FA Med, Q1, Fluid Therapy

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FA Med, Q1, Fluid Therapy
2013-02-03 14:23:07
FA Med Q1 Fluid Therapy

FA Med, Q1, Fluid Therapy
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  1. what are 2 conditions commonly associated with herefords?
    squamous cell carcinoma and vaginal prolapse
  2. what are the 4 F's that describe abdominal contour?
    fat, fetus, flatus (gas), fluid (edema)
  3. with hands off exam, where do you look on cattle to get an idea of how recently they ate or if they are off food?
    • left flank
    • (caved in means off food/empty rumen;
    • slightly indented = ate a while ago; convex = just ate)
  4. what are causes of bilateral ventral distention of abdomen?
    • usually pregnancy
    • can also be uterine hydrops or ascites/peritoneal effusion
  5. what are causes of bilateral dorsal distention of abdomen?
    ruminal gas or severe distention of other organs
  6. How would abdomen appear with vagal indigestion?
    left dorsal distention with right ventral distention
  