Topic:Fluid Therapy
Fluid therapy in horses involves the administration of fluids to maintain or restore hydration, electrolyte balance, and acid-base status. It is commonly used in veterinary medicine to address conditions such as dehydration, shock, or electrolyte imbalances resulting from illness, injury, or surgery. The types of fluids used can vary, including crystalloids, colloids, and hypertonic solutions, each with specific indications based on the horse's clinical condition. This page gathers peer-reviewed research studies and scholarly articles that explore the methodologies, applications, and outcomes of fluid therapy in equine medicine.
Critical Care of the Colic Patient: Monitoring, Fluid Therapy, and More. A successful outcome to management of the critical colic patient is highly dependent on how the patient is monitored and treated, particularly, in the perioperative period. In this article, we will provide an update on monitoring techniques, advances in fluid therapy, nutrition management and pharmacotherapeutic agents, inclusive of pain monitoring and management, prokinetics, and management of systemic inflammatory response syndrome and the hypercoagulable state.
Basic Postoperative Care of the Equine Colic Patient. The 3 time periods around colic surgery (preoperative, operative, and postoperative) are all critical to successful outcomes. Although much focus is often paid to the first 2 time periods, the importance of sound clinical judgment and rational decision-making in the postoperative period cannot be overstated. This article will outline the basic principles of monitoring, fluid therapy, antimicrobial therapy, analgesia, nutrition, and other therapeutics routinely used in patients following colic surgery. Discussions of the economics of colic surgery and expectations for normal return to function ...
Acute Kidney Injury and Renal Failure in Horses. Nephrotoxic and hemodynamically mediated disorders are the most common causes of acute renal failure (ARF) in horses and foals. Leptospira spp. is the most common infectious cause of ARF. Initial treatments for ARF include elimination of nephrotoxic drugs, correction of predisposing disorders, and fluid therapy to promote diuresis. Horses and foals with polyuric ARF often have a good prognosis, while those with oliguric or anuric ARF have a guarded to poor prognosis. When fluid therapy is unsuccessful in improving urine production, various drugs treatments have been used in an attempt to incre...
Comparison of liberal and goal-directed fluid therapy after small intestinal surgery for strangulating lesions in horses. There are few guidelines for the appropriate mode of fluid administration during and after colic surgery, and is challenging to reach the right balance while avoiding overhydration. This study aimed to compare goal-directed fluid therapy (GDFT) and 'liberal' fluid regimens (LFRs) in horses undergoing small intestinal surgery. Methods: Eighteen horses subjected to small intestinal surgery were matched according to the surgical lesion, type of anastomosis, length of resection, and duration of clinical signs. Horses in the LFR group were administered intravenous (IV) fluids for at least 24 h. In ...
Comparative Trial of Continuous Flow Enteral and Intravenous Fluid Therapy in Horses. Continuous flow enteral fluid therapy with isotonic and hypotonic enteral electrolyte solutions are as safe and effective as intravenous fluid therapy. The aim of this study was to carry out a comparative assessment between continuous flow enteral and intravenous (IV) fluid therapy in adult experimentally dehydrated horses. Six experimentally dehydrated adult mares were used in a study carried out in a 6 × 3 crossover design, which each animal received three different treatments (isotonic enteral fluid therapy-EsISO, hypotonic enteral fluid therapy-EsHYPO and intravenous fluid therapy with La...
Current Concepts in Fluid Therapy in Horses. Despite the frequent inclusion of fluid therapy in the treatment of many conditions in horses, there are limited studies available to provide evidenced-based, species-specific recommendations. Thus, equine fluid therapy is based on the application of physiology and extrapolation from evidence in other veterinary species and human medicine. The physiologic principles that underly the use of fluids in medicine are, at first glance, straightforward and simple to understand. However, in the past 20 years, multiple studies in human medicine have shown that creating recommendations based on theory i...
Effect of Feed Intake on Water Consumption in Horses: Relevance to Maintenance Fluid Therapy. Maintenance fluid therapy is challenging in horses that cannot drink or are denied feed and water because of concerns about gastrointestinal tract function and patency. Intravenous fluid delivery to meet water needs based on current recommendations for maintenance requirements were obtained in fed horses and therefore might not apply to horses that are not being fed. This is a critical flaw because of the interdependence between intestinal tract water and extracellular water to support digestion while preserving water balance, a concept explained by the enterosystemic cycle. Because horses dri...
[Intravenous Administration of Sterile vs. Non-Sterile Infusion Solutions in Horses]. Kopper JJ, Bolger ME, Kogan CJ et al. Outcome and complications in horses administered sterile or non-sterile fluids intravenously. J Vet Intern Med 2019; 33: 2739–2745 DIE INTRAVENöSE VERABREICHUNG VON LöSUNGEN DIENT ZUR ERHALTUNG ODER WIEDERHERSTELLUNG DES FLüSSIGKEITSVOLUMENS IN DEN GEFäßEN UND DER GEWEBEDURCHBLUTUNG. SIE IST ENTSCHEIDEND BEI DER BEHANDLUNG VON PFERDEN MIT ERKRANKUNGEN, DIE EINE HYPOVOLäMIE ZUR FOLGE HABEN. ZU DEN TYPISCHEN INDIKATIONEN GEHöREN EIN HOHER GASTROINTESTINALER WASSERVERLUST, EINE EINGESTELLTE WASSERAUFNAHME BZW. EINE NICHT TOLERIERTE ENTERALE FLüSSIGK...
