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Just found this:
http://veterinarycalendar.dvm360.com/emergency-medicine-birds-proceedings?rel=canonical
Fluid therapy—When planning fluid therapy always take into account blood loss, dehydration and shock. Blood loss or volume depletion can result from a variety of disease conditions such as blood feather damage, trauma, GI bleeding, and/or bone marrow suppression. Likewise, dehydration and shock can result from not only hemorrhage or trauma but from a multitude of acute or chronic systemic illnesses. Dehydration results from decreased fluid intake or increased fluid losses with or without the presence of systemic illness.1 Shock is the clinical state resulting from an inadequate supply of oxygen to tissues or the inability of the tissues to properly utilize oxygen and shock may result from hypovolemia, hypoxemia, septicemia/endotoxemia, trauma, anesthesia, anaphylaxis, cardiac disease/failure, systemic illness, etc.2 Patients in or at high risk of shock may benefit from large volume fluid expansion. An IV bolus of fluids (10 ml/kg slowly) to maintain blood pressure, circulation and oxygenation of peripheral tissues is well tolerated in birds with few untoward effects (e.g. pulmonary edema, coughing, dyspnea, ascites, polyuria, diarrhea, and relative anemia).1
Assessing Hydration Status—Estimate hydration status using the signalment (dehydration is more severe in juvenile birds) presenting clinical signs, history and physical examination. Turgescence, filling time and luminal volume of the basilic artery and vein, skin turgor on the dorsal aspect of the feet, sunken appearance to the eyes, tacky mucous membranes, decreased skin elasticity on the dorsal aspect of the metatarsus, and increased heart rate are findings that suggest dehydration to varying degrees. An objective method for assessing hydration status is to obtain a PCV and total protein. It is reasonable to suggest that most critically ill patients are dehydrated to some degree and possibly hypovolemic. In most instances mild to moderately ill birds are assumed to be approximately 5 % dehydrated while severely ill birds are assumed to be approximately 8-10% (or greater) dehydrated.
Fluid Administration—The goal of fluid therapy should be to replace fluid deficits and maintain hydration status as the patient recuperates. Fluids should always be warmed (~104 °F) prior to administration. The daily maintenance fluid requirements for birds has been estimated at 50-60 ml/kg/day (depending upon the species). The fluid deficit is calculated by multiplying the normal body weight in grams by the estimated percent of dehydration to obtain the milliliters of fluid required. The deficit should then be replaced over 24 hours (or sooner) while maintenance requirements are met at the same time. The clinician should also take into account ongoing fluid losses when determining fluid requirements. Hetastarch (10-15ml IV or IO slowly every 6-8 hours for 1-4 treatments) in conjunction with isotonic crystalloids ( the volume is reduced to 40-60% of normal requirements) is recommended for the treatment of hypovolemia when plasma volume expansion is desired.1 Hetastarch is contraindicated in patients with anuric or oliguric renal disease not associated with hypovolemia, congestive heart failure or in any situation where volume overload is a potential problem.
Calculation of Fluid Requirements—Example: Yellow-naped Amazon parrot
Normal weight = 500 g, estimate 8% dehydrated and with diarrhea:
Maintenance fluid required = 50 ml/kg x 0.5 kg = 25 ml; replace in first 24 hours or sooner
Fluid deficit = 500 g x 0.08 = 40 ml; deficit replaced in first 24 hours
Ongoing losses (2%) = 500g x 0.02 = 10ml; replace in first 24 hours
Routes of Fluid Administration— Fluids may be given intravenously, intraosseously, orally, and subcutaneously. The route of fluid administration should be based upon the clinical disorder, its severity and duration. Oral fluid therapy is useful for patients that are mildly dehydrated. Advantages include ease of rapid administration and low cost. However, fluids given this route tend to absorb slowly and are not appropriate for patients with gastrointestinal disorders, sudden or marked fluid loss, CNS disease or inability to stand. Subcutaneous fluids are also quick and easy to administer. However, this route is not recommended for moderately or severely dehydrated patients, because peripheral vasoconstriction may significantly reduce absorption, and only non-irritating isotonic fluids are appropriate. Sites for subcutaneous administration include the inguinal (inguen) region and interscapular regions. Intravenous and intraosseous (IO) routes are the preferred route when fluid loss is severe or sudden. Advantages of these routes are that they are fast, precise, and allow the use of hypertonic fluids. Disadvantages are time limitations, pain (IO) and available catheter sites and other complications (phlebitis, thrombophlebitis, local infection and removal by the patient) Sites for intravenous fluid administration include the jugular veins, basilic veins, and the medial metatarsal veins. Sites for intraosseous administration include the distal ulna and the proximal tibiotarsus.
Fluid Choice—The fluid of choice is one that best approximates the fluid lost; this most often is Lactated Ringer's Solution (LRS) or Normosol-R with or without dextrose (2.5%). Repeated assessment of the patient following fluid administration should include a physical examination (assess hydrations status), auscultation of the heart and lungs, PCV and total protein and the patient's weight.
