May 2023

In part 2 in two partsCareer girlVeterinary continuing education onlinenews, Ph.D.Add rhett · pazzi oettingerDACVECC, a review of the fluid therapy in veterinary medicine, and you need to know.Veterinary patients treated from the dehydration to identify a physical, please continue reading for more information!If you haven't read part 1, please check itClick here toBefore you continue!

Fluid therapy is one of the most commonly used therapy animals practitioners., as soon as the immediate life-threatening liquid no focus will shift to the patient's level of dehydration, maintain level and for suspected sustained losses.

Below are often used to evaluate patients with dehydration characteristics:

The physical examination results of dehydration patients

Dehydration percentage Clinical signs
< 5 No abnormalities are detected
5-8 - Skin elasticity, mucous membrane is dry
8-10 Elasticity of the skin, mucous membrane is dry, orbital sag, CRT slightly longer
10-12 Severe skin uplift and prolonged the CRT, mucous membrane is dry, orbital sag, may be signs of shock
> 12 All the above plus signs of shock, often life-threatening

Dehydration measurement is subjective and is expected to clinical detection of less than 5%.

To check from time to tome chronic dehydration evidence but stable cardiovascular parameters (i.e., there is no evidence to low blood volume) of the patients, according to the stability of the patients, the degree of chronic disease, complications, lack of correct fluids in 6-24 hours (such as lung disease, for example).

Low blood volume after treatment, the liquid treatment plan using the following formula:

  1. Dehydration rehydration fluids (L) = weight (kg) x x 1000 percentage dehydration
  2. Daily maintenance requirements = weight (kg) x 2 -- 4 ml/kg/h.
  3. Continuing losses = 3-4 ml/kg/vomiting or diarrhea

Liquid treatment of complications
Although fluid therapy is often considered a kind of benign treatment, but it is not without risk.According to the characteristics of individual patients considering the complications include:

  • Pulmonary edema
    • The volume overload
    • Increased vascular permeability
  • Rapid transfer of sodium
    • The nervous system symptoms
      • slow
      • Brain edema
      • A seizure
    • phlebitis
      • Use of hypertonic agent

What is candy in calyx, why is it important?
Candy within calyx is a kind of gel matrix, is arranged on the surface all the vascular endothelium.It is composed of glycosaminoglycans, proteoglycan and glycoproteins.It is a kind of dynamic structure, has a variety of functions, including micro hemostatic, inhibit thrombosis, adjust the white blood cells through the endothelial cell adhesion and migration, regulate vascular tone and permeability, and adjust the flow of fluid through the endothelial cells.Why it is notorious, because candy in calyx damage will result in increasing vascular permeability, capillary leakage and edema, proinflammatory and high coagulation state and vascular tension change and so on.Currently, there seems to be no a special therapy is strongly recommended, do not have any study of veterinary medicine available.Suggestions for wise liquid treatment, therefore, in order to avoid further damage in candy calyx.

conclusion
Intravenous infusion treatment can quickly, can save emergency patient's life.Comprehensive medical history, physical examination and preliminary diagnosis can be used to help distinguish between may deteriorate due to liquid treatment of the disease process (i.e., cardiac shock), and to help clinical doctors to choose the best liquid types in order to improve the clinical condition.

Table: colloid and its chemical properties.

colloid The average molecular weight
(KDa)		 molar
substitution		 The conference of the parties
(MMHG)
5% of albumin 69 There is no 23.2 + / - 0.1
25% of albumin 69 There is no > 200
Fresh frozen plasma 69 There is no 17.1 + / - 0.6
0.9% Hetastarch in 6% NaCl 600 0.7 32.7 + / - 0.2
The balance of electrolyte solution 6% Hetastarch - Hextend ™ 670 0.75 37.9 + / - 0.1
6% walter luven ™ 130 0.4 37.1 + / - 0.8
6% Vetstarch ™ 130 0.4 40 *
  • Cell/tissue

Table: common crystal and its chemical properties.

The solution The LRS A plasma enzyme;norm 0.9% sodium chloride
Na 130 140 154
K. 4 5 0
The Ca 3 0 0
Mg 0 3 0
Cl 109 98 154
gluconate 0 23 0
Lactic acid 28 0 0
acetate 0 27 0
Osmotic pressure 270 294 310

Resources (please note that the list of resources for part 1 and part 2) :

  1. Barron ME, Wilkes MM, Navickis RJ.Colloid more security system evaluation.Arch surgery in 2004;139(5)：552-63。
  2. Chen Deer.Colloid: current recommendations.Vet Clin No Amer Small Anim Pract 2008;38 (3) : 587-93.
  3. Choi PT, Yip G, Quinonez LG, etc.Liquid crystal of recovery and colloid: system evaluation.Emergency medicine 1999;27(1)：200-10。
  4. Cohn LA, Kerl ME, Lenox CE, etc.Healthy dogs react to infusion human serum albumin.Am J Vet Res 2007;68:657-663
  5. Cornelius LM.The liquid therapy of small animal practice.J Am veterinary medical association.1980;176:110.
  6. Cornelius LM, Finco DR, Culver DH.The ringer's lactate solution rapid infusion to dog body physiological effect.The journal of the American veterinary research.1978;You trust, 85.
  7. Cunha MG, Freitas GC, Carregaro AB,Etc.In salinger lactate solution or normal saline solution (0.9% NaCl) in the treatment of experimental urethral obstruction of the cats' kidney and heart and lung.The journal of the American veterinary research.2010;71:840-846.
  8. A brief introduction DiBartola SP, Bateman s. fluid therapy.In: DiBartola SP.Small animal practice in body fluids, electrolytes and acid-base disordersVersion 4.In st Louis, Missouri: Elsevier;2012:331-350.
  9. Gaudette S, Hughes D, Boller m. candy within calyx: health and the structure and function of critical illness.J Vet Emerg Crit Care (SAN Antonio).2020;30(2)：117-134。 doi:10.1111/vec.12925
  10. Hansen, B DeFrancesco t. liquid treatment critically ill in dogs and cats after hydration estimation and the relationship between the weight change.J Vet Emerg Crit care.2002;"5.
  11. Ms Moore LE, garvey.Hydroxyethyl starch influence on hypoalbuminemia dog serum colloid osmotic pressure.J Vet Intern Med 1996;10 (5) : 300-3
  12. Rose RJ.Five different electrolyte solution for dogs some physiological and biochemical effect of intravenously.Vet J Pharmacol Ther, magazine.1979;House of 9.
  13. Silverstein DC, Aldrich J, et al.Evaluate the dog response recovery liquid dosage of blood volume changes.Veterinary emergency and intensive care med 2005;16 (3) : 185-192.
  14. Trow AV, Rozanski EA, Delaforcade AM, etc.Used in the human blood albumin in critically ill dog evaluation: 73 cases (2003-2006).J Am Vet Med Assoc. 2008;233 (4) : 60

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