FM2 Pt1-1 Fluid Therapy

Question 1

Why is fluid therapy recommended during anesthesia for cats?

Answer 1

To support fluid balance, especially when anesthesia exceeds 30 minutes, and to minimize disturbances in cardiovascular function, such as hypotension.

Question 2

What are common causes of fluid imbalance during anesthesia in cats?

Answer 2

Inability to drink, ongoing fluid loss through urine and respiration, vasodilation due to anesthetics, decreased cardiovascular autoregulation, and potential blood loss during surgery.

Question 3

Which cats are more likely to require routine fluid therapy during anesthesia?

Answer 3

Cats that are cardiovascularly unstable, hypotensive, pediatric, geriatric, have systemic diseases like renal disease, or are undergoing surgery with significant tissue exposure or expected blood loss.

Question 4

What is the circulating blood volume in cats, and how is it calculated?

Answer 4

The circulating blood volume is about 6-7% of body weight. For a 5 kg cat, it is approximately 350 ml.

Question 5

When is blood loss during surgery considered significant in cats?

Answer 5

Blood loss greater than 10% of blood volume (~35 ml in a 5 kg cat) is considered significant and may require more aggressive fluid therapy.

Question 6

How can you estimate the amount of blood loss during surgery in a cat?

Answer 6

By weighing blood-soaked swabs and comparing them to a pre-weighed water-saturated swab; 1 g of weight gain roughly equals 1 ml of blood loss.

Question 7

Why is it important to measure Packed Cell Volume (PCV) and Total Solids (TS) before anesthesia?

Answer 7

To establish a baseline before blood loss, allowing for better assessment of the impact of blood loss on the cat’s PCV and hemoglobin concentration after surgery.

Question 8

What happens to PCV during acute blood loss and fluid replacement in cats?

Answer 8

During acute blood loss, PCV remains stable initially, but it falls after fluid replacement due to dilution of the red blood cells.

Question 9

How can fluid therapy help during anesthesia in cats?

Answer 9

It can help maintain blood pressure, support cardiac output, and compensate for blood loss and fluid shifts during surgery.

Question 10

Why is fluid therapy especially important for pediatric and geriatric cats during anesthesia?

Answer 10

These cats are less able to regulate fluid balance and maintain cardiovascular stability during anesthesia.

Question 11

What is the recommended route of fluid administration during anesthesia and surgery for cats?

Answer 11

Intravenous (IV) via an intravenous catheter.

Question 12

Why is IV fluid administration preferred over subcutaneous or peritoneal administration during anesthesia?

Answer 12

IV administration provides reliable and rapid fluid absorption, which is necessary for effective fluid support during anesthesia.

Question 13

What alternative method can be used if intravenous access cannot be established?

Answer 13

Fluid can be administered via an intraosseous needle placed into the medullary cavity of a long bone.

Question 14

Why is it important to control the rate of IV fluid administration in cats?

Answer 14

Cats have a small circulating blood volume, and rapid infusion of large amounts of fluid can cause fluid overload, leading to pulmonary edema or pleural effusion.

Question 15

What equipment can be used to control the rate of fluid administration in cats?

Answer 15

Fluid infusion pumps, syringe drivers, burette giving sets, or paediatric giving sets.

Question 16

What are the benefits of using a burette giving set during fluid administration?

Answer 16

It allows precise control of fluid volume by limiting the amount of fluid that can be rapidly infused, reducing the risk of over-infusion.

Question 17

What types of fluids are recommended for routine use during anesthesia in cats?

Answer 17

Replacement isotonic polyionic crystalloid solutions such as Ringer’s lactate, Hartmann’s solution, or 0.9% NaCl.

Question 18

What is the normal rate of fluid administration during anesthesia in cats?

Answer 18

Typically 4-5 mls/kg/hour, depending on the surgical procedure and fluid loss.

Question 19

What might require an increased rate of fluid administration during anesthesia?

Answer 19

Significant tissue exposure, blood loss, or the need to support blood pressure during anesthesia.

Question 20

When should synthetic colloids be used instead of crystalloids during anesthesia?

Answer 20

When moderate to severe hypotension occurs, as colloids remain in the circulation longer, providing more effective fluid support with a lower volume.

Question 21

How should blood loss exceeding 10% of blood volume be managed during anesthesia?

Answer 21

By increasing the rate of fluid administration or switching to a colloid solution.

Question 22

What are the possible fluid-related complications of using too high a rate of administration during anesthesia?

Answer 22

It can adversely affect mortality by causing fluid overload and related complications.

Question 23

Why should fluids administered during the peri-operative period be warmed?

Answer 23

To prevent a reduction in the cat’s body temperature, as cold fluids can lower body temperature.

Question 24

What is the ideal temperature range for warming isotonic and crystalloid fluids before administration?

Answer 24

36-37°C.

Question 25

What is the preferred route for fluid administration during the peri-operative period in cats?

Answer 25

Intravenously (IV), or intraosseously if IV access cannot be established.

Question 26

Why is it important to use appropriate administration apparatus during fluid therapy in cats?

Answer 26

To prevent fluid overload by delivering fluids in a controlled manner.

Question 27

What equipment is recommended to prevent fluid overload during fluid administration?

Answer 27

A syringe driver or other controlled administration apparatus.

Question 28

How should the rate of fluid administration be adjusted during the peri-operative period?

Answer 28

The rate should be adjusted according to the individual requirements of the patient, considering factors such as blood loss, surgery type, and the cat’s condition.

Question 29

Why is it important to monitor the total amount of fluid administered to a cat during surgery?

Answer 29

To avoid fluid overload, which can lead to complications like pulmonary edema or pleural effusion.

Question 30

What additional step can be taken if fluid balance is problematic during the peri-operative period?

Answer 30

Placing a urinary catheter to more accurately measure urinary output and ensure proper fluid balance.