Hydration

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45 Terms

1

body water content

  • 60% of body weight in adults

  • 80% of body weight in neonates

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2

body water intracellular

66%

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3

body water interstitial (around the cells)

28%

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4

body water in blood vessels

5%

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5

signs of continues loss of body water

  • loss of moisture from the skin (results in tenting)

  • sunken appearance

  • drying of mucous membranes

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6

Normovolemia

  • adequate body water volume or normal hydration

  • maintained by ensuring input is equal to output

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7

measurable losses

  • urination

  • other secretory functions- sweat, tears , saliva, feces, vaginal secretions, gland seceretions

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8

non measurable losses

  • evaporation from the body surface (skin, eye , mucus membranes)

  • during respirations

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9

body water is lost when

  • high ambient temp

  • dry arid environment

  • increased exercise

  • fever

  • open body cavities

  • certain pathological processes (vomit, diarrhea, diuresis, bleeding)

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10

adult water maintenance

60ml/kg//day

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11

pediatric maintenance

120ml/kg/day (2x adult)

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12

maintenance volume

the volume of water that we require for daily survival

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13

pathology occurs when

  1. excessive water loss

  2. lack in intake

  3. excessive intake

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14

hypovolemia

dehydration

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15

hypervolemia

overhydration

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16

overhydration

  • aka water intoxication

  • uncommon to rare

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17

overhydration causes

  • iatrogenic - (excessive fluid therapy)

  • endocrine problems

  • behavioral overconsumption

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18

overhydration pathological changes

  • increased volume in blood vessels

  • decreases oncotic and osmotic pressures in blood vessels

  • fluid leaves blood vessels and enters interstitial space

  • decreases osmotic pressure in the interstitial space

  • fluid enters the cells

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19

overhydration pathological effects

  • increased demand on the heart (increased water added to blood vessels increases BP)

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20

diuresis

increased urine production

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21

Pulmonary hypertension

  • fluid enters in lungs and pleural space

  • due a combination of high BP and decreased oncotic pressures in the blood vessels

  • if heart can’t push fluid through fast enough there will be increases pressure in pulmonary vessels;s, if significant may force fluid into lungs and pleural space

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22

pulmonary edema

increased fluid in the lungs

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23

Pleural effusion

fluid in the pleural space (around the lungs)

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24

cerebral edema and brain compression

  • increased water causes the concentration of Na to drop and this decreases the osmotic pressure in the interstitial space

  • water moves from extracellular space into intracellular causing the cells to swell

  • swelling of cells causes cerebral edema and compression

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25

Clinical signs of cerebral edema

  • increased HR, BP, RR

  • dyspnea- increased resp effort

  • increased and dilute urine

  • neurological signs (headache, behavioural changes,ataxia, tremors, blindness, seizures, coma)

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26

Patients at risk for overhydration

  • heart failure

  • kidney failure

  • end stage liver failure

  • small animals

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27

treating overhydration

  • stop fluids

  • diuretics - drugs that promote urine production

  • correct any underlying endocrine condition

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28

dehydration

the body loses more water than it takes in

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29

causes of dehydration

  • not drinking enough

  • any form of water deprivation

  • animals forced to “drink snow”

  • animals in drought conditions

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30

increased losses

  • lactating animals require more water

  • animals that are athletes

  • hot weather, hyperthermia, prolonged fever

  • vomit, diarrhea

  • renal losses

  • iatrogenic( diuretics)

  • blood loss

  • small animals

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31

diagnosing dehydration

  1. history

  2. PE finding

  3. diagnostic tests

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32

history

  • very important for determining cause

  • owner can comment on amount and duration of losses

  • owner to comment on availability and water intake

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33

PE findings

  • assessing hydration is part of every PE

  • hospitalized patients should be evaluates at least once daily

  • minimum exam includes

    • weight changes

    • CRT

    • MM texture

    • skin tent

    • HR

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34

diagnostic tests

  • increased pack cell volume

  • increased total proteins

  • increased urine concentration

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35

degree of dehydration

clinical signs that are noted with diagnostic test results

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36

<3% dehydrated

  • subclinical

  • no changes on PE

  • long term may later production and performance

  • changes appear on diagnostic tests

  • treatment - drink water

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37

3-5% dehydrated

  • mild

  • often subclinical

  • if clinical- lethargic, maybe tacky MM or weight change

  • changes on diagnostic testing

  • diagnosis often based on history

  • treatment oral fluids

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38

5-8% dehydrated

  • moderate

  • weight loss, lethargic,prolonged CRT, tacky MM, mild skin tent,

  • clearly seen on diagnostics

  • treatment- IV fluids

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39

8-10% dehydrated

  • marked

  • weight loss, lethargic to depressed, prolonged CRT, tacky to dry MM, skin tent, mild tachycardia,may look sunken

  • clearly seen on diagnostics

  • treatment - IV fluids and correct electrolytes

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40

10-12% dehydrated

  • severe

  • significant weight loss, depressed, prolonged CRT, dry MM, skin tent, sunken eyes, tachycardia, cool extremities

  • diagnostic tests show other changes to electrolytes and other organ functions

  • treatment Iv fluids and organ support

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41

>12% dehydrated

  • Moribund

  • this animal is in shock and dying

  • treatment shock fluids, possible CPR

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42

method 2 calculation based on body weight loss

  • works best for animal is hospitalised or been seen within days

  • calculation should always match up with clinical signs

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43

deficit volume

  • teh volume of fluids that’s lacking in a dehydrated patient

  • needs to be replaced to return to normal

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44

Pathology associated with dehydration

  • danadge is related to decreased blood pressure that causes decreased tissue perfusion. tissue cells receive less oxygen and nutrient delivery, decreased removal of metabolic waste products

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45

Hypernatremia

increased Na concentration causes body water to shift compartments

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