May 2023

In part 1 in two partsCareer girlVeterinary continuing education onlinenews, Ph.D.Add rhett · pazzi oettingerDACVECC, provides a practical, fluid method based on the case.After all, you each time the use of fluid therapy.Being single.Veterinary day, whether you are small animals, exotic animals, large animals, or a horse veterinary!However, it is not just a "set and forget it", it is not only the water and salt.So, please continue reading for more information!Don't forget that in a few weeks back part 2.

Fluid therapy is one of the most commonly used therapy animals practitioners.Although a lot of work, but the general consensus is that there isn't a liquid type than another type is more suitable for the recovery.That's why people often debate clinic should buy what kind of liquid act.In addition, the required type liquid may vary according to the underlying disease process.

Fluid therapy in medicine such an important reason is that the organism is mainly composed of...Liquid composition!In non obese adult dogs or cats, the body water content is about 60% of the weight.The whole body moisture distribution between the two main compartments further: (ICF) in cells and extracellular fluid (ECF).

Whole body water (TBW) fluid chamber

ICF compartment is two separate room in the larger one, accounting for 40% of the 66% of the whole body moisture and weight.It through water permeable but most solute impermeable membrane with ECF room is separated.ECF consists of the remaining 33% of the TBW and 20% of body weight.25% of the ECF subdivided into plasma (ECF) and interstitial 75% (ECF) fluid chamber.

The demand for liquid treatment is usually divided into two categories:

  1. Recovery in patients with intravascular volume (low blood volume)
  2. Replace blood vessels outside the liquid (dehydration)

There are four types ofLow perfusionIn the veterinary practice in general:

  1. Low blood volume (that is, the intravascular volume decrease)
  2. Distribution/fester sex (that is, the vascular tension loss, liquid transfer, the third clearance)
  3. Cardiac myocardial dysfunction (i.e., leading to cardiac output and hypoperfusion)
  4. Obstructive (i.e., due to obstruction, such as due to the expansion of the stomach and intestinal reverse or pericardial effusion, decrease the heart on the right side of the venous return)

Distinguish which type of perfusion deficiency is important, because they are the initial treatment and long-term treatment will vary according to the underlying disease process.Compared with cardiac causes, when the blood volume is insufficient clinical symptoms (mucosa pale, capillary refill time prolonging, poor quality of mental retardation, pulse, limbs cold and tachycardia (bradycardia or cat), intravascular fluids must be replaced for emergency recovery.

When considering replacement of liquid, we normally first consider the liquid is isotonic liquid crystal.Liquid crystal is sodium chloride and other physiological activity of the solute (K+The Ca2 +Or magnesium2 +, glucose and buffer).Sodium is the main solute in the extracellular space, most of the extracellular space is outside the blood vessels, so sodium will mainly exist in the vascular space.Veterinary commonly used liquid crystal including ringer's lactate solution, Normosol -r and Plasma - Lyte 148.These fluids are classified as isotonic solution, because of their concentration and osmotic pressure and electrolyte ECF (plasma) is similar.The liquid in the intravascular and interstitial compartment between rapid distribution.Thirty minutes later, intravascular injection of 75% of the amount of liquid is transferred to clearance in organization.Using ooze liquid crystal, such as dog impact of liquid volume is estimated to be 90 ml/kg, the cat is 60 ml/kg.The author initially as quickly as possible to replace a quarter to a third of calculating volume, to assess the perfusion parameters, especially the mucous membrane of heart rate, color, quality of CRT, pulse, blood pressure, finally the urine volume.

In addition to isotonic crystals, synthesis of colloid is low blood volume of patients to consider another option.Hetastarch, Vetstarch ® and glucan synthesis of colloid is not easily across the vascular membrane liquid molecules (molecular weight > 10000 daltons).Synthesis of colloid in patients with normal high permeability, so the liquid from the interstitial space into vascular space, and to keep the liquid in the vascular space.Compared with isotonic crystal, the synthesis of colloidal infusion of an increase in blood volume is greater than the quantity.

Although the objective standard is a colloid osmotic pressure gauge is used to measure the osmotic pressure, but the use of the general principles of the synthesis of colloidal therapy include:

  • When liquid crystal can't effectively improve or maintain blood volume
  • Peripheral edema
  • Support the colloidPenetration ofpressure
  • Capillary permeability
  • The total protein < 3.5 g/dL
  • Albumin < 1.5 g/dl

Common colloid push note dose 10-20 ml/kg for dogs and cats 5-10 ml/kg, then a quick and frequent review.Like the isotonic crystal, the authors use the 1/3 of the volume to XNUMX/XNUMX as the initial push note, then the patients were reviewed.


In addition to isotonic colloidal crystal and synthesis, another alternative fluid therapy is hypertonic crystals, especially in the hypertonic saline.Hypertonic saline is considered can be fast dilate blood vessels inside the chamber, and used in patients with normal hydration status.Dehydration or high natremia disabled patients with hypertonic saline.Hypertonic saline has strong effect, due to its strong penetration, can be other liquid inhalation of intravascular compartment.Typical dose is recommended for rapid recovery in 4 minutes using HS 20% of 7-7.5 ml/kg.In addition, the theoretical hypertonic saline has other useful features, including the improvement of myocardial contraction force, activation causes peripheral vascular expansion neurogenic reflection, improve microcirculation by preventing blood capillary collapse, swelling of the endothelial cells and change the function of polymorphonuclear cells (PMN) and endothelial cells.Complications, including slow heart beat (bradycardia) and ery low sodium bronchoconstriction, wave, fluid overload and pulmonary edema, phlebitis and ventricular arrhythmia.

In order to prolong the effect of fluid resuscitation, the author also considers the combined use of hypertonic saline/synthetic colloid.To achieve the fluid mixture, using 1:2. 5 percentage of 23.4% hypertonic saline (sodium chloride) and Hetastarch or Vetstarch.For this solution easily, 43 ml will be 17 ml of 23.4% hypertonic saline and colloid mixed in 60 ml syringe.And then be used for 3 to 5 ml of canine patients push agent, be used for 2-3 ml feline patients push agent, and then review.

But wait!There is plenty of fluid therapy.Tune intoPart 2In a few weeks to understand more information about the fluid therapy!

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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