Fluid therapy

Question 1

How could fluid be lost via sick animals?

Answer 1

• Vomit
• Reflux
• Diarrhoea
• Blood loss
• Discharge

Question 2

What are the normal PCV values for cats, dogs and rabbits?

Answer 2

Cats = 24 - 45%
Dogs = 37 - 55%
Rabbits = 36 - 48%

Question 3

What are the normal total protein values for cats and dogs?

Answer 3

Cats = 60 - 80g/litre
Dogs = 50-70g/litre

Question 4

What indications are there for fluid therapy?

Answer 4

• Maintenance of patient unable to eat/drink
• Replace fluid losses that have been removed by disease
• Correct dehydration
• Correct electrolyte imbalances
• Provide circulatory support for shock patient
• Assist removing toxins
• Cooling/warming patient

Question 5

How do you calculate total volume requirement using

1. The deficit
2. Maintenance requirements
3. Additional ongoing losses?

Answer 5

1. Fluid deficit (mls) = % dehydration x bodyweight (kg) x 10
2. Maintenance requirement = 50ml x bodyweight (kg) / 24 hours
3. Additional ongoing losses (if present) mls = 4ml x bodyweight (kg) x episodes

Question 6

What calculation can be done for hypovolaemic shock?

Answer 6

Initial rate of up to 20mls/kg/hr (10ml/kg/hr in cats)

-DO NOT EXCEED 1 HOUR

Question 7

What calculation can be done for anaesthesia support in a healthy patient?

Answer 7

10ml/kg/hr

Question 8

What indications may there be to do a blood transfusion?

Answer 8

• Hypovolaemic shock (Acute & severe blood loss)
• Anaemia
• Clotting disorders eg. severe thrombocytopenia (low number of platelets), anticoagulant rodenticide intoxication, DIC (deceminated intravascular coagulation = random clots around the body)

Question 9

What indications may there be for a plasma transfusion?

Answer 9

• Albumin loss (main plasma protein in blood, malabsorption disorder and leaking albumin)
• Intravascular volume expansion
• Some clotting disorders

Question 10

What circumstances are blood typing and cross matching necessary?

Answer 10

• Known to have a previous blood transfusion (more than 4-7 days ago)
• Unknown transfusion history
• History of transfusion reaction
• Previously had more than one pregnancies
• All cats

Question 11

What is checked with blood when cross matching?

Answer 11

• Testing for micro and macro agglutination (are RBC’s clumping together) and haemolysis (check if RBC’s have burst)
• Check colour on slide (if yellow = normal, if red = RBC’s have burst

Question 12

What is essential for a general blood donor?

Answer 12

• Healthy
• Vaccinated (not recently)
• Not pregnant
• Good age (1-8 years), weight (cats = 4.5kg+, dogs = 25kg+) and PCV (cats = >35%, dogs = >40%)

Question 13

Explain how a blood sample must be collected for a blood transfusion

Answer 13

• Taken from jugular vein
• Sterile prep and clean stick required
• Collected into a prepared blood collection bag
• Collection bad will either contain Acid citrate dextrose (ACD) or citrate phosphate dextrose (CPD)
• Weigh to correct amount (too little = possible anticoagulant poisoning, too much = possible clotting)
• Gently rock bag to mix with anticoagulant

Question 14

How long can blood be stored for blood transfusions and why?

Answer 14

• Ideally use within 6 hours to reduce inactivation of platelets and clotting factors and risk of bacterial growth
• ACD anticoagulant may be stored at 1-6*C for 21 days
• CPD anticoagulant may be stored at 1-6*C for 28 days
• Packed RBC’s (plasma removed) can be stored at 1-6*C for 21 days (up to 42 days ion additive been used)

Question 15

What is the calculation for the volume of blood that can be transfused to cats and dogs?

Answer 15

Cats = 10-15mls/kg
Dogs = 20mls/kg

Question 16

How should blood be transfused for the first 10-15 minutes?

Answer 16

SLOWLY at 0.1ml/kg

Question 17

How must plasma be stored for transfusion?

Answer 17

• Freeze within 8 hours of collection

- Frozen at -30*C for up to 12 months

Question 18

What are some clinical signs that may be seen for a transfusion reaction?

Answer 18

• Drop in PCV
• Tachycardia
• Tachypnoea
• CRT >2s
• Hypotension
• Weakness and collapse
• Vocalisation
• Pyrexia
• Emesis
• Muscle tremors and seizures
• Restlessness and irritability
• Urticaria

Question 19

What treatment can be done for a patient with a transfusion reaction?

Answer 19

• Stop transfusion immediately
• IV catheter aspirated to get rid of residual before administering treatment]
• Mild allergic reactions = corticosteroids and/or antihistamines
• Severe reactions = aggressive IVFT, adrenaline, antihistamines, corticosteroids, O2 therapy