Outcome and complications in horses administered sterile or non-sterile fluids intravenously.
Abstract: Obtaining commercial fluids for intravenous administration (IVF) was challenging during a recent shortage. This necessitated use of custom-made non-sterile fluids for intravenous administration (JUGs) in some hospitals. There are no studies comparing outcome of horses treated with JUG versus IVF and limited information is available about adverse effects of JUGs. Objective: To evaluate death, complications, blood pH, and plasma electrolyte concentrations of horses that received JUG versus IVFs. Methods: One hundred eighty-six horses that received IVFs and 37 that received JUGs. Methods: A retrospective review of medical records was performed to identify horses that received IVFs or JUGs during hospitalization. Information including survival to discharge, complications (fever [>38.5°C], jugular vein phlebitis/thrombosis, arrhythmia, or laminitis), blood pH, and plasma electrolyte concentrations were obtained. Results: There was no difference (P = .67) in survival to discharge for horses that received JUGs (78%) compared to horses that received IVFs (87%). Horses that received JUGs were more likely to develop a jugular vein complication (3 of 37 versus 1 of 186, odds ratio 17.2 [95% CI 1.9-389.8], P = .04). Horses that received JUGs were more likely to have electrolyte abnormalities consistent with hyperchloremic metabolic acidosis. Conclusions: Veterinarians using JUGs should obtain informed client consent because of a potential increased risk of jugular vein complications. Chloride content of JUGs should be considered to limit development of hyperchloremic metabolic acidosis.
© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Publication Date: 2019-10-14 PubMed ID: 31609037PubMed Central: PMC6872628DOI: 10.1111/jvim.15631Google Scholar: Lookup
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Summary
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This study compares the outcomes and complications of horses treated with sterile and non-sterile intravenous fluids, during a commercial fluids shortage. It found that while survival rates were consistent across both treatments, those receiving non-sterile fluids had higher incidences of complications such as jugular vein issues and electrolyte abnormalities.
Research Objective
The research aimed to compare and analyze the outcomes and complications in horses that received sterile fluids for intravenous administration (IVFs) and those that received non-sterile fluids (JUGs) in situations where access to commercial fluids was limited. Specific factors analyzed include survival to discharge, complications such as fever, jugular vein phlebitis/thrombosis, arrhythmia, laminitis, blood pH, and plasma electrolyte concentrations.
Methodology
- The study was a retrospective review of medical records of 223 hospitalized horses, with 186 receiving IVFs and 37 receiving JUGs.
- The researchers collected and analyzed data on complications, blood pH, and plasma electrolyte concentrations in addition to survival rates.
Results
- Survival to discharge rates were not significantly different between the two groups, with a survival rate of 78% for those receiving JUGs compared to 87% for those receiving IVFs.
- However, horses that received JUGs were more likely to develop a complication related to the jugular vein, with an increased odds ratio of 17.2.
- Furthermore, horses that received JUGs were also more likely to exhibit electrolyte abnormalities, particularly a condition called hyperchloremic metabolic acidosis.
Conclusions
- The use of JUGs potentially carries increased risks, mainly related to jugular vein complications. As such, veterinarians should seek informed consent from clients before using JUGs.
- To prevent hyperchloremic metabolic acidosis, consideration should be given to the chloride content of JUGs used.
Cite This Article
APA
Kopper JJ, Bolger ME, Kogan CJ, Schott HC.
(2019).
Outcome and complications in horses administered sterile or non-sterile fluids intravenously.
J Vet Intern Med, 33(6), 2739-2745.
https://doi.org/10.1111/jvim.15631 Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.
- Center for Interdisciplinary Statistical Education and Research, Washington State University, Pullman, Washington.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.
MeSH Terms
- Animals
- Drug Compounding / veterinary
- Female
- Fluid Therapy / veterinary
- Horse Diseases / chemically induced
- Horse Diseases / drug therapy
- Horse Diseases / mortality
- Horses
- Infusions, Intravenous
- Jugular Veins
- Male
- Retrospective Studies
Conflict of Interest Statement
Authors declare no conflict of interest.
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Citations
This article has been cited 4 times.- Miranda ALS, Antunes BC, Minozzo JC, Lima SA, Botelho AFM, Campos MTG, Chávez-Olórtegui CD, Soto-Blanco B. Clinical Effects of the Immunization Protocol Using Loxosceles Venom in Naïve Horses. Toxins (Basel) 2022 May 13;14(5).
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- Gomez DE, Buczinski S, Darby S, Palmisano M, Beatty SSK, Mackay RJ. Agreement of 2 electrolyte analyzers for identifying electrolyte and acid-base disorders in sick horses. J Vet Intern Med 2020 Nov;34(6):2758-2766.
- Miranda ALS, Antunes BC, Minozzo JC, Lima SA, Botelho AFM, Campos MTG, Chávez-Olórtegui C, Soto-Blanco B. The Health Status of Horses Used for at Least Six Complete Cycles of Loxoscelic Antivenom Production. Toxins (Basel) 2023 Sep 26;15(10).
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