LAM 1 Acid/Base and Electrolyte Disorders Flashcards
In a horse with a GI impaction, what rate would you use to calculate the daily fluid maintenance requirement?
2x maintenance
(approx 120ml/kg/day)
A 10 year old horse presents 8% dehydrated and off feed for 2 days. What type of fluids would you administer?
LRS with K+
*Always supplement K+ in horses off feed!
A horse presents with colic and is 10% dehydrated. Electrolyte panel is normal, so it is not necessary to supplement K+ in the fluids at this time. True or false?
FALSE
Plasma/serum K+ levels may be normal even though in cases of anorexia and colic there is a total body depletion of K+
Why is KCl an effective euthanasia solution?
Hyperkalemia causes cardiac arrhythmias and standstill
T/F: Potassium supplementation should be given at a max rate of 0.5mEq/kg/hr, and should go in the replacement fluids for faster correction.
FALSE
The rate is correct, but K+ supplementation should always be added to the maintenance fluid to avoid administering it too fast
Hypokalemia is associated with what acid/base disorder?
alkalosis
An 8 year old endurance horse has just finished an 80 mile run, and now has an apparent case of the hiccups. Labwork shows hypokalemia and an iCa++ level of 1.1mg/dL. What type of fluids will you administer this horse?
NaCl (0.9% saline) with K+ and Ca++
*This horse has “Thumps”, or Synchronous Diaphragmatic Flutter, which is caused by hypocalcemia, hypoklemia and metabolic alkalosis.
You are called out to examine a pleasure horse with hiccups. On PE you notice that the horse has oral lesions. What is the likely cause for the clinical signs in this patient?
GIT disease (blister beatles)
*Oral lesions (obvi) and SDF/thumps can both be manifestations of blister beatle toxicosis in non-performance horses
A 400kg horse with a 5 day history of diarrhea is presented 10% dehydrated. You immediately administer 40L of hypertonic saline to correct the dehyration. Soon after, the horse starts exhibiting neurological signs. What is the likely cause?
Chronic diarrhea leading to chronic hyponatremia.
By administering hypertonic saline, the Na+ level was changed too rapidly, causing neuronal shrinkage.
*In cases of chronic hypernatremia, Na+ level should be corrected slowly, over a week. 0.9% saline is the fluid of choice because it is close to physiologic level.
A horse presents with clinical signs of Na+ toxicity after extended use of a salt lick this afternoon. How quickly should the Na+ level be corrected in this patient?
Na+ should be corrected rapidly in acute cases
Clinical signs of hyper/hypo natremia manifest due to what effect on the body?
Rapid change in tonicity, causing neuronal swelling or shrinkage.
At a pH of 7.4, what is the ratio of HCO3- to CO2?
20:1
A horse under anethesia has a PCO2 of 60mmHg. What pH does this correspond to?
ph = 7.3
For every 10mmHg increase in the PCO2, pH will decrease by 0.05.
A 3 month old foal presents in septic shock and you prepare to administer fluids. You know that shock is associated with metabolic acidosis due to loss of bicarbonate, so you do blood test and find that the bicarb level is 16. What is the appropriate treatment for this result?
LRS and supplement bicarb
(Administer 1/2 the bicarb deficit in the first hour, then reevaluate. If still low, administer the rest of the dose over 12-24 hours)
*Bicarbonate is supplemented when the level is <17, or when the pH <7.2.
DO NOT give bicarb to a hypoventilating patient
Due to significant chloride loss, this acid/base disorder can be seen in endurance athletes (sweat losses), or in cases of choke or gastric impaction.
Metabolic alkalosis
