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17 Cards in this Set

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what is the difference between dehydration, hypovolemia, and hypovolemic shock?
dehydration is loss of fluid from ECF & ICF
Hypovolemia is loss from vasculature
Hypovolemic shock is loss of enough vascular fluid to cause inadequate oxygen delivery to tissues
Does the hypovolemic patient have to be dehydrated?
No. A patient with hemorrhage is hypovolemic without being dehydrated.
how will clinical signs differ between interstitial losses vs. hypovolemic?
dehydration causes prolonged skin tent, sunken eyes, dry mucous membranes.
hypovolemia causes increased heart rate, prolonged CRT, CNS depression, weak pulses
Give an example of a patient who may show clinical signs of only interstitial fluid losses
mild case of vomiting and diarrhea
Give an example of a patient who may show clinical signs of interstitial and vascular fluid losses
severe vomiting and diarrhea at around 8% total body water loss
How do we detect intracellular losses?
can not detect clinically but can be assumed to be severe when sodium levels are elevated
How is interstitial losses treated differently than hypovolemia when giving fluids?
dehydration losses are replaced slowly (it takes time for the fluid to leave vascular space and enter the intercellular space)
Hypovolemic losses can be replaced quickly and should be due to the potential for organ injury in cases of hypovolemic shock
What are the advantages for giving fluids IV
IV is the best way to administer fluids in cases of extended care due to severe dehydration and ongoing losses. Best in shock b/c if can be delievered QUICKLY
What are the advantages for giving fluids IO?
good if cannot obtain IV access- very small animals
Fast speed, good for dehydration and shock
What are the advantages for giving fluids SC?
good for small dehydration volumes in small animals but too slow to fill vascular volume in hypovolemic shock and hard to give enough in larger dogs without over distending skin
What are the advantages for giving fluids IP
good for dehydration losses but too slow for shock
When can we give fluids orally?
When patient is dehydrated and NOT vomiting. Too slow for shock
How would you administer fluids in a 10 kg vomiting dog that cannot drink water. The dog is estimated to be 5% dehydrated and is suspected to have 200ml of additional fluid loss above normal fluid losses every 24 hours.
need to address replacement deficit, maintenance, and ongoing losses
- replacement 5% x 10 kg = 500ml
- maintenance 60 x 10 = 600 ml/day
- ongoing losses = 200 ml
500+600+200 = 1300ml/day/24 = 54ml/hr
How would you give a 10 kg dog in hypovolemic shock fluids?
SHOCK RATE in dogs is 80-90 ml/kg/day so give 800 to 900 ml/hr. Given very quickly so intravascular space can be filled and oxygen delivery restored
why are sympathiomemitics not given in hypovolemic shock?
Normal sympathetic stimulation is activated in hemorrhagic shock and therefore further stimulation is not necessary and may lead to further problems such as excessive vasoconstriction to the GI
Why are steroids not recommended in hypovolemic shock as membrane stabilizers?
steroids will further decrease blood flow to the GIT and kidneys
What other procedures or tx may be helpful in hypovolemic shock in particular if it is hypovolemic shock due to bleeding (hemorrhagic shock)?
-surgery to stop bleeding
- blood transfusion to increase O2 carrying capacity
- careful not to give to much fluids in hemorrhagic shock prior to surgery as may disrupt clot formation. Just give enough fluids to return to normal.