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What are the 6 questions to be answered before fluid therapy?

• When should fluid therapy be instituted?

• What kind of fluid/s should be given?

• How much fluid should be given?

• How fast should the fluid be given?

• How is fluid treatment administered?

• How is the success of fluid treatment be evaluated?

What does fluid therapy serve to correct?

Dehydration, Over Hydration, Electrolyte Imbalance

What conditions characterize metabolic acidosis?

Diarrhea, Renal Diseases, CNS Depression, Hyperpnea, Hypoadrenocorticism, Ketosis, Starvation, Diabetes Mellitus

What should fluids contain in metabolic acidosis?

Sugar

What fluids are recommended for metabolic acidosis?

Lactated Ringer's Solution, Dextrose 5% in LRS, Dextrose 5% in Water, NaHCO₃, Na Lactate, Na Gluconate

What is metabolic alkalosis associated with?

Emesis (Vomiting), Excessive Diuretics, Hyperadrenocorticism, Nervous Excitement, Convulsion, Depressed Breathing

What should fluid contain in metabolic alkalosis?

Sodium chloride

What fluids are recommended for metabolic alkalosis?

NaCl, Isotonic Saline NH₄Cl (Ammonium Chloride), Ringer's Solution, Normal Saline Solution (NSS)

What conditions characterize respiratory acidosis?

Pneumonia, Pulmonary Edema, Emphysema, Pneumothorax, Respiratory Muscle Paralysis, Anesthetic Over Dosage, Hypoventilation

What should fluid contain in respiratory acidosis?

Sugar

What fluids are recommended for respiratory acidosis?

LRS, D5LRS, D5W

What is respiratory alkalosis associated with?

Fever, Encephalitis, Salicylate Poisoning, Deficiency of Oxygen/Hypoxia, Heat Prostration, Hysteria

What fluids are recommended for respiratory alkalosis?

ISS, NaCl, NH₄Cl

What is one consideration based on blood pH before fluid therapy?

The pH of the blood

How should electrolytes be balanced based on serum electrolyte composition?

With the use of the fluids

What disorders of water, sodium, chloride balance are categorized under serum electrolyte composition?

Hypernatremia, Hyponatremia, Hyperchloremia, Hypochloremia, Hypokalemia, Hyperkalemia

What characterizes hypernatremia?

Increased sodium

What is hypernatremia associated with?

Pure water loss

What fluids are recommended for hypernatremia?

5% Dextrose in Water, Normal Saline + 50% Dextrose

What characterizes hyponatremia?

Decrease sodium

What fluids are recommended for hyponatremia?

Normal Saline, Lactated Ringer Solution (LRS)

What characterizes hyperchloremia?

Increase chloride

What fluids are recommended for hyperchloremia?

Sodium Carbonate, Sodium Bicarbonate, Sodium Gluconate, Sodium Acetate, Sodium Lactate, Normal Saline

What characterizes hypochloremia and hypokalemia?

Increase chloride and increased potassium

What fluids are recommended for hypochloremia and hypokalemia?

Normal Saline, Normal Saline + Potassium Chloride, 0.9% NaCl, 1.9% NH₄Cl, Ringer's Solution

What characterizes hyperkalemia?

Increase potassium

What fluids are recommended for hyperkalemia?

NaHCO₃, Calcium Gluconate, NSS + 10% Glucose, NSS + 20% Glucose

What is the maintenance dose formula?

Maintenance Dose = Normal Water Turn-Over × Body Weight

What does normal water turn-over depend on?

The dose and activity of the animal

What is the normal water turn-over for young and lactating animals?

130 ml/kg bw/day

What is the normal water turn-over for mature animals?

65 ml/kg/day

What is the percentage of mild dehydration?

4%

What are the signs of mild dehydration?

With history of fluid loss

What is the percentage of moderate dehydration?

6%

What are the signs of moderate dehydration?

With history of fluid loss, Skin lacks pliability, Dry coat + mucous membrane, Tongue still moist

What percentages indicate severe dehydration?

8%, 10–12%, 14–15%

What are the signs of 8% severe dehydration?

With history of fluid loss, Skin lacks pliability, Dry coat + mucous membrane, Dry tongue, Sunken eyeball

What additional sign occurs at 10–12% dehydration?

Aside from those mentioned above, There is circulatory insufficiency

What occurs at 14–15% dehydration?

Circulatory shock

What is the replacement dose formula?

Replacement Dose = Degree of Dehydration × Body Weight

What is continuing loss?

If the animal being in the treatment period, this additional amount must be estimated and added to the maintenance and replacement doses

What is the total fluid formula?

Total Fluid = Maintenance Dose + Replacement Dose + Continuing Loss

What is the rate of administration formula?

Rate of Administration = Total Fluid × Normal Drops per mL of IV Set, 24/hr

How many drops/mL does a microdrip (Pedia) have?

60 drops/mL

How many drops/mL does a macrodrip (Adult) have?

20 drops/mL

What does gtt come from?

