INS AND OUTS OF FOAL FLUID THERAPY PAMELA WILKINS, DVM, MS, PHD, DACVIM-LA, DACVECC University of Illinois, Champaign-Urbana IL USA
In this VETgirl online large animal veterinary CE webinar, Dr. Pamela Wilkins, DVM, MS, PhD, DACVIM (Large Animal), DACVECC, reviewed fluid therapy in foals – what’s new and should we still be reaching for crystalloids?
KEY HIGHLIGHTS
The clinician managing critically ill neonates must recognize that intravenous fluid therapy simply cannot be scaled down from adult management approaches. Fluid management of the ill neonate, particularly over the first few days of life, must take into consideration that the neonate is undergoing a large transition from the fetal to the neonatal state and that important physiologic changes are taking place. These transitions include shifts in renal handling of free water and sodium and increased insensible losses because of evaporation from the body surface area and the respiratory tract. The newborn kidney has a limited ability to excrete excess free water and sodium, and the barrier between the vascular and interstitial space is more porous than that of adults. Water and sodium overload, particularly in the first few days of life, can have disastrous long- term consequences for the neonate. 1 EXCESS FLUID ADMINSTRATION In the ill equine neonate, excess fluid administration frequently manifests as generalized edema formation and excessive weight gain, frequently equivalent to the volume of excess fluid administered intravenously. In cases in which antidiuretic hormone secretion is inappropriate, as in some foals with PAS, generalized edema may not form, but the excess free water is maintained in the vascular space. This
more than 24 hours of age on a milk diet. If measured, serum osmolarity is less than urine osmolarity. The treatment for this disorder is fluid restriction until weight loss occurs, electrolyte abnormalities normalize, and urine concentration decreases. If the clinician is unaware of this differential diagnosis, the neonate can be assumed mistakenly to be in renal failure, and the condition can be exacerbated by excessive intravenous fluid administration in an attempt to produce diuresis. (continued)
syndrome of inappropriate anti diuretic hormone secretion is recognized in the foal that gains excessive weight not manifested as edema generally, with decreased urine output and electrolyte abnormalities such as hyponatremia and hypochloremia. The foal manifests neurologic abnormalities associated with hyponatremia. The plasma or serum creatinine concentration varies in these cases, but urine always is concentrated compared with the normally dilute, copious amounts of urine produced by foals
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