diarrhea treatment Flashcards
CALF DIARRHEA TREATMENT GOALS
! Correct acid base, electrolyte, and free water abnormalities
! Provide nutritional support
! Eliminate/prevent E coli bacteremia
! Monitor for and manage sequelae of septicemia
whats our first step to decided whether to use IV vs oral treatment to correct acid base, electrolyte, and free water abnormalities…
… estimate dehydration and assess mentation/suckle!
fluid therapy plan includes 4 components:
- shock therapy
- replacement fluid
- Daily maintenance fluid volumes
- Ongoing losses?
How to calculate shock therapy plan
Shock Therapy = 90 ml/kg MAX (start w 30ml/kg, reassess)
how to calculate replacement fluid therapy plan
Replacement fluid (L) = dehydration (%) × body weight (kg)
how to calculate daily maintenance fluid volume
Daily maintenance fluid volumes = 80 to 100 mL/kg x body weight (kg) per day
Purpose of Hypertonic Saline Solution (HSS):, and how to administer? what will it do?
- Commercial HSS range from 5-8%
- 4 ml/kg of 7.2% (72g NaCl in 1L H2O) over 5-10 minutes
…Intravascular volume increase by 3-4 ml per ml HSS - H2O is recruited from:
> intracellular compartment
> interstitial compartment
…HSS should always be accompanied by oral or IV isotonic fluids!!!! (about 10x the HSS volume)
With HSS, you are buying time for fluid treatment in shock conditions!
Sodium Bicarbonate (IV); how is requirement calculated?
Sodium bicarbonate requirement (mEq)
= BWt (kg) × base deficit (mEq/L) × 0.6 (L/kg)
OR
“Give isotonic sodium bicarbonate solution at approximately 10% body weight over a period of several hours (eg, 4 L to
a 40-kg calf)”
(Isotonic NaHCO3 is 1.3% solution…155 mEq/L)
when can we give oral rehydration to a calf in need? goal? considerations?
Only when calf is willing and able to suckle (ie. standing, suckle, <8% dehydrated)…
- Goal is to maximize fluid and electrolyte absorption
- Optimal rehydration depends on Na+ absorption, as water molecule follows solutes to expand ECF
- Glucose facilitates Na+ transport
A good oral electrolyte solution (OES) must:
(1) Supply Na+ to normalize extracellular fluid volume
(2) Provide agents that facilitate absorption of Na+ and water from the intestine
(glucose, citrate, acetate, propionate, or glycine)
(3) Provide an alkalinizing agent
(acetate, propionate, or bicarbonate)
(4) Provide energy
Oral electrolyte solutions (OES) differ markedly in composition and efficacy
when administering an oral electrolyte solution to a dehydrated calf, what SID level for the solution is ideal?
SID ≥ 80 mEq/L is ideal!
OTHER MAJOR TREATMENT GOAL when treating diarrhea, aside from rehydration
Facilitate repair of damaged intestinal epithelium
= FEED THE GUT!
! FRESH MILK, FRESH MILK, FRESH MILK
! Milk replacer
how is the coliform load altered in calfs with diarrhea? what does this mean for bacteremia and what other factors contribute?
- The coliform load is increased in the small intestine of diarrheic calves
- 30% of the calves with severe diarrhea are bacteraemic
> Significantly higher in calves with failure of passive transfer
> Significantly higher in calves < 5 days of age
Antibiotic considerations/recommendations in treatment protocols in diarrheic calves with no systemic illness
In calves with diarrhea and no systemic illness (ie. normal appetite, no fever) AB are not recommended and calves should be closely monitored for systemic signs, especially after rehydration
Antibiotic considerations/recommendations in treatment protocols in diarrheic calves
with systemic illness
In calves with diarrhea plus systemic illness (ie. depression, poor suckle and minimal improvement once dehydration / acidosis is resolved), AB may be recommended:
* Amoxicillin
* Potentiated sulfonamide (less effective)
* Cephalosporin: ceftiofur
