Fluid Therapy in your veterinary practice: Twice maintenance just isn't good enough!

Fluid therapy is a topic that sometimes gets overlooked by veterinarians,

This is partly because there is a misconception that developing fluid plans can be very difficult. However, if you keep it simple, you can develop a tailored fluid therapy plan for your patient that is much better than a blanket ‘twice maintenance’ rate.

4 Basic components to think about...

There are 4 basic components to a fluid therapy plan that you need to think about:

• Perfusion deficit
• Hydration deficit
• Maintenance requirements
• Ongoing losses

1. Perfusion deficit

Perfusion deficits need to be corrected immediately. Start with a 10mls/kg IV fluid bolus of buffered crystalloids and repeat as necessary to shock volumes (60mls/kg for cats, 90mls/kg for dogs) until clinical parameters improve.

2. Hydration deficit

Once you have corrected your perfusion deficits, then you start correcting dehydration deficits. Correction of dehydration is generally done over a course of 24 hours.

3. Maintenance requirements

Maintenance requirements are fairly standard and formulas are readily available in many sources.

4. Ongoing losses

Determining ongoing losses can be a bit tricky, but you need to try your best to include this in the fluid plan. Patients that are vomiting, have diarrhoea, polyuric etc, will need extra fluid to cover for ongoing losses. These losses can be measured – by weighing the faeces, weighing absorbent bedding if the patient has urinated on it, or by rough estimation.

So when taking these 4 components of a fluid therapy plan into account, you will soon see that twice maintenance is not enough!

The final and most important part of every fluid therapy plan is reassessment.

Reassess your patient every couple of hours to determine if your plan is appropriate and adjust accordingly.

Any questions for Gerardo? Ask them in the Comments section below...

This post originally appeared on Dr Poli's Blog on the 'miniVET guide Companion Animal Medicine' website and has been reproduced with full permission.

About Gerardo

Dr Gerardo Poli is an emergency and critical care veterinarian and company Director at Animal Emergency Services.  He has a strong focus in the triage, stabilisation and management of critically ill patients, small animal ultrasound and radiology and emergency surgery.

He is the author of The Mini Vet Guide To Companion Animal Medicine; a pocket sized, quick-reference guide designed to help veterinary students through their final years of vet school and also for recently graduated veterinarian making the transition into vet clinical practice. 

Find out more about The MiniVet Guide to Companion Animal Medicine by visitng the website: www.minivetguide.com

Or visit the Facebook Page: www.facebook.com/DrGerardoPoli

You can also find out more about the Animal Emergency Service in Brisbane here: www.animalemergencyservice.com.au