 not belived to occur in puppies <8 weeks, but other study of 4 week old uppies showed USG equal to or higher than 1.030.
Why are pediatrics more prone to hypoglycemia
- limited glycogen stores
- defiency of gluconeogenic substrates
- insufficient hepatic gluconeogenesis
- poor response to glucagon
What is the controversy on lactate containing fluids for pediatrics?
Some sources suggest avoiding lactate-containing fluids in animals less than 6 weeks of age because they do not effectively metabolize lactate into bicarbonate
Other sources suggest that because lactate can be used as a substitute energy source by the neonatal brain, lactated Ringer solution may actually be preferred to other crystalloids.
At this time, there is no general consensus
How much plasma has be administered to increase albumin by 0.5 g/dL in a dog?
22.5 mL/kg
What can be a treatment strategy for puppies and kittens where colostrum ingestion has not occured?
plasma or serum from a mother or another healthy, well-vaccinated adult
- 16 mL for puppies
- 15 mL for kittens
- divide into 2-3 portions and administer SC every 6 to 8 hours
How do you treat kittens with neonatal isoerythrolysis
transfusion of washed red blood cells
initially RBCs from the type B queen can be given at ~ 5 mL per kitten because the circulating antibodies attack the type A blood of the kitten
If transfusions past day 3 postpartum required ⇒ type A kittens will have formed antibodies to the type B blood ⇒ give washed cells from a type A donor
How do you tube feed a pippy or kitten
use an orogastric tube, e.g., 5F or 8F red rubber
measure from the tip fo the nose to the last rib
guide down the left side of the mouth
When blood products are given via the IP route, how fast is the absorption of blood cells?
up to 72 hours for most cells
What are complications of IO catheters?
bone fracture
osteomyelitis
pain
sepsis from infection
