The Veterinary clinics of North America. Small animal practice
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Vet. Clin. North Am. Small Anim. Pract. · May 2008
ReviewMaintaining fluid and electrolyte balance in heart failure.
Advanced heart failure and its treatment are often associated with a variety of hemodynamic, fluid, and electrolyte derangements. This article gives the practitioner an overview of the pathophysiology of common fluid and electrolyte alterations present in animals with heart failure, highlighting specific clinical correlates. Additionally, specific therapeutic interventions are discussed to manage these fluid and electrolyte abnormalities.
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Vet. Clin. North Am. Small Anim. Pract. · May 2008
ReviewFluid therapy: options and rational administration.
Fluid administration is a primary component of therapy in many small animal patients. Several different classes of fluid may be given, and there are multiple options within each class. ⋯ Monitoring vital parameters and bedside monitoring of laboratory variables allow assessment of fluid therapy success or failure. Successful fluid administration also requires that parenteral fluid therapy ultimately be discontinued with minimal adverse effects for the patient.
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Colloids are increasingly becoming considered indispensable in the management of critically ill patients. Typical indications for colloid administration include patients with tissue edema, hypovolemia, and low oncotic pressure. ⋯ Newer colloids have been modified to limit effects on the coagulation system, and they may be used to modulate the inflammatory response, which could prove to be particularly useful in the management of critically ill patients. A better understanding of how different fluids influence the host response may enable us to explore new applications of fluid replacement therapy beyond simply replenishing volume deficits.
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The intravenous administration of fluids is one of the most important aspects of patient care in hospitalized animals. Intravenous fluids are administered to replace or prevent dehydration, treat hypovolemic shock and intravascular volume depletion, correct acid-base and electrolyte abnormalities, and maintain vascular access for administration of drugs, blood product components, and parenteral nutrition. Intravenous catheterization also can provide a means of blood sample collection, thus avoiding frequent and uncomfortable venipunctures in critically ill animals. Although the benefits of intravenous catheterization and fluid administration are numerous, inherent risks are associated with the procedures, and care must be taken to avoid potential complications.
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Vet. Clin. North Am. Small Anim. Pract. · May 2008
ReviewManaging fluid and electrolyte disorders in renal failure.
Because of the role of the kidneys in maintaining homeostasis in the body, kidney failure leads to derangements of fluid, electrolyte, and acid-base balance. The most effective therapy of a uremic crisis is careful management of fluid balance, which involves thoughtful assessment of hydration, a fluid treatment plan personalized for the specific patient, repeated and frequent reassessment of fluid and electrolyte balance, and appropriate changes in the treatment plan in response to the rapidly changing clinical situation of the patient that has renal failure. Disorders of sodium, chloride, potassium, calcium, and phosphorus are commonly encountered in renal failure and may be life threatening. Treatment of metabolic acidosis and nutritional support are frequently needed.