Ch 5: Fluids

Question 1

Water constitutes what percentage of body weight in a normal dog or cat?

Answer 1

60%

Question 2

What is the water distribution in a pet?

Answer 2

1. intracellular 2/3 total body water (40%)
2. Extracellular 1/3 total body water (20%)

Question 3

In intracellular compartment, waht is the major anion and cation?

Answer 3

Cation K
anion PO4

Question 4

What is the major cation and anion in extracellular fluid?

Answer 4

Cation- Na
Anion, CL- and HCO3

Question 5

What are the subdivisions of the extracellular space?

Answer 5

Plasma 25% of ESF (intravascular)
Interstitial (extravascular) 75%

Question 6

What is the osmolality of the intracellular and xtracellular compartment?

Answer 6

290-310mOsm/L

Question 7

What are the signs of intravascular volume deficits?

Answer 7

compensatory vasoconstriction
pale MM
poor pulse quality
tachycardia
prolonged CRT
cold extremities

Question 8

What detectable abnormalities will you see with a patient that is <5% dehydrated

Answer 8

None

Question 9

What detectable abnormalities will you see with a patient that is 5-8% dehydrated

Answer 9

decreased skin turgor, dry MM

Question 10

What detectable abnormalities will you see with a patient that is 8-10% dehydrated

Answer 10

decreased skin turgor, dry MM, sunken in eyes, slight prolongation of CRT

Question 11

What detectable abnormalities will you see with a patient that is 10-12% dehydrated

Answer 11

severe skin tenting, prolonged CRT, dry mm, sunken orbits, possible signs of shock

Question 12

what signs are seen if patient is >12% dehydrated

Answer 12

all the signs from below but also shock, often life threatening

Question 13

What are replacement fluids?

Answer 13

Isotonic. Those w/ electrolyte composition similar to ECF
1. 0.9% NaCl
2. LRS
3. plasmalyte
4. Norm R

Question 14

What are maintenance crystalloids?

Answer 14

Hypotonic, contain less Na (40-60 meq/L) and more K (15-30 meq/L) than replacement fluids
1. 0.45% Nacl
2. 0.45% NaCl + 2.5% dextrose
3. plasma-lyte 56
4. plasmalyte _ dextrose
5. Norm M with 5% dextrose
6. 5% dextrose in water

Question 15

What is the purpose of isotonic fluid?

Answer 15

to expand IV space and interstial space and maintain hydration.

Question 16

Following administration of isotonic fluid, how logn does it take for them to pass between IV and intestitial space and by what percentage

Answer 16

20-30 min
extracellular fluid expants by 75%, intracellular by 25%

Question 17

What patients would benefit from 0.9% NaCl

Answer 17

animals with hypochloremic, hyponatremic, or hypochloremi metabolic alkalosis

Question 18

If you have abnormal Na concentration, how much can you increase and decrease your Na by / hr

Answer 18

0.5mEq/L/hr (increase)
1meq/L/hr decrease

Question 19

What is the Osm, Na, K, Cl, Ca, Lactate, acetate, gluconate for 0.9%NaCl

Answer 19

Osm 308, Na 154, Cl 154

Question 20

What is the Osm, Na, K, Cl, Ca, Lactate, acetate, gluconate for LRS

Answer 20

273 oSM, Na 130, K 3, Cl 109, Ca 3, Lactate 28,

Question 21

What is the Osm, Na, K, Cl, Ca, Lactate, acetate, gluconate for P-lyte and Norm-R

Answer 21

OSM 295, Na 140, K 5, Cl98, Acetate 27, Glyconate 23

Question 22

What is the Osm, Na, K, Cl, Ca, Lactate, acetate, gluconate for 7.5%NaCl

Answer 22

Osm 2400, Na 1200, Cl 1200

Question 22

How long is the intravascular volume expansion from hypertonic?

Answer 22

<30 min

Question 23

What do synthetic colloids do?

Answer 23

large molecular weight >20k daltons
they increase colloids osmotic pressure of plasma making it hyperoncotic to extravascular fluid

Question 24

What is hydroxyethyl stratches

Answer 24

made from wide size range of amylopectin polymers Lower weight average molecular weight (130 kDa) thought to be more rapidly cleared and minimize contact with factor VIII and von Willebrand factor, leading to less coagulopathies

Question 25

What is the side effect of giving hypertonic saline too fast?

Answer 25

Rates >1 ml/kg/min → osmotic stimulation of pulmonary C fibers → vagal hypotension, bradycardia, bronchoconstriction If given in small peripheral vessel → hemolysis and phlebitis, central admin is recommended

Question 26

What effect does hypertonic saline have on bicarb on K

Answer 26

decreases bicarb and K due to dilution and osmotic diuresis

Question 27

How do colloids affect clotting?

Answer 27

Disruption of normal coagulation, causing coagulopathy → depleted factor VIII and vWF, impairment of platelet function, interference with stability fibrin clots (increased fibrinolysis)

Question 28

What is the prbc dose?

Answer 28

VT= BW x blood volume x [(desired PCV– current PCV)/donor PCV)] Blood volume 90ml/kg in dogs, 50ml/kg in cats Other formula: Vol(ml) = 1.5 x desired PCV x kg BW

Question 29

What is the HCT of pRBC

Answer 29

80%

Question 30

What is FFP?

Answer 30

plasma that is frozen w/in 6 mo of collection and stored less than a year Store at -20C for a year

Question 31

What is frozen plasma?

Answer 31

Stored for >1yr and no longer contains labile clotting factors V, VIII, VWF, fibrinogen -20C for up to 4 yrs

Question 32

What is the components of cryoprecepitate

Answer 32

VIII, VWF, fibronectin, fibrinogen -20C for up to a year | No factor VII

Question 33

What is in PRP

Answer 33

platelets store at 22C for 5 days

Question 34

What happens if you give a Type A cat B blood and vice versa

Answer 34

Type A cat given B blood: decreased RBC lifespan (2 day). Have large quantities of Anti-b antibodies Type A blood given to B cat: death (RBC lifespan is 1 hr). Type B cats have strongly occuring anti- A antibodies

Question 35

How many dog blood types?

Answer 35

8, Donor should DEA 1.1 and 1.7 negative

Question 36

What is considered hyponatremia in a dog and cat

Answer 36

Dog <140 Cat <149

Question 37

How should chronic hyponatremia be corrected and why?

Answer 37

0.5meq/L/h because it could result in acute demyelination syndrom aka central pontine myelenosis

Question 38

What is considered hypernatremia in cats vs dog

Answer 38

cats >160 dog >150

Question 39

What is the calculation for correction of Na deficit with free water in hypernatremia?

Answer 39

Question 40

What are the corrected Cl Formulas?

Answer 40

Question 41

How do you calculate the amount of bicarbonate required to return base deficit to 0

Answer 41

Question 42

What is the normal AG for a dog versus a cat?

Answer 42

Dog 11-26 Cat 13-27