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Journal of veterinary internal medicine2019; 33(6); 2739-2745; doi: 10.1111/jvim.15631

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.
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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

Journal of veterinary internal medicine
ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 33
Issue: 6
Pages: 2739-2745

Researcher Affiliations

Kopper, Jamie J
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.
Bolger, Megan E
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan.
Kogan, Clark J
  • Center for Interdisciplinary Statistical Education and Research, Washington State University, Pullman, Washington.
Schott, Harold C
  • 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.

References

This article includes 35 references
  1. Schott HC 2nd. Fluid therapy: a primer for students, technicians, and veterinarians in equine practice.. Vet Clin North Am Equine Pract 2006 Apr;22(1):1-14.
    pubmed: 16627100doi: 10.1016/j.cveq.2005.12.021google scholar: lookup
  2. Fielding L. Crystalloid and colloid therapy.. Vet Clin North Am Equine Pract 2014 Aug;30(2):415-25, viii-ix.
    pubmed: 25016499doi: 10.1016/j.cveq.2014.04.008google scholar: lookup
  3. Muir WW, Ueyama Y, Noel-Morgan J, Kilborne A, Page J. A Systematic Review of the Quality of IV Fluid Therapy in Veterinary Medicine.. Front Vet Sci 2017;4:127.
    pmc: PMC5557817pubmed: 28856137doi: 10.3389/fvets.2017.00127google scholar: lookup
  4. Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M. Association between a chloride-liberal vs chloride-restrictive intravenous fluid administration strategy and kidney injury in critically ill adults.. JAMA 2012 Oct 17;308(15):1566-72.
    pubmed: 23073953doi: 10.1001/jama.2012.13356google scholar: lookup
  5. Boniatti MM, Cardoso PR, Castilho RK, Vieira SR. Is hyperchloremia associated with mortality in critically ill patients? A prospective cohort study.. J Crit Care 2011 Apr;26(2):175-9.
    pubmed: 20619601doi: 10.1016/j.jcrc.2010.04.013google scholar: lookup
  6. Silva Junior JM, Neves EF, Santana TC, Ferreira UP, Marti YN, Silva JM. The importance of intraoperative hyperchloremia.. Rev Bras Anestesiol 2009 May-Jun;59(3):304-13.
    pubmed: 19488543doi: 10.1590/s0034-70942009000300005google scholar: lookup
  7. Young JB, Utter GH, Schermer CR, Galante JM, Phan HH, Yang Y, Anderson BA, Scherer LA. Saline versus Plasma-Lyte A in initial resuscitation of trauma patients: a randomized trial.. Ann Surg 2014 Feb;259(2):255-62.
    pubmed: 23732264doi: 10.1097/sla.0b013e318295febagoogle scholar: lookup
  8. Prough DS, Bidani A. Hyperchloremic metabolic acidosis is a predictable consequence of intraoperative infusion of 0.9% saline.. Anesthesiology 1999 May;90(5):1247-9.
    pubmed: 10319767doi: 10.1097/00000542-199905000-00003google scholar: lookup
  9. Chowdhury AH, Cox EF, Francis ST, Lobo DN. A randomized, controlled, double-blind crossover study on the effects of 2-L infusions of 0.9% saline and plasma-lyte® 148 on renal blood flow velocity and renal cortical tissue perfusion in healthy volunteers.. Ann Surg 2012 Jul;256(1):18-24.
    pubmed: 22580944doi: 10.1097/sla.0b013e318256be72google scholar: lookup
  10. Kellum JA, Song M, Almasri E. Hyperchloremic acidosis increases circulating inflammatory molecules in experimental sepsis.. Chest 2006 Oct;130(4):962-7.
    pubmed: 17035425doi: 10.1378/chest.130.4.962google scholar: lookup