The Latin word "gutta", which means drop in English

What are the common routes of fluid treatment administration?

Intravenous (IV), Subcutaneous (SQ), Oral (PO), Per Rectum

When is oral fluid treatment not recommended?

If the patient is vomiting

What is the disadvantage of the subcutaneous route?

Swelling

When is the peritoneal route used?

Only in large animals and laboratory animal

When is the per rectum route used?

In neonates up to 7 days of age

How is the success of fluid treatment evaluated?

Based on the observation of signs or symptoms exhibited by the animal

What do diuretics induce?

Urination

What does the osmotic diuretic mechanism increase?

The osmotic pressure within the lumen of the proximal tubule and the loop of Henle

What is osmosis?

Pressure gradient where molecules will move from lower concentration to higher concentration

What are osmotic diuretics used to treat?

Nephritis, Renal Failure, Cystitis

What fluids are regulated by osmotic diuretics?

CSF, Intra-ocular Fluid

What is another effect of osmotic diuretics?

Induction of Polyuria to eliminate toxin

What do carbonic anhydrase inhibitors inhibit?

The resorption of bicarbonate by the tubular cells

What does inhibition of bicarbonate resorption lead to?

Retention of bicarbonate in the tubular lumen

What are carbonic anhydrase inhibitors used to treat?

Chronic Glaucoma, Udder Edema

What is an effect of carbonic anhydrase inhibitors on intra-ocular pressure?

Reduce Intra-ocular Pressure

What is another therapeutic use of carbonic anhydrase inhibitors?

Adjunct to treatment of Epilepsy

What condition can carbonic anhydrase inhibitors treat at high altitude?

Acute Mountain (High-Altitude) Sickness

What do benzothiadiazides/thiazides decrease?

Sodium reabsorption and therefore decreases fluid absorption

What conditions are treated by benzothiadiazides/thiazides?

Edema: Congestive Heart Failure, Renal, Cardiac and Hepatic Origin, Nephrogenic Diabetes Insipidus

What do aldosterone antagonists block?

The effect of aldosterone, preventing the reabsorption of sodium, which encourages water loss

What type of antagonist is Spironolactone?

True competitive antagonist of aldosterone

What additional activity does Spironolactone have?

Some estrogen-like activity

What conditions are treated by Spironolactone?

Hypokalemia, Edema + Renal, Liver and Cardiac Failure, Severe Ascites

What does Heparin prevent?

Release of aldosterone

What do methylxanthine/xanthine/aminouracils promote?

Renal vascular vasodilation

What do methylxanthine/xanthine/aminouracils increase?

Heart Function, Pressure, Filtration, Water Release

What do potassium-retaining agents prevent?

Reabsorption in the collecting tubule

What does Spironolactone inhibit?

Aldosterone receptors

What does Spironolactone prevent?

Excessive excretion of potassium

What do Loop of Henle diuretics inhibit?

Sodium, Potassium, Chloride transport in the Loop of Henle

What are Loop of Henle diuretics used to treat?

Edema, Pulmonary Congestion, Ascites, Hydrothorax, Renal Failure, Chronic Heart Failure, Exercise-Induced Pulmonary Hemorrhage (Horse)

What are Loop of Henle diuretics contraindicated in?

Anuria, NSAID, Aminoglycoside

What is a noted effect of Loop of Henle diuretics?

Ototoxic effect

What do Triazine derivatives prevent?

The absorption of sodium and chloride in the distal convoluted tubule

What do Triazine derivatives increase?

Urinary Flow Rate, Urinary Prostaglandin E₂ Excretion

What do aquretics inhibit?

V₂ receptors, which mediate antidiuretic hormone

What does NEP degrade?

Atrial natriuretic factor (ANF)

What is ANF?

It is the muscle of the right atrium released in response to blood volume overload, leading to sodium excretion and diuresis

What does Dopamine (D₁) receptor agonism increase?

Renal Blood Flow, Filtration

What does Dopamine (D₁) receptor agonism induce?

Urination

What do hematinics increase?

The Hgb content of the blood

What do hemostatics control?

Bleeding

What do anti-hemostatics do?

Interfere with clotting, increase fibrinolysis, or affect platelet activity

What do inotropes increase?

The strength of heart muscle contraction

What do vasoactive drugs alter?

Vascular tone to reduce preload or afterload

What properties do inodilators have?

Both vasodilator and positive inotropic properties

What is the primary function of iron in erythropoiesis?

To serve as a core component of hemoglobin, responsible for oxygen transport

What is Vitamin B12 vital for?

Vital cofactor for enzymes involved in DNA synthesis

Why is Vitamin B12 crucial in bone marrow?

Crucial for cell division, especially in rapid production of new RBCs in bone marrow

What is folic acid essential for?

Erythrogenesis

What is folic acid converted to?

Tetrahydrofolic acid

What is tetrahydrofolic acid crucial for?

DNA and RNA synthesis

What does folic acid allow erythroblasts to do?

Proliferate and differentiate properly