Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ag Animal Test 3 > Treatment of Neonatal Diarrhea > Flashcards

Treatment of Neonatal Diarrhea Flashcards

1
Q

What will eventually kill neonates with diarrhea?

A
  • Fluid, electrolyte, acid/base derangements***
  • Bacteremia, septicemia, toxemia
  • energy deficits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

TBW % of body weight

A
  • 55-75%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is ICF % of TBW?

A

2/3 (intracellular)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What % is ECF Of TBW? What % is plasma and interstitial fluid?

A
  • 1/3 TBW
  • 20% of that is ECF
  • 80% of that is ECF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is most body water?

A
  • Inside of cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is most ECF water?

A
  • Outside the vascular tree
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where is the deficit with dehydration?

A
  • Extra-vascular primarily
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Clinical signs of dehydration

A
  • Skin tent is increased
  • Eyes are sunken
  • Mucous membranes are tacky
  • Eyes are “dry”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is the deficit with decreased perfusion?

A
  • INTRAvascular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical signs of decreased perfusion

A
  • HR is increased
  • CRT is decreased
  • Temp is decreased
  • Pulse strength is decreased
  • MM color is pale
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When can calves maintain perfusion even while dehydrated?

A
  • Early diarrhea
  • Gut will still be functional
  • CLinical signs associated with decreased bicarbonate and potassium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

By the time you notice decreased perfusion, how significant are the deficits usually?

A
  • Quite significant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are 7 questions to consider with fluid therapy?

A
  • Is it indicated?* (first)
  • Cost? (first)
  • Route?
  • Volume?
  • Rate?
  • Type?
  • Duration?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do you need to know to determine if fluids are indicated?

A
  • History
  • PE
  • lab analysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

At what % of dehydration can we recognize it clinically?

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

At what % of dehydration is the animal at risk of death?

A
  • 10-12%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do you use to estimate fluid deficits with dehydration?

A
  • Increased skin tenting
  • Tacky mm
  • Sunken eyes
  • Dry eyes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What do you use to estimate fluid deficits with poor perfusion?

A
  • Tachycardia
  • Weak pulse
  • Increased CRT
  • Pale mm
  • Decreased temperature
  • Decreased muscle tone!*
  • Recumbent!*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you come up with a decision for estimation of dehydration?

A
  • Typically based on a conglomeration of all (or some) of the available information
  • The more the better
  • Not all parameters will be present or coincide 100%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Laboratory analysis that can be performed to assess dehydration (in adjunct to physical exam)

A
  • PCV
  • TP
  • Na
  • Osmolarity
  • etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mild dehydration

A

5-7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Moderate dehydration

A

8-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Severe dehydration

A

> 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Relative cost of IV vs oral costs

A
  • $150-250 for IV and $20-60 for oral meds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What three things do you need to think about with route of fluisd?

A
  • Status (Stable vs critical)
  • Nature of the case (locale, environment)
  • Economic constraints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the two broad categories of route of fluids?

A
  • Central

- Peripheral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Central route examples

A
  • IV ONLY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Peripheral route examples

A
  • Oral, subcutaneous, intraperitoneal, intraosseous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Oral route - what does it require?

A
  • Requires a functional or well-perfused gut
  • physiologic and natural approach
  • Gut is often functional in the face of intestinal disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Oral fluid ingredients to consider

A
  • Na
  • Glucose (energy and helps with glucose/Na co-transporter)
  • K
  • Cl
  • Alkalinizing agents (HCO3, citrate, acetate) if metabolic acidosis
  • Glycine to enhance glucose absorption
  • Maybe geling agents?? (probably not)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Homemade oral fluid sample recipe

A
  • 1 tsp light salt
  • 2 tsp NaHCO3
  • Pectin
  • 1 can beef consume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

SC route benefits

A
  • Convenient
  • No volume overload
  • Owner administer
  • Helpful for maintenance
  • 50-200mL/site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When not to do SC route?

A
  • Critical cases!
34
Q

Intraperitoneal benefits

A
  • Large volumes can be given
35
Q

Intraperitoneal caveats

A
  • Must use isotonic fluids
  • Risk of peritonitis
  • Don’t put glucose in there
36
Q

Intraosseous catheter location

A
  • Tibial tuberosity, trochanteric fossa of the femur and wing of the ilium
37
Q

Benefits of intraosseous

A
  • Rapid uptake
38
Q

Caveats of intraosseous catheters?

A
  • Risk of osteomyelitis
39
Q

IV - which cases?

A
  • CRITICAL cases
40
Q

Benefits of IV

A
  • rapid correction of deficits
  • Large volumes
  • Hypertonic tolerated
41
Q

Drawbacks of IV

A

-Catheter management

42
Q

During severe circulatory shock, which is the ONLY route that is not considered peripheral?

A
  • IV
43
Q

What clues on PE might suggest that an animal is a poor candidate for peripheral fluid therapy?

A
  • Cold extremities

- Difficulty ambulating

44
Q

What are three factors to consider with volume replacement?

A
  1. Deficit
  2. Maintenance
  3. Ongoing losses
45
Q

How to calculate deficit volume?

