Fluid therapy

1. FLUID THERAPY FOR HEPATIC FAILURE
• Primary focus in LF is correction of intravascular volume
deficits.
• Colloids can be used as an adjunct fluid therapy to
crystalloids.
• Hyponatremia and Hypokaleimia are important electrolyte
abnormality with LF.
• The liver is the primary organ responsible for glucose
production. Glucose support should be considered in the fluid
therapy plan for all patients with LF.
• The liver is important in acid–base physiology.
– It is involved in metabolism of organic acid anions (i.e., lactate), metabolism of
ammonia, and production of albumin.
• Metabolic acidosis in horses with ALF is likely a result of
hypoperfusion, increased anaerobic metabolism, and
production of lactic acid

2. FLUID THERAPY FOR HEPATIC FAILURE
• Resuscitation fluids for horses with liver failure
– Hypertonic saline (7.2%): 4 mL/kg
– Isotonic crystalloid with acetate buffer qs to 5%
– dextrose and 20 mEq KCl/L: 50 mL/kg
• Fluid therapy following resuscitation for horses with
liver failure
– Acetate‐buffered balanced electrolyte solution qs to 5–10% dextrose
and 20–40 mEq KCl/L

3. FLUID THERAPY FOR GI DISEASE
• Fluid therapy is mainstay of treatment for horses with
gastrointestinal disorders
– Various forms of colitis (salmonellosis, clostridiosis, grain overload, etc.),
– Functional inflammatory disorders of the small intestine (duodenitis/proximal
jejunitis), and strangulating or non‐strangulating obstructive disorders
resulting in colic
• Hypovolemia and dehydration. There are two common scenarios in
evaluating the body water status of horses with gastrointestinal disease.
– Horses with colic of more than 1 day duration are likely to show clinical signs
of dehydration upto 5% (extracellular fluid volume depletion), largely as a
consequence of reduced water intake
– The second scenario is found in cases of more acute, severe colic or colitis that
have concurrent hypovolemia as a consequence of intravascular fluid losses
(20–25%) due to changes in endothelial permeability along with intestinal
mucosal malabsorptive and hypersecretory processes

4. FLUID REQMT CONSIDERATION WHEN DESIGNING THE FLUID THERAPY FOR GI DISEASE
FLUID THERAPY FOR GI DISEASE

5. – Non‐strangulating obstructions
• IV fluid therapy for systemic rehydration
• Enteral rehydration has added advantage over IV
– NaCl 28 g, NaHCO3 17 g, KCl 3 g in 5 Ltr of warm water
– Functional obstructions (duodenitis / proximal
jejunitis) DPJ
• Enteral therapy not advised due to inability of int to take load
• Correction should be take into account
– Deficits - percent dehydration × body weight in kg
– Maintenance requirements - 2–3 mL/kg/h
– Ongoing losses (nasogastric reflux volume)
FLUID THERAPY FOR GI DISEASE

6. • Strangulating obstructions
– Strangulating obstructive - ischemia of a segment
of small or large intestine
– Hypertonic saline solution (7.2–7.5% sodium
chloride) should be administered in the acute
strangulating obstructive colic patient when signs
of shock with inadequate tissue perfusion are
present.
– The volume administered is 2–6 mL/kg and it has
approximately eight times the tonicity of plasma
FLUID THERAPY FOR GI DISEASE

7. • Colitis
– Disease of intestinal dysbiosis, rather than a result
of the overgrowth of an individual pathogen
• The first priority in acute colitis is to stabilize the
patient hemodynamically with fluid and electrolyte
therapy.
• Acid base balance maintenance
FLUID THERAPY FOR GI DISEASE