  11. Shaw AD, Bagshaw SM, Goldstein SL, Scherer LA, Duan M, Schermer CR, Kellum JA. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte.. Ann Surg 2012 May;255(5):821-9.
    pubmed: 22470070doi: 10.1097/sla.0b013e31825074f5google scholar: lookup
  12. Hippensteel JA, Uchimido R, Tyler PD, Burke RC, Han X, Zhang F, McMurtry SA, Colbert JF, Lindsell CJ, Angus DC, Kellum JA, Yealy DM, Linhardt RJ, Shapiro NI, Schmidt EP. Intravenous fluid resuscitation is associated with septic endothelial glycocalyx degradation.. Crit Care 2019 Jul 23;23(1):259.
    pmc: PMC6652002pubmed: 31337421doi: 10.1186/s13054-019-2534-2google scholar: lookup
  13. nFood and Drug Administration CVMn. Large Volume Intravenous (IV) Solution Shortage. http://wwwfdagov/AnimalVeterinary/SafetyHealth/ProductSafetyInformation/ucm440393htm?source=govdelivery&utm_medium=email&utm_source=govdeliveryAccess 2015.
  14. D'Agostino RB Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group.. Stat Med 1998 Oct 15;17(19):2265-81.
    pubmed: 9802183doi: 10.1002/(sici)1097-0258(19981015)17:19<2265::aid-sim918>3.0.co;2-bgoogle scholar: lookup
  15. Dolente BA, Beech J, Lindborg S, Smith G. Evaluation of risk factors for development of catheter-associated jugular thrombophlebitis in horses: 50 cases (1993-1998).. J Am Vet Med Assoc 2005 Oct 1;227(7):1134-41.
    pubmed: 16220676doi: 10.2460/javma.2005.227.1134google scholar: lookup
  16. Aksoy K, Simhofer H, Patan B. Pathologische Veränderungen an den Jugularvenen von 395 Pferden nach Versorgung mit zwei unterschiedlichen Venenverweilkatheter‐Systemen. Vet Med Austria 2008;95:243‐254.
  17. Tagalakis V, Kahn SR, Libman M, Blostein M. The epidemiology of peripheral vein infusion thrombophlebitis: a critical review.. Am J Med 2002 Aug 1;113(2):146-51.
    pubmed: 12133753doi: 10.1016/s0002-9343(02)01163-4google scholar: lookup
  18. Maki DG, Ringer M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. A randomized controlled trial.. Ann Intern Med 1991 May 15;114(10):845-54.
    pubmed: 2014945doi: 10.7326/0003-4819-114-10-845google scholar: lookup
  19. Traub-Dargatz JL, Dargatz DA. A retrospective study of vein thrombosis in horses treated with intravenous fluids in a veterinary teaching hospital.. J Vet Intern Med 1994 Jul-Aug;8(4):264-6.
    pubmed: 7983621doi: 10.1111/j.1939-1676.1994.tb03230.xgoogle scholar: lookup
  20. Schoster A. Complications of intravenous catheterization in horses.. Schweiz Arch Tierheilkd 2017 Sep;159(9):477-485.
    pubmed: 28952957doi: 10.17236/sat00126google scholar: lookup
  21. Lowell JA, Bothe A Jr. Central venous catheter related thrombosis.. Surg Oncol Clin N Am 1995 Jul;4(3):479-92.
    pubmed: 7552789
  22. Divers TJ. Prevention and treatment of thrombosis, phlebitis, and laminitis in horses with gastrointestinal diseases.. Vet Clin North Am Equine Pract 2003 Dec;19(3):779-90.
    pubmed: 14740769doi: 10.1016/j.cveq.2003.08.002google scholar: lookup
  23. Lankveld DP, Ensink JM, van Dijk P, Klein WR. Factors influencing the occurrence of thrombophlebitis after post-surgical long-term intravenous catheterization of colic horses: a study of 38 cases.. J Vet Med A Physiol Pathol Clin Med 2001 Nov;48(9):545-52.
    pubmed: 11765811doi: 10.1046/j.1439-0442.2001.00383.xgoogle scholar: lookup
  24. Dickson LR, Badcoe LM, Burbidge H, Kannegieter NJ. Jugular thrombophlebitis resulting from an anaesthetic induction technique in the horse.. Equine Vet J 1990 May;22(3):177-9.
    pubmed: 2361504doi: 10.1111/j.2042-3306.1990.tb04242.xgoogle scholar: lookup
  25. Spurlock SL, Spurlock GH. Risk factors of catheter‐related complications. Compend Contin Educ Pract Vet 1990;12:214‐245.
  26. Schafer AI. The hypercoagulable states.. Ann Intern Med 1985 Jun;102(6):814-28.
    pubmed: 3158262doi: 10.7326/0003-4819-102-6-814google scholar: lookup
  27. Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: Long-term complications and survival.. Equine Vet J 2005 Jul;37(4):310-4.
    pubmed: 16028618doi: 10.2746/0425164054529445google scholar: lookup
  28. Magnusson CB, Poulsen KP, Budde JA, Hartmann FA, Aulik NA, Raabis SM, Moreira ASD, Darien BJ, Peek SF. Quality Control of Compounded Crystalloid Fluids for Intravenous Delivery to Horses.. J Vet Intern Med 2018 Jan;32(1):469-473.
    pmc: PMC5787182pubmed: 29114956doi: 10.1111/jvim.14864google scholar: lookup
  29. Holcombe SJ, Jacobs CC, Cook VL, Gandy JC, Hauptman JG, Sordillo LM. Duration of in vivo endotoxin tolerance in horses.. Vet Immunol Immunopathol 2016 May;173:10-6.
    pubmed: 27090620doi: 10.1016/j.vetimm.2016.03.016google scholar: lookup
  30. Taylor PM, Silver M, Fowden AL. Intravenous catheterisation of foetus and mare in late pregnancy: management and respiratory, circulatory and metabolic effects.. Equine Vet J 1992 Sep;24(5):391-6.
    pubmed: 1396515doi: 10.1111/j.2042-3306.1992.tb02862.xgoogle scholar: lookup
  31. Moreau P, Lavoie JP. Evaluation of athletic performance in horses with jugular vein thrombophlebitis: 91 cases (1988-2005).. J Am Vet Med Assoc 2009 Nov 1;235(9):1073-8.
    pubmed: 19878008doi: 10.2460/javma.235.9.1073google scholar: lookup
  32. Yunos NM, Bellomo R, Glassford N, Sutcliffe H, Lam Q, Bailey M. Chloride-liberal vs. chloride-restrictive intravenous fluid administration and acute kidney injury: an extended analysis.. Intensive Care Med 2015 Feb;41(2):257-64.
    pubmed: 25518951doi: 10.1007/s00134-014-3593-0google scholar: lookup
  33. Magder S. Balanced versus unbalanced salt solutions: what difference does it make?. Best Pract Res Clin Anaesthesiol 2014 Sep;28(3):235-47.
    pubmed: 25208959doi: 10.1016/j.bpa.2014.07.001google scholar: lookup
  34. Krajewski ML, Raghunathan K, Paluszkiewicz SM, Schermer CR, Shaw AD. Meta-analysis of high- versus low-chloride content in perioperative and critical care fluid resuscitation.. Br J Surg 2015 Jan;102(1):24-36.
    pmc: PMC4282059pubmed: 25357011doi: 10.1002/bjs.9651google scholar: lookup
  35. McCluskey SA, Karkouti K, Wijeysundera D, Minkovich L, Tait G, Beattie WS. Hyperchloremia after noncardiac surgery is independently associated with increased morbidity and mortality: a propensity-matched cohort study.. Anesth Analg 2013 Aug;117(2):412-21.
    pubmed: 23757473doi: 10.1213/ane.0b013e318293d81egoogle scholar: lookup

Citations

This article has been cited 4 times.
  1. 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).
    doi: 10.3390/toxins14050338pubmed: 35622586google scholar: lookup
  2. Crabtree NE, Epstein KL. Current Concepts in Fluid Therapy in Horses. Front Vet Sci 2021;8:648774.
    doi: 10.3389/fvets.2021.648774pubmed: 33855057google scholar: lookup
  3. 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.
    doi: 10.1111/jvim.15889pubmed: 32965055google scholar: lookup
  4. 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).
    doi: 10.3390/toxins15100589pubmed: 37888620google scholar: lookup
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