How Are the Etiologies of Shock Treated?

August 10, 2018

Andrew Linklater, DVM, DACVECC of Lakeshore Veterinary Specialists talks about how the 4 etiologies of shock are treated.

Andrew Linklater, DVM, DACVECC of Lakeshore Veterinary Specialists talks about how the 4 etiologies of shock are treated.

"So each etiology of shock is treated a little bit differently. The most common one that we see is going to be hypovolemic shock, so the body has lost fluid and we need to replace it. It's just a simple thing to identify and recognize—it becomes complex when we're talking about doses of medications— but generally, we're talking about boluses or rapid intravenous infusions of relatively large volumes of fluid, whether they're crystalloids or colloid or both. Sometimes if it's a patient in hemorrhagic shock we might add blood products to that as well, but we're giving a bolus of fluids and then reassessing our patient. So usually we're giving either a small or a large volume of fluid in a short period of time and then reassessing our patient. And that can be repeated several times while we're investigating what got them into this situation in the first place, doing some diagnostic tests that sort of thing so generally the hypovolemic etiology of shock is going to be our most common.

When we talk about some of the other etiologies of shock, like vasogenic or distributive, often those patients do have diseases that led them to lose volume so we give them fluids, but sometimes we might need to add vasopressors on top of that if they're just not responding. With cardiogenic shock, usually we need to, if it's a pericardial effusion, we tap it and remove the fluid or if they're having an arrhythmia from that or poor contractility from dilated cardiomyopathy we need to treat that as well. And finally obstructive shock. And again there's some sort of obstruction that's causing the intravascular fluid to not be where it should be. So a pericardial effusion, we tap that fluid from around the heart and remove it. Or a GDV we do a gastrocentesis and remove that fluid to allow that blood to flow through the vena cava."