2 Calculation of Fluid Deficit and Choice of Fluids

Transcript

Welcome back to Fluid therapy in the cattle.

In lesson 1, we have seen the distribution of fluid in the body and how to assess dehydration in the case of cattle and calves.

Now we are going to see lesson 2 in which we are going to see how to calculate the Fluid deficit and what are the choices of fluid we have to meet this dehydration.

Now the calculation of fluid requirement in the animal, there is a formula.

The fluid deficit in liters = the percentage of dehydration multiplied with bodyweight

= % dehydration * body weight

Now in this, we have got an example. Always when you solve with an example, it is best remembered in our mind. So we have solved 1 question practically. Please follow us. You can also solve it.

To calculate the Fluid deficit for a cow weighing 360 kg body weight and 10% dehydrated. In this problem we have 2 things in our hands already, what is called bodyweight 360 and there is a formula fluid in deficit required is the percentage of dehydration multiplied with body weight, so substituting the available things in the formula, namely the 10% and this 360 KG, so if we multiply, we get 36 liters, so 36 liters is the dehydration requirement in case of this cattle.

Body weight = 360 kgs

Fluid deficit in litres = % dehydration * body weight

= 10% * 360 = 10/100 * 360 = 36 litres

Substituting this in the water distribution, as we have seen in the last class, the total deficit is 36 liters, ECF is the total deficit multiplied by one-third. So substituting 36 multiplied with 1/3 is 12 liters. So ECF deficit is 12 letters.

Total deficit = 36 litres ECF = TD * 1/3 = 36 * 1/3 = 12 litres

Now please substitute this into the Plasma, what is Plasma?

Plasma is 1/4 of ECF, so 12 liters multiplied by one-fourth, we get 3 liters.

Plasma = ECF * 1/4 = 12 * 1/4 = 3 litres OR

Plasma = TD * 1/12 = 36 * 1/12 = 3 litres

We can also do the plasma estimation by 1/12th of the total deficit. So what is called 36 / 12 we get 3 liters.

Why we have estimated this because Plasma requirement has to be infused into the animal because that is the one which is reflecting the severe dehydration. So this is already lost. It needs immediate pumping into the animal. How fast you can do it to the animals, there is a chance of restoring the circulating volume. Now the plasma requirement that you have calculated is 3 liters. Please give this requirement immediately within a matter of half an hour to one hour. So with 50%, you have to give it in the first 6 hours, namely, the 9 liters and the remaining 24 hours kindly give in the remaining 12 to 24 hours, so that is a thumb rule. If it is an acute case, give it more rapidly. If it is a chronic case, give it slowly. Now here we are going to see how to calculate the bodyweight because the bodyweight forms an important thing in the percentage of dehydration calculation.

So we have got 4 methods;

1. one is by so formula, 2. another is by Android application, 3. another is a weight measuring tape, and 4. 4th is the weighing machine.

Let us see about the formula, which is the commonly used Shaffer’s formula. W = LG2 / 300 , where L is the length of the animal from point of shoulder to point of buttocks in inches, and G is the chest girth of the animal in inches.

(showing image in the slide) There is a beautiful photo in that which explains how to measure L and how to measure G. So substitute that in the formula. We will be able to get the animal’s body weight. So, there are different applications available in the Google Play Store. You can download any one of them which suits you in this. (showing image in the slide) We have shown the TANUVAS FEED CALCULATOR, where there is an app, which you can see which gives length and girth. So you measure using a tape and substitute that in this app. What you have to do is, you have to move that dot towards the measurement which you have taken in the L as well as in G. The bodyweight is immediately given by the app, with that you can substitute in the formula, percentage dehydration multiplied with bodyweight, that is how it is made very simple.

(showing image in the slide) This shows how to measure the body weight using tape, this tape is a beautiful application where if you are going to look into the tape it gives the bodyweight immediately and there are measurements in centimeters as well as inches. What you need to do is, take the tape and measure the chest girth, as soon as you measure, it gives in centimeters and inches, immediately by the side of it, there is a bodyweight. So, this is very much applicable in the case of the field where it gives spontaneous body weight, but you need to know this tape is specific for different breeds, maybe for a jersey, it has got the different tape and HF different tape, and indigenous cattle we have got a different tape.

Calculation of Total Fluid requirement: this fluid requirement we have got 3 components;

1. one is the Volume of Replacement, which you have calculated based upon your formula, 2. number 2 is the Volume required for the Maintenance of the animal, and 3. the 3 is the Volume of the Production requirement.

So you add up all three, which gives the total fluid requirement of the animal.

Now, this gives take-home points; these are all the thumb rules, please make a note of it.

• Each litter of milk produced requires one liter of water
• for every rise in environment temperature, body temperature 1 degree, we require about 4.5-5 liters of water on a per-day basis, the normal body temperature is in the range of 101.5 – 102.5 F, so if there is an increase in one-degree rise in the body temperature, you have to supplement a minimum of 4.25 liters, this is the thumb rule.

Now let us work out with an example; where we substitute the Fluid requirement in the case of a cattle with a temperature of 103.5 degrees Fahrenheit and milk yield of 5 liters. Now, as you substitute for the elevated temperature of 1 degree Fahrenheit, we have to give 5 liters of water, which is the requirement is 5 liters for milk production for every litter of milk we need one liter of water. So substituting in that, we get 5 liters, 5 liters= five-liter for the temperature. we get a total of 10 liters. This is over and above the maintenance and dehydration requirement. Now we are going to see the importance of fluid therapy in adults and how we are going to face it. Most likely it is dehydration and does not happen to be a shock unless it is a severe case of sepsis or a very severely decompromised disease. It is usually negative base, excess and mature cattle are always likely to be alkalotic except in certain diseases like acidosis or case of diarrhea. And many of the conditions diseased condition or disorder is accompanied by hypochloremia, hypokalemia, and please consider hypocalcemia, which is to substitute calcium. We are going to see the Routes of fluid administration; we’ve got 2 routes,

1. one is Parenteral Route and another is
2. the Enteral Oral Route.

When you consider Parenteral Route, IV is best and the replacement is immediate and more so in the case of neonates. In terms of the Enteral Oral Route, when the animal is not severely dehydrated, you can go for Enteral Oral Route, thinking the IV fluids are very costly. So first 4 to 6 hours, the corrective therapy is 100 to 150 ml/kg BW, and if it is for 20 to 24 hours, the maintenance therapy will be 60 to 150 ml/kg BW per 24 hours, you can give intravenous or oral.

Fluid therapy: here we are going to see the quantity, as we have taken from the percentage of dehydration. The rate of fluid therapy, if it is for routine, is 10 to 20 ml if it is a case of Crystalloid and in case of colloid, we are going to give at 5 to10 ml per kg body weight, this is when you are going to give as a routine.

But in case of a shock, the rate is different. For example, in the case of calves, 50-80 ml/kg IV you have to give and see that within 30 to 60 minutes the animal response. But the dose rate is different in the case of cattle which is 30 ml/kg/IV in the case of the first hour, so if you can increase the fluid rate, you can even go up to 50 ml, but the restriction should be in the IV set. In the normal IV set, we may not be able to reach even 30 ml/kg, that’s why the rate we have decided to give at 30 ml/kg.

This gives Rapid Intravenous(IV) fluid administration, which has been compromised by restriction of the rate of fluid by the routine Intravenous fluid is being overcome by rapid intravenous fluid administration.

(showing image in the slide)What is beautiful in this, here the diameter of the IV set is more and we are going to choose an intravenous needle or hypodermic needle to the extent of 14 gauge. So there will be a Rapid fluid administration, in which you can administer 50 ml/kg BW, that facilitates the fluid resuscitation therapy in case of shock.

(showing image in the slide) In this slide, we see a Buffalo receiving fluid therapy through Rapid Intravenous fluid administration, in the right slide you can see we have almost got 30 sachets of fluid, where the fluid goes very rapidly and the 500 ml of fluid takes roughly about 2 minutes 10 seconds. So you can imagine how much amount of time we can conserve.

Here we are going to see the Parenteral therapy, we have got the two fluids Crystalloid and Colloids.

Crystalloid: These are the solution that contains small particles that can easily go into the bloodstream to cells and also into the tissues. So these are used as maintenance.

Colloids: The colloids are the fluids that have got a larger molecular weight, which helps to retain the fluid within the circulating system.

Isotonic solution: These are called so because they have got 280-300 mOsm/liter and they are used for expanding circulating volume and replacing the actual fluid losses. These are the Routine fluids that we are going to use in our day-to-day life, namely the Normal Saline, which has got 0.9% sodium chloride(NaCl), again it is isotonic and provides sodium and chloride. The Ringer’s solution is again isotonic, it provides Sodium(Na+), Chloride(Cl-), Potassium(K+), and Calcium(Ca2+). Next is Ringer’s lactate solution, which is also isotonic, provides Sodium(Na+), Chloride(Cl-), Potassium(K+), Calcium(Ca2+) chloride, in addition it gives Lactate. Next is favorable which we are routinely using is DNS(Dextrose Normal Saline), which provides 0.9% sodium chloride and 5% dextrose. Again, it is isotonic.

Hypotonic solution: Here we have got 0.45% sodium chloride or have 0.25% sodium chloride. Here we’ve got 5% dextrose or 2.5% dextrose. These are called hypotonic solutions.

Hypertonic solutions: So these are to reestablish equilibrium in electrolytes and acid-base imbalances. In addition, we have got 10% dextrose, 5% protein hydrolysate, high electrolyte concentrates like 5 or 7.5% sodium bicarbonate, calcium gluconate, or calcium borogluconate. These are all hypertonic solutions, these are given very slowly and rapid infusion causes catastrophic changes.

Colloids: so as we discussed in the previous slides, Colloids are those solutions, which contain large molecules, help to retain the fluids within the bloodstreams. So these are used for plasma volume expanding and they require less volume and short time and even blood or albumin or hypertonic solutions or what is called colloids.

(showing image in the slide)This slide shows colloid, on the left side we have got Dextran and right side we have got Gelatin. These are commonly used as colloids.

So we have seen the Hydroxyethyl Starch on the left side and right side you got blood both are called colloids which we are using for Fluid therapy. Oral dehydration; Oral restoration of Cattle, so in substitute to parenteral administration, namely IV, we have to go through the oral route. For the oral route, we need to have the types of equipment namely, the infusion pump, the tube that connects the infusion pump, and the Rumen tube, and we need to have a Rumen tube that is firm and strong. After assembling this, then we can pass the Rumen tube into the mouth we take utmost precaution not to damage the esophagus, once it is in the Rumen, we can connect the pre-set infusion pump into the Rumen tube, then you can start pumping the fluids of maybe 20 to 25 liters into the Rumen and it hardly takes 3 to 5 minutes.

(showing image in the slide)Here on the left side, we have an infusion pump, which we have been using in larger, maybe the horse that can also be used in the case of cattle, the only thing it has to be suitably adapted and attached to the Rumen pump, then it becomes very easy so that you can use the same pump for cattle as well as horses.

Now have known how to give the oral solution, pumping into the Rumen, we need to know what is the ORS composition. The ORS for the adult and the Calf are different.

For the adult we use;

• Sodium chloride-160 gram,
• Potassium chloride-20 gram,
• Calcium chloride-10 gram,
• propylene Glycol-300 ml and
• mix it with 20 liters of Water,

and then you can pump through the Rumen pump.

Calf: so it is

• Sodium chloride- 4gram,
• Potassium chloride-1gram, in addition, we have got
• Sodium acetate-4gram,
• Dextrose-10gram,
• mix it in 8 liters of water.

This can be pumped into the case of cattle and One more ORS is available for cattle for routine maintenance, which is called standard. We have got 7 grams of Sodium chloride, 1.25 grams of Potassium chloride, 5 gram of Calcium chloride, please mix it with 1litre water and this is going to give you 120mmol of Sodium chloride, 16.8mmol of Potassium chloride, and 4.5mmol of calcium chloride making Osmolarity of 287 mOsm per liter. You may wonder how we can pump in 20-25 liters into the Rumen. please note that Rumen volume is 13%-17% of the body weight, so it can easily accommodate 50-65 liters in an Indian cattle, which weighs about 350kg to 400kg bodyweight.

(showing image in the slide) So this slide gives a beautiful ORS Composition for Rumen impaction. What is that? Magnesium oxide 500 gram, mix it with 5 liters of water, make it to the homogeneous solution and pump it into the animal. So in addition to maintaining or compensating the dehydration by IV Fluid, you will see that the animal passes on dung taking precaution that there is no mechanical obstruction. Here we are taking an example of a

For Bullock, which has not been passed dung for 6 days and an Anorectic rectal examination reveals Mucus and the absence of dung. So we have used this ORS impaction protocol, that is 500 grams Magnesia oxide with 5 liters of water and the animal passed dung.

(showing image in the slide)This slide shows left side is before treatment and the right side is after treatment for a Bullock with Rumen impaction.

For Calf, with less than 8% dehydration, you can go with ORS. With more than 8% dehydration it is a must, that you go fluid resuscitation with intravenous route. So less than 8%, we have got over his composition of 2.5-grams Sodium chloride, 1.5-gram Potassium chloride, 5-gram Sodium acetate, and 28-gram Dextrose mix it in 1 liter of water and give it 2 liters at a time and repeat it 3-4 times a day. So remember if it is less than 8% dehydration, go by oral route. More than 8% of dehydration go by intravenous route.

This ORS is exclusively for Recumbent Cows, where we have got Sodium chloride-44 gram Potassium chloride-180 gram, mix it with 24 liters of water and then you pump into the Rumen and it is a beautiful oral solution for the Recumbent cow because potassium happens to be one of the contributing factors for continued recumbents, so give potassium the animal is facilitated for ambulation.

In this lesson, we have seen how to calculate body dehydration and what are the choices of the fluids and what are the routes. The Intravenous route, the Parenteral route and effectively we have dealt with an example.

In the next lesson, we are going to see the fluid basic deficit, acid-base imbalance, and how to manage the dehydration or acid-base imbalance in the animals.

Thank you!