A

BW (kg) x % dehydration = deficit in liters

e.g. 100 kg x 0.08 = 8 L

46
Q

What should maintenance fluids account for?

A
  • Sensible losses (urine, feces)

- Insensible losses (skin, respiratory)

47
Q

Maintenance requirements

A

mL/lb/hr

  • OR 80 mL/kg/day
48
Q

What do ongoing losses relate to?

A
  • Disease
  • Vomiting
  • Diarrhea
  • POlyuria
  • Burns and wounds
49
Q

What is the total fluid requirement plan?

A
  • Deficit + maintenance + ongoing losses
50
Q

How fast can a deficit be corrected?

A
  • Generally 1/2 the deficit can be corrected IV quite rapidly
  • Often in teh first hour with the remainder in the next 4-6 hours or longer
  • Guidelines vary for species
51
Q

How rapidly can calves with diarrhea have the deficit corrected?

A
  • 2-4 hours
52
Q

How quickly can you correct other species?

A
  • Take 24 hours approximately
53
Q

What multiple of maintenance is it generally considered okay to go?

A

Up to 4x maintenance

  • More than that you need to pay attention to signs of overhydration
54
Q

Shock rate of fluids

A
  • 90 mL/kg/hR
55
Q

Signs of excessive fluid flow rates

A
  • Pulmonary and cerebral edema
  • Ascites, chemosis (conjunctival edema), diarrhea
  • Consider the cardiopulmonary state at high flow rates
  • If at a high flow rate, consider measuring CVP
56
Q

How to determine type of fluids?

A
  • Based on history, PE, lab data

- Clinical experience and other non-measured parameters will guide the decision

57
Q

Criteria for choosing a fluid

A
  1. Fluid is needed to correct the VOLUME deficit
  2. Correct electrolyte deficits or excesses
  3. Address acid/base problems
58
Q

What are the polionic fluids?

A
  • Lactated Ringers
  • Normosol
  • Plasmalyte
59
Q

What is in D5W?

A
  • 50g/L glucose
60
Q

What is in 10% dextrose?

A

100 g/L

61
Q

What is in D2.5%, NaCl 0.45%?

A
  • 25 g/L dextrose

77 Na and 77 Cl

62
Q

What’s in NaCl 0.9%?

A
  • 154 Na

- 154 Cl

63
Q

What’s in LRS?

A
  • 130 Na
  • 109 Cl
  • 4 K
  • 3 Ca
  • 28 Buffer lactate
64
Q

What is in plasma?

A
  • 1 g/L glucose
  • 145 Na
  • 105 Cl
  • 5 K
  • 10 Ca
  • 24-28 HCO3 buffer
65
Q

What are the polyionic fluids?

A
  • LRS
  • Plasmalyte
  • Normosol
66
Q

What can happen if you choose 5% dextrose?

A
  • Diuresis
67
Q

What can happen if you choose 0.9% saline?

A
  • Acidifying
68
Q

Bicarbonate deficit formula

A
  • HCO3 def = BW (kg) x deficit x (0.3-0.6)
69
Q

Normal bicarbonate

A

30 mEq/L

  • If they are at 10 mEq/L that’s a 20 deficit
70
Q

How to calculate deficit

A

Normal HCO3 (30) - existing HCO3

71
Q

What is the 0.3-0.6 in the equation for calculating deficits?

A
  • % of body water interchangeable with HCO3
72
Q

Look at the examples for a calf with a deficit

A
  • Just do it
73
Q

What happens if you add NaHCO3 to LRS?

A
  • High sodium and osmolality

- We can push the sodium too high

74
Q

What should you add NaHCO3 to keep sodium and osmolarity okay?

A
  • Use 1.3% NaHCO3 added to water
75
Q

What is a good rule of thumb in minimal deficit situations?

A
  • Simply correcting the hydration status will allow correction of the deficit via renal and respiratory pathways
  • The dumbest kidney is still smarter than the smartest clinician
76
Q

Base deficit estimate for a calf that is still drinking <8 days and > 8 days

A
  • 0 if <8 days

- 5 if >8 days

77
Q

Base deficit estimate for a calf that is standing but having diarrhea <8 days and > 8 days

A
  • 5 if <8 days

- 10 if >8 days

78
Q

Base deficit estimate for a calf that is sternal but laying down <8 days and > 8 days

A
  • 10 if <8 days

- 15 if >8 days

79
Q

Base deficit estimate for a calf that is totally recumbent <8 days and > 8 days

A
  • 10 if <8 days

- 20 if >8 days

80
Q

Goal for duration of therapy

A
  • Get calves back to oral fluids
  • Monitor hydration parameters, mentation, temperature, suckle, etc.
  • Realize that hydrating a calf with a history of severe diarrhea will often times result in the diarrhea returning
81
Q

When should fluid therapy be dc’ed?

A
  • When hydration is accomplished
  • Animal is capable of maintaining fluid balance
  • Hours to days
  • Switch from IV to oral
  • Clinical response

Ag Animal Test 3 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions