Flashcards in Basics of Equine Fluid Therapy Deck (37):

1

## How do you address hydration status

### via the circulating fluid volume (HR, CRT, PP, Jugular filling time and amount, temperature of extremities), TBW (MM and skin tent), CLinical signs and Lab measures

2

## How do you calculate Fluid Requirements?

###
Need to know Fluid decificts

Maintenance needs

Abnormal fluid losses

3

## How do you decide type of fluids?

###
Crystalloids or collids? (how long will we need help bringing up fluids?)

What electrolytes will it need? Na/K

What is the acid base status?

Is glucose controlled? esp in foals!!

4

## How do you decide rate of fluids?

### consider if we are replacing deficit, maintenance fluids, fluids with ongoing abnormal losses.

5

## How do you decide route of fluids?

### Go IV if there are immediate needs, need to be precise, or greater than 5% DH (which is any time we see dehydration). Otherwise go oral when it is not needed immediately and not severe.

6

## Basic outline of TBW...

###
60% of BW is water, of which

20% is ECF (1/4 plasma, 3/4 ISF)

40% is ICF

7

## How do we replace the deficit?

###
Assess hydration status

Use clinical signs to find the deficit

Laboratory parameters

8

## Replacing deficits should include which rates of fluids?

###
adults - 4L per hour is the fastest. (give the amount over 2 hours if possible)

neonates - don't handle well so .5 in first 6 hrs and the rest over 12-24 hrs.

9

## What is maintenance fluid rates?

###
adults - 55-65 ml/kg/day (1L/hr for 500kg)

neonates - 80-120 ml/kg/day (200 ml/50 kg)

10

## whats a tolerable oral rate of fluids?

### 8L q 2-4 hours. no more than 20L at once.

11

## What are examples of crystalloids and which is most important?

###
plasmalyte, ringers, LRS, normosol, 0.9 NaCl (saline), 5% dextrose.

Hypertonic saline (7.2%) is the most important to know how to use

12

## What should we know for giving hypertonic saline

###
give at 2-4 ml/kg FAST

give with isotonic fluids later

restores volume, Bp, and CO

13

## Colloids include

### plasma, whole blood, dextran, hetastarch and pentastarch (safer)

14

## What are the indications for plasma?

### hypoprotein, FPT, coagpathies

15

## how much plasma do you give?

###
7L per 1g/dL of TP

1-2 L for FPT septic foal

16

## CLinical signs of plasma complications

### tachy, tahcypnea, muscle fascic, hypotension,m collapse, urticaria, possible anaphylaxis.

17

## How do you give plasma?

### slowly (50 ml/hour) and TPR every 5 minutes for 3 times.

18

## t1/2 of hetastarch

### 7 days.

19

## When will we give K electrolytes in the fluids?

### if

20

## When will we give Na electrolytes in the fluids?

### If

21

## How much K will change pH 0.1 units?

### 0.6 mEq/L

22

## What do you do if hypoglycemia?

### bolus 5-10 g into the foal

23

## what is normal BG in a foal?

### 80-120 mg/dL

24

## What is the ECF for the bicarb calc in foals and adults?

### 30% in adults, 50% ECF in foals.

25

## When do you include bicarb in the fluids?

###
if BD is >10-15 mEq/L or

if venous blood is pH is

26

## When anion gap is down, what is the most important (and common) thing to look into and fix?

### Lactic acidosis which is caused by decreased peripheral O2. So increase the BV and this will come back to normal.

27

## What is the formula for calculating bicarb deficit?

### mMol/mEq = BW*ECF*BD

28

## What are the causes of hyperkalemia and what is the best way to treat the main one?

###
Metabolic acidosis - Correct which will bring the H back out of Intracellular space and K goes in.

uroperitoneum

HYPP

29

## What is the formula to figure out fluids (L) needing replaced

### % DH *BW (kg) = L deficit

30

## Mild moderate and severe DH are what percentages DH?

### 5, 8, and 12.

31

## What are causes of maintenance water losses?

###
sensible losses - Urinary and GI

insensible losses - Resp and sweating

32

## What are numbers associated with maintenance losses?

###
adult - 55-65 ml/kg/day

neonates - 80-120 ml/kg/day

33

## Causes of abnormal losses ongoing

### high temp, fever, diarrhea, polyuria.

34

## Explain 5% DH in MM, CRT, Skin tent, HR

###
normal to tacky mm

35

## Explain 8% DH in MM, CRT, Skin tent, HR

###
tacky mm

2-3 sec CRT

3-5 s ST

>50 HR

sunken eyes, weak pulse

36

## Explain 12% DH in MM, CRT, Skin tent, HR

###
dry mm

>5 s CRT

>5 s ST

>60 HR

moribund, cold extremities

37