-Kathy
http://veterinarycalendar.dvm360.com/emergency-medicine-birds-proceedings?rel=canonical
Fluid therapy—When planning fluid therapy always take into account blood loss, dehydration and shock. Blood loss or volume depletion can result from a variety of disease conditions such as blood feather damage, trauma, GI bleeding, and/or bone marrow suppression. Likewise, dehydration and shock can result from not only hemorrhage or trauma but from a multitude of acute or chronic systemic illnesses. Dehydration results from decreased fluid intake or increased fluid losses with or without the presence of systemic illness.1 Shock is the clinical state resulting from an inadequate supply of oxygen to tissues or the inability of the tissues to properly utilize oxygen and shock may result from hypovolemia, hypoxemia, septicemia/endotoxemia, trauma, anesthesia, anaphylaxis, cardiac disease/failure, systemic illness, etc.2 Patients in or at high risk of shock may benefit from large volume fluid expansion. An IV bolus of fluids (10 ml/kg slowly) to maintain blood pressure, circulation and oxygenation of peripheral tissues is well tolerated in birds with few untoward effects (e.g. pulmonary edema, coughing, dyspnea, ascites, polyuria, diarrhea, and relative anemia).1
Assessing Hydration Status—Estimate hydration status using the signalment (dehydration is more severe in juvenile birds) presenting clinical signs, history and physical examination. Turgescence, filling time and luminal volume of the basilic artery and vein, skin turgor on the dorsal aspect of the feet, sunken appearance to the eyes, tacky mucous membranes, decreased skin elasticity on the dorsal aspect of the metatarsus, and increased heart rate are findings that suggest dehydration to varying degrees. An objective method for assessing hydration status is to obtain a PCV and total protein. It is reasonable to suggest that most critically ill patients are dehydrated to some degree and possibly hypovolemic. In most instances mild to moderately ill birds are assumed to be approximately 5 % dehydrated while severely ill birds are assumed to be approximately 8-10% (or greater) dehydrated.
Fluid Administration—The goal of fluid therapy should be to replace fluid deficits and maintain hydration status as the patient recuperates. Fluids should always be warmed (~104 °F) prior to administration. The daily maintenance fluid requirements for birds has been estimated at 50-60 ml/kg/day (depending upon the species). The fluid deficit is calculated by multiplying the normal body weight in grams by the estimated percent of dehydration to obtain the milliliters of fluid required. The deficit should then be replaced over 24 hours (or sooner) while maintenance requirements are met at the same time. The clinician should also take into account ongoing fluid losses when determining fluid requirements. Hetastarch (10-15ml IV or IO slowly every 6-8 hours for 1-4 treatments) in conjunction with isotonic crystalloids ( the volume is reduced to 40-60% of normal requirements) is recommended for the treatment of hypovolemia when plasma volume expansion is desired.1 Hetastarch is contraindicated in patients with anuric or oliguric renal disease not associated with hypovolemia, congestive heart failure or in any situation where volume overload is a potential problem.
Calculation of Fluid Requirements—Example: Yellow-naped Amazon parrot
Normal weight = 500 g, estimate 8% dehydrated and with diarrhea:
Maintenance fluid required = 50 ml/kg x 0.5 kg = 25 ml; replace in first 24 hours or sooner
Fluid deficit = 500 g x 0.08 = 40 ml; deficit replaced in first 24 hours
Ongoing losses (2%) = 500g x 0.02 = 10ml; replace in first 24 hours
Routes of Fluid Administration— Fluids may be given intravenously, intraosseously, orally, and subcutaneously. The route of fluid administration should be based upon the clinical disorder, its severity and duration. Oral fluid therapy is useful for patients that are mildly dehydrated. Advantages include ease of rapid administration and low cost. However, fluids given this route tend to absorb slowly and are not appropriate for patients with gastrointestinal disorders, sudden or marked fluid loss, CNS disease or inability to stand. Subcutaneous fluids are also quick and easy to administer. However, this route is not recommended for moderately or severely dehydrated patients, because peripheral vasoconstriction may significantly reduce absorption, and only non-irritating isotonic fluids are appropriate. Sites for subcutaneous administration include the inguinal (inguen) region and interscapular regions. Intravenous and intraosseous (IO) routes are the preferred route when fluid loss is severe or sudden. Advantages of these routes are that they are fast, precise, and allow the use of hypertonic fluids. Disadvantages are time limitations, pain (IO) and available catheter sites and other complications (phlebitis, thrombophlebitis, local infection and removal by the patient) Sites for intravenous fluid administration include the jugular veins, basilic veins, and the medial metatarsal veins. Sites for intraosseous administration include the distal ulna and the proximal tibiotarsus.
Fluid Choice—The fluid of choice is one that best approximates the fluid lost; this most often is Lactated Ringer's Solution (LRS) or Normosol-R with or without dextrose (2.5%). Repeated assessment of the patient following fluid administration should include a physical examination (assess hydrations status), auscultation of the heart and lungs, PCV and total protein and the patient's weight.
-Kathy
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