Fluids 8: Fluid therapy in the field

Considerations for fluid administration route

Enteral route of fluid therapy is the most feasible and cost effective

IV route is often too cumbersome, expensive and associated with risks

How to get that volume into the animal? PO ….if possible Enteral fluid administration is first choice!

Indications: Impactions and Dehydration

Remember potential contra indications? What material is needed?

Bolus or continuous rate infusion (CRI)?

Enteral NG tubes for neonates / horses, Per rectum administration (horses / potbellied pigs)

How much fluid can be safely administered in the stomach as a bolus?

Depends on the species and the size of the animal

Indwelling enteral tube in horses (PO / PR)

Smaller size and therefor easier to place

Per rectum (PR) is also a possibility

Less need for monitoring compared to an IV catheter

Not suitable for adult ruminants due to eructation

Ruminal acidosis fluids

Add alkali fluids to the rumen to raise the rumen pH

May use the oro-gastric tube to remove rumen fluid first

Transfaunation

hypocalcemia ruminal fluids

Supplement some oral calcium to provide a longer duration of calcium support

Shock ruminal fluids

Mastitis?

Add to hypertonic saline to ensure fluid drawn into the intravascular space

LDA ruminal fluids

Supplement fluids and add potassium which likely been sequestrated because of the

displaced abomasum

hypertonic saline (HSS) IV + fluids PO

Commercially available fluid IV combined with PO tap water (bovine): Good for shock

2-4 mL HSS/kg IV over 5 min (~2-3 L/bovine) → Followed by 40-60 L of PO water/oral fluids

Give free access to water and if they don’t drink in 5 min, tube them

Home made fluids?

PO - Lots of oral recipes for adults and juveniles(good and bad) using tap water.

PR - normal tap water without electrolytes

IV homemade fluids

ideally sterilize prepared fluids or distilled water last resort: tap water due to potential contaminants

all components can be heat sterilized except

NaHCO3- avoid contamination during preparation

What testing is appropriate? PCV/TP – is the animal as dehydrated at it looks?

Lactate may also give you a clue as it will show level of anaerobic respiration due to lack of perfusion/ hypvolaemia

Determine if a blood transfusion or plasma transfusion may be needed

Don’t want to overhydrate if these values are low

What testing is appropriate? Potassium

if want to supplement IV I suggest always have a baseline as blood potassium can be very high but once rehydrate or relieve the problem(ie a blocked bladder) than it can drop rapidly.

If in doubt appropriate to supplement potassium orally

Supplement assumptions for scouring neonatal calves

If >1 day duration = Metabolic acidosis with / low bicarbonate → Hypo Na and Cl (GIT loss, unless owner treated)

Hypoglycemia especially if hypothermic, not been eating (need little and often).

Hyper K (due to metabolic acidosis and K+-H+ exchange and dehydration)? K reduced due to lack of intake?

Shock rate fluids for calves

Bwt x 0.08 x 0.25

● 45,000g x 0.08 (or 45kg x 80ml) = 3600ml / 3.6L → Give ¼ of this fluid

Therefore 3600 x 0.25 = 900ml.

What type of fluid? Normosol-R? 0.9% NaCl? (mildy acidifying)