Retrospective evaluation of the effect of intravenous fluid administration on development of postoperative reflux in horses with colic (2004-2012): 194 horses. To evaluate the role of intravenous fluid volume and electrolyte supplementation on the development of postoperative reflux (POR) in horses undergoing celiotomy for colic. Methods: Case-control study spanning 2004-2012 for horses undergoing celiotomy for colic. Methods: University teaching hospital. Methods: Sixty-seven client-owned horses >1 year of age with POR were each matched to 2 controls with similar surgical lesions that did not demonstrate POR. Results: Survival was significantly lower in cases (65.7%) than controls (96.1%). Factors found to be associated with POR included decrease...
Practical Fluid Therapy and Treatment Modalities for Field Conditions for Horses and Foals with Gastrointestinal Problems. With advances in technology and owner education, field management in equine veterinary medicine continues to evolve. Equine gastrointestinal disease is one of the most common types of emergencies evaluated by equine practitioners, and many of these patients can be effectively managed in the field. Although the equine veterinarian must make numerous decisions, fluid therapy, pain management, and antimicrobial use are 3 of the major choices that must be addressed when initiating field treatment of equine gastrointestinal disease. This article addresses the practical use of these 3 treatment cate...
Congenital nutritional myodegeneration in a neonatal foal. A 2-day-old Quarter Horse colt was presented to the Atlantic Veterinary College for recumbency and diarrhea. Dietary history of the dam, serum biochemistry findings, and whole blood selenium levels were consistent with nutritional myodegeneration. The patient was treated successfully with fluid therapy and broad-spectrum antimicrobials. Recovery was uneventful, and the patient was discharged with a favorable prognosis. Un poulain Quarter Horse âgé de deux jours a été présenté à l’Atlantic Veterinary College pour un décubitus et de la diarrhée. L’anamnèse nutritionnelle de la mè...
Effects of administration of a synthetic low molecular weight/low molar substitution hydroxyethyl starch solution in healthy neonatal foals. This study compared the effects of IV administration of isotonic fluid therapy and colloidal fluid therapy in healthy neonatal foals. Fifteen healthy neonatal foals were used in a randomized blinded prospective clinical study. Foals were randomly assigned to receive a bolus of 20 mL/kg of tetrastarch (TES) or balanced crystalloid solution. Vital parameters, colloid osmotic pressure (COP), and various clinicopathologic variables were assessed prior to infusion and at various time points up to 120 h after infusion. The treatment group (TES) had a significant increase in both COP and percentage i...
Crystalloid and colloid therapy. Fluid therapy is a cornerstone of emergency medicine, but equine practitioners should be aware of recent developments that have modified previous recommendations. First, new emphasis on the avoidance of hyperchloremia suggests that crystalloids with a lower chloride concentration may be more appropriate for use. Second, modifications to the understanding of the Starling equation suggest that the benefits of colloids may be more limited than previously thought. In addition, the negative effects of fluid overload on morbidity and mortality are becoming increasingly recognized. Although more spec...
General anesthesia in horses on fluid and electrolyte therapy. The purpose of this article is to update the community of veterinarians performing general anesthesia in horses on fluid therapy. The rationale behind intraoperative fluid therapy, fluid dynamics, and various fluid options (crystalloids, hypertonic saline, colloids) is discussed. Additionally, electrolytes (calcium, potassium, and sodium) are included in the discussion in relation to general anesthesia and intraoperative fluid management.
A comparison of hypertonic (7.2%) and isotonic (0.9%) saline for fluid resuscitation in horses: a randomized, double-blinded, clinical trial. Hypertonic saline solution (7.2%) (HSS) can quickly replace intravascular volume deficits. HSS more recently has been advocated in the treatment of traumatic brain injury, but its use in dehydrated patients remains controversial. Objective: Hypertonic saline solution will show a significant improvement in both clinical and laboratory hydration parameters as compared to isotonic (0.9%) saline solution (ISS). Methods: Endurance horses eliminated from the 2009 Western States 100-mile (220-km) endurance ride and requiring IV fluid therapy were eligible for enrollment in the study. Methods: Twenty-...
Fluid therapy in equine patients: small-volume fluid resuscitation. Fluid therapy is an important component of resuscitation and treatment of critically ill equine patients. However, the decision of which fluid type to use in certain critical situations is somewhat controversial. This article focuses on the potential benefits of performing small-volume resuscitation in critically ill horses by combining hypertonic saline with a colloid (e.g., hetastarch).
Successful treatment of hyperkalaemic periodic paralysis in a horse during isoflurane anaesthesia. A 3-year-old, 400 kg, gelding Quarter Horse was presented for investigation of epistaxis. Methods: The horse was bright, alert and responsive with rectal temperature, heart rate and respiration rate within normal limits. Results: During a second general anaesthetic for surgical treatment of guttural pouch mycosis by balloon-tipped catheter occlusion of the right major palatine artery and ligation of the right external carotid artery, signs consistent with hyperkalaemic periodic paralysis (HYPP) were exhibited. These included concurrent hyperkalaemia, hypercapnoea, sinus tachycardia, and muscle...
Retrospective study assessing efficacy of treatment of large colonic impactions. Cases with a history of colic due to a large colonic impaction were recruited retrospectively to assess the treatment efficacy and complications of oral and parenteral fluid therapy regimes for correction of primary large colon impactions. Oral isotonic fluids had been administered at varying intervals following initial treatment with magnesium sulphate and water. There was no significant difference in complication rates between groups. Considering complication rates with impaction clearance, hourly administration of oral fluids appears to be the most appropriate treatment regime of those inve...
Estimation of acute fluid shifts using bioelectrical impedance analysis in horses. Multi-frequency bioelectrical impedance analysis (MF-BIA) has been used to evaluate extracellular fluid volume (ECFV), but not fluid fluxes associated with fluid or furosemide administration in horses. If able to detect acute changes in ECFV, MF-BIA would be useful in monitoring fluid therapy in horses. Objective: The purpose of this study was to evaluate the ability of MF-BIA to detect acute fluid compartment changes in horses. We hypothesized that MF-BIA would detect clinically relevant (10-20%) changes in ECFV. Methods: Six healthy mares were used in the study. Methods: This is an original ...
Enteral fluid therapy in large animals. Enteral fluids administered alone, or in conjunction with intravenous fluids, are reported to be useful for the treatment of dehydration and electrolyte loss associated with diarrhoea in a number of species, following exercise in horses and for feed impaction of the large intestine of horses. Enteral fluids are suitable for treatment of mild to moderately dehydrated patients with some intact intestinal epithelium and motile small intestine. In patients that will drink voluntarily or tolerate nasal intubation the use of enteral fluids may avoid the complications associated with intravenous flui...
Effect of a 24-hour infusion of an isotonic electrolyte replacement fluid on the renal clearance of electrolytes in healthy neonatal foals. To determine the effects of a 24-hour infusion of an isotonic electrolyte replacement fluid (IERF) on weight, serum and urine electrolyte concentrations, and other clinicopathologic variables in healthy neonatal foals. Methods: 4 healthy 4-day-old foals. Methods: Prospective study. Methods: An IERF was administered to each foal at an estimated rate of 80 mL/kg/d (36.4 mL/lb/d) for 24 hours. Body weight was measured before and after the infusion period. Urine was collected via catheter during 4-hour periods; blood samples were collected at 4-hour intervals. Variables including urine production;...
Intravascular hemolysis associated with severe cutaneous burn injuries in five horses. Five horses were evaluated because of severe cutaneous burn injuries following a barn fire. Gross hemolysis and morphologic changes in RBCs consistent with oxidative damage were detected in all of the horses. Of these horses, 4 became azotemic. The overall goals of treatment included wound care, correction of dehydration and provision of diuresis, control of inflammation, pain management, and prophylaxis against sepsis. After treatment, 2 horses survived and were discharged from the hospital. Red blood cell damage and hemolysis following cutaneous burn injury have been investigated in other sp...
Influence of fluid therapy on gentamicin pharmacokinetics in colic horses. The aminoglycoside antibiotic gentamicin is commonly used in equine medicine for the prevention and treatment of Gram-negative and staphylococcal bacteria in surgically treated colic patients. The pharmacokinetics of gentamicin in these patients might be altered by the disease status, and/or under the influence of fluid therapy. The purpose of this study was to investigate the effect of intravenous fluid treatment on gentamicin kinetics in colic patients. Colic patients subjected to laparotomy were given fluid infusions according to clinical status. Following gentamicin administration, blood s...
Postoperative management of the large colon volvulus patient. Horses with large colon volvulus (LCV) often require intensive postoperative medical management. Although early referral and surgical intervention are critical for minimal postoperative complications and a successful outcome, this is often not possible for many reasons. Endotoxemia, extensive mucosal damage with subsequent severe hypoproteinemia, and focal ischemic necrosis are the major causes of postoperative morbidity and mortality. Although fluid therapy, flunixin meglumine, and antimicrobials are still the mainstay of perioperative management, synthetic colloids are being used to maintain...
Fluid therapy in horses with gastrointestinal disease. Fluid therapy is essential to the successful management of horses with gastrointestinal disease. Affected horses can present in a wide spectrum of metabolic derangement depending on the extent and severity of the underlying disease process. Precise quantitation of fluid deficits and losses is usually not possible; thus, formulating a rational plan, applying diligent and ongoing monitoring, and making adjustments to meet individual demands provide the best approach to fluid therapy in these horses. Although restoration of fluid and electrolyte homeostasis can be complicated, it is probably best...