Fluid therapy

in Veterinary practice

By
.Noura El-Shahat A.A
 Why fluid therapy is needed in
?Veterinary practice
• It is an important and life saving therapy
used in day to day veterinary practice.

• The purpose of fluid therapy is to:

• correct dehydration
• Electrolyte imbalances or metabolic
imbalances& hydrogen ion imbalance .
• Energy losses.
 Basics of Body Fluid

• Water is the primary body fluid

• Total body water =0.6x Bwt.Kg
• Higher in neonates, lower in
eldery
Water is very much needed for vital
metabolic activities such as:

• Excretion of metabolic wastes.

• Transport of enzymes & ions.
• Maintainance of blood volume and blood
pressure.
• Thermoregulation.

**Hence water is one of the most important

vital nutrient of the body.
 Basics of Body Fluid
• Body water is distributed among three types of
compartments: intracellular, intravascular, and
interstitial

– Intracellular fluid (ICF) = fluid within the cell (two-

thirds of body water)

– Extracellular fluid (ECF) = fluid within the blood

vessels and in the tissue spaces between the blood
vessels and cells (one-third of body fluid)
 Body 100%

Water 60% Tissues 40%

Intracellular 40% Extra cellular 20%

Interstitial space Intravascular space

15% 5%
 Basics of Body Fluid
• To establish equilibrium, body water moves
along its concentration gradient
Extracellular fluid shifts between the
intravascular space (blood vessels) and
the interstitial space (tissues) to maintain
a fluid balance with the ECF
compartment.
Fluid exchange occurs only across the
capillary walls.
 Basics of Body Fluid
• Body water contains solutes (substances that
dissolve in solvent; particles).

– Primary ions in the body are sodium,

potassium, chloride, phosphate, and
bicarbonate
K&
Cl phos Na

HCo3
 Tonicity of Fluids
• Tonicity refers to the osmotic pressure of a
solution based on the number of particles
per kilogram of solution (osmolality)
• An isotonic solution has the same osmotic
pressure as blood and extracellular water
• A hypotonic solution has osmolality lower
than that of blood.
• A hypertonic solution has osmolality
higher than that of blood.
 Types of fluid therapy
• Fluid therapy in animals may involve:

Crystalloids: are diffusible substances that

dissolve in solution.

Colloids: non diffusible substances

Whole blood and blood products

Crystalloids:
Are group of Na based electrolyte fluids.
They enter ECF and from there
equilibrate with other fluid
compartments in the body to restore
fluid balance.
1- Isotonic Sodium Chloride 0.9% (Saline):
• This solution contain Na& Cl, no K
• It is indicated in fluid and electrolyte losses,
particularly when plasma K levels are increased
due to underlying disease an d additional
administration of K must be avided during fluid
therapy.

2- Ringer solution:
Na, Cl and some K
In water and electrolyte losses when thre is also
some K deficit as vomiting.
3- Ringer lactate :
Contains Na, Cl, K and lactate

4- Sodium bicarbonate 1.3, 5, 8.4%:

Contain NaHCo3 and used in acidosis.

5- Dextrose saline 5%:

Contain Na, Cl and glucose
Used in water, electrolytes loss and hypoglycaemia
Dextrose 5%:
Small amount of glucose
No electrolyte
Pimary water loss& hypoglycaemia.
6- Rintose:
• Rintose is a unique preparation containing balanced
electrolyte solution and dextrose

• specially recommended for

diarrhoea, ketosis, dehydration and debility in animals
and as a supportive therapy.

Composition of Rintose:
• Each 100ml of Rintose contains
Dextrose: 20gm
Sodium Chloride: 0.600 gm
Potassium Chloride: 0.040 gm
Calcium chloride: 0.027gm
Sodium Lactate: 0.312 gm
 Composition - Similar to plasma
Rintose Plasma Electrolytes(Meq
/L)
131 140 Na

5 4 K

112 100 Cl
28 24 Hco3

.For Cattle/Buffalo/Horses: 500-2000ml/day

.Sheep/Goat: 100-200 ml/day for 2-3 days

.Calves: 100-500ml/day for 2-3 days

Comparison of Rintose with other infusion fluids: -
Electrolytes in MEq/L
Dextrose Hco3 Cl +K +Na Fluid
-- -- )154( -- )154( Normal Saline

)20%( -- -- -- -- Dextrose-20%

)10%( -- -- -- -- Dextrose-10%
)5%( -- )154( -- )154( Dextrose
saline
-- )113( )4 ( )103( .Ringer Soln
-- )27( )113( )4 ( )130( Lactated Ringer
)24( )100( )4 ( )140( Plasma

)20%( )28( )112( )5 ( )131( Rintose

 Oral fluid therapy
100g/1-2 L water/ calves -50 Super- lyte

As super- lyte Vit-Lyte

sachet / Lwater/2-3 times/ 1 Lectade

daily
g/1 Lwater/2-3 times/ daily 100 Deit Scour

sachet/200ml/water/ times 1 Rehydran

/daily
 Colloids
Colloids:
Are groups of fluids containing large
molecules deigned to remain in the
intravenous space longer than crystalloid
fluids.
This means that colloids are able to expand
and maintain the vascular volume more
effectively and are commonly termed
plasma expanders.
Colloids are used in cases of shock
where C .V . Function needs to be
improved rapidly as in case of:

Haemorrhage
Shock
Sever dehydration
 Types of Colloids
 Natural
 Plasma
 Albumin
 Synthetic
 Dextrans
 Hydroxyethyl starch
 Gelatins
 Clinical situations requiring fluid
therapy
Replace like with like
 Blood loss replace deficit with
blood
 Water loss replace deficit with
water
 Water &electrolyte replace
deficit with Water &electrolyte
 Calculating Fluid Volume
 Must consider that animals require fluids for the
following:
 Rehydration
 Maintenance
 Ongoing fluid loss

 Make sure the units of measure are the same

when performing these calculations

 Make sure the volumes make sense; we don’t

give 20 liters to a 4-pound cat
 Rehydration fluid therapy

Rehydration fluid therapy= % of

dehydration x Bwt.
Detection the degree of dehydration
depends up on:
Mucous Skin fold Sunken of %
membrane test eye dehydration

Moist Barely not" - 4-6

detected "detected

Moist .sec 2-4 slight“ ++ 6-8

"detected

tacky .sec 10 -6 less" +++ 8-10

”than 0.5cm
Dry .sec 20-45 0.5-1" ++++ 10-12
"cm Coldness of“
”extremities
Maintenance fluid therapy= 50ml/kg

Ongoing fluid therapy: varies from 1-4 litres

depending on the severity of diarrhoea

Amount of bicarbonate required= Bwt. x base

deficit (mmol)x0.5 “factor”

Mmol/l
= gm
Amount of bicarbonate = 12
Base deficit determined from
clinical examination:
5 Standing, strong suck reflex

10 Standing, weak suck reflex

15 Sternal recumbency

20 Lateral recumbency
:Example 1
A calf (weighted 45 kg) is presented with
diarrhoea and sternal recumbency

Clinical examination revealed that

respiratory rate (44 beats/ min)
An irregular heart rate (76 beats/ min)
Low normal rectal temperature 38.4
.Skin fold test returned after 7 seconds
 :Fluid therapy required for this calf

 Rehydration fluid therapy= 8% X45= 3.6 L

 Ongoing losses are estimated as equal to the

replacement requirments= 3.6 L

 Maintenance fluids= 50x 45=2250 ml= 2.5L

 Total fluid therapy= 3.6+3.6+2.5=9.7 L

Animal shows signs of acidosis “harried respirator
rates”

Amount of required Sod. Bicarbonate= 45 x

(base deficit) 15x 0.5= 337.5 mmol

Amount of required Sod. Bicarbonate= 28 gm

Amount of required Sod. Bicarbonate= 2 liters of

sod. Bicarbonate 1.3%
Example 2:
An adult 14-lb cat with 3% dehydration comes
into the clinic. It is estimated that the cat
vomited 100 ml of fluid overnight.

Step 1:
Convert 14 lb to kg using the conversion factor
2.2 lb = 1 kg
14 lb x 2.2 lb/kg = 6.4 kg
Rehydration fluid is based on the estimated
percent of dehydration
% dehydration x weight in kg = deficit in liters

 Step 2: Calculate replacement for dehydration

3% = 0.03
0.03 x 6.4 kg = 0.192 l
0.192 l x 1,000 ml/l = 192 ml
192 ml x 0.8 (80% of dehydration value replaced in
24 hours) = 154 ml to replace on first day
 Maintenance fluid is the volume of fluid needed
daily to maintain body function

 Maintenance fluids can be dosed at 50

ml/kg/day in adults and 110 ml/kg/day in
young animals

 Step 3: Calculate maintenance volume

6.4 kg x 50 ml/kg/day = 320 ml per day
 Ongoing fluid loss is an estimation based on
the additional loss of fluid due to vomiting
or diarrhea

 Step 4: Take estimated volume lost in fluid

and add to the other volumes

 Final step: Take all values and add together

320 ml + 192 ml + 100 ml = 612 ml
?How and How Quickly Is It Given
 Rateof fluid replacement parallels the
severity of dehydration.

 Ideally, fluids are given over a 24-hour

period.

 Fluidsare stored and given by fluid bags

or bottles attached to administration sets
 Routes of Fluid Administration
 The route of administration of fluid
therapy depends upon:
 type of disease
 condition of the patient
 severity of dehydration
 Type of electrolyte/Acid-base
balance.
 Routes of Fluid Administration
Disadvantages Advantages Route of
administration
Less rapid Safest route Oral
absorption Easy
Possible
aspiration
Cannot use for
vomiting animals
Possible Relatively easy Subcutaneous
infection to administer
Must use isotonic Absorption
fluids distributed over
Slower time
 Routes of Fluid Administration
Disadvantages Advantages Route of
administration
Possible fluid Precise amount Intravenous
overload and given is
vessel damage available rapidly
Requires close Various
monitoring tonicities of fluid
Must be sterile can be used
Possible Relatively rapid Intraperitoneal
infection absorption
Cannot use Can be used
hypertonic when IV access
solutions is not available
 Routes of Fluid Administration
Disadvantages Advantages Route of
administration

Not frequently Good Rectally

used absorption
Rapid
absorption
Thank you