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Fluid therapy in small ruminants (Proceedings)
Information on fluid therapy in sheep, goats, llamas, alpacas, crias, and lambs.
Basics
Catheters
Adult sheep/goats/llamas/alpacas and crias: 16 G 3.25" in jugular
Kids/lambs: 18G 2" in jugular
Intraosseous in neonates if can't get catheter in
Always make stab incision completely through skin with #15 blade, will save time and catheters
Dehydration deficit
BW(kg) x %dehydration = deficit in liters (careful with small ruminants)
ex. 40 goat that 8% dehydrated needs 40 x .08 = 3.2 L
Maintenance
1 ml/lb/hr
Bicarb deficit
Neonate: BW(kg) x base deficit x .6 = mEq bicarb
Adult: BW(kg) x base deficit x .3 = mEq bicarb
Can substitute (normal bicarb - measured bicarb) for BD
mEq bicarb/12 = grams bicarb
Lambs and Kids
Following dystocia
(may look normal initially, but crash 2-4 hours later, be aggressive in therapy)
If depressed: Measure bicarb and correct deficit or use BD of 10
Consider SoluDelta-Dortef (1 mg/lb)
Consider oxygen even if no respiratory difficulty and normal color
Dehydrated non-diarrheic (septic, hasn't nursed, etc.):
May be hypoglycemic
If < 8 % dehydrated, mild depression, still walking:
150-250 mls oral calf electrolytes without bicarb
If > 8% dehydrated, depressed, recumbent:
Correct fluid deficit with balanced electrolyte solution
Add: 20 mEq KCl/L and 20-40 mls 50% dextrose/L (will = 1-2% dextrose in solution)
OR
4 ml/kg hypertonic saline solution (administer over 5 min) followed by oral calf electrolytes without bicarb
- if no response consider acidosis and treat like dystocia above
- may need more glucose if severe hypoglycemia
- follow up with milk
Diarrhea:
dehydrated, acidotic, hyperkalemic, whole body depleted in K+ (not usually hypoglycemic)
For deficit:
If < 8 % dehydrated, mild depression, still walking:
150-250 mls calf electrolytes without bicarb (if available, if not use with bicarb)
If > 8% dehydrated, depressed, recumbent:
bicarb: calculate bicarb needs if blood work available or use BD of 10
8% bicarb = 1 mEq/ml
fluid: make up fluid deficit with balanced electrolyte solution
add: 20 mEq KCl/L and 20-40 mls 50% dextrose/L (will = 1-2% dextrose in solution)
give half first hour then other half over 2 hours
OR
4 ml/kg hypertonic saline solution (administer over 5 min) followed by oral calf electrolytes with bicarb
(do not use HSS if suspect mixing error of oral electrolytes administered by owner)
- follow up with oral calf electrolytes without bicarb (if available, if not use with bicarb) per day as long as severe diarrhea continues
- leave on milk or milk/milk replacer unless chronic diarrhea and use of TPN
- always mix electrolytes according to directions with water, not milk
- always refrigerate calf electrolytes that go unused and discard after 3 days
Adults
usually alkalotic, mild hypokalemia, mild hypocalcemia
If < 8 % dehydrated, mild depression, still walking:
correct deficit with oral fluids unless rumen disease or GI obstruction
can add KCL and calcium gel to oral fluids
If > 8% dehydrated, depressed, recumbent:
IV isotonic fluids with 20 mEq KCl/L and calcium solution at 25-50 ml/L
OR
- 4 ml/kg hypertonic saline solution (~ 2 L per adult cow) administer as fast as possible through 14 G catheter
- follow with oral fluids (will usually drink following HSS) if no GI disease or IV if GI disease
If grain overload:
- calculate bicarb deficit if blood work available or use BD of 10 and administer IV
- follow up with IV fluids (do not give large amounts of oral fluids, already have rumen distension)
- can give some bicarb orally but probably no use if severe (need rumenotomy)
- DO NOT USE hypertonic saline solution (may be already hyperosmolar)
Llamas/Alpacas
- unpredictable electrolyte and acid/base status so always run bloodwork, esp. in crias
- adults get fatty liver commonly when off feed so consider PPN if anorexic for more than a few days
- camelids get hypoproteinemic easily
TPN/PPN
- use formula in back of Smith Large Animal Internal Medicine
- for neonates use TPN
- for adults use PPN since fatty liver is a concern if negative energy balance (just leave out lipids in formula)
- start at 1/4 target rate (in Smith under formula), if glucose 150-200 in six hours leave at current rate, if > 200, slow rate slightly, if < 150, increase rate by another 1/4 (these are basic rules, try not to change rate drastically and give them time for insulin to increase
- keep increasing until get to target rate (I have never gotten to target rate, but always see benefits even at low rate)
- monitor glucose/PCV/TP q 6 hours, electrolytes/acid/base status daily (watch out for hypokalemia)
- wean off slowly
- MUST BE administered with fluid pump
OR
- for adults
- 5L normosol + 500 ml 50% Dextrose + 1 Liter Aminosyn + K and Ca as needed + 20 ml B vitamins at rate of 5% body weight per day
Insulin is recommended in camelids with TPN or above fluid regimen (0.4 u/kg ultralente SQ q24hrs). Stop insulin 24 hours before stopping fluids.
Tips
If on continuous fluids consider bolusing q 3 hours. (have better control of rate in animals with long necks and thick skin that cause kinking of catheters)
NOT appropriate if glucose content is > 2% or for PPN/TPN
- 1 level teaspoon is approximately 5 grams of most salts
- NaHCO3: 1 gm = 12 mEq so 240 mEq = 20 grams or ~ 4 tsp.
- Isotonic saline: 9gms/L non-iodized table salt,
- 2 tsp NaCl/L water is isotonic saline
- Supplement potassium:10-20mEq/L or 1gm/L(14mEq/L)
- half a tsp. lite salt/L water (lite salt is half sodium chloride and half potassium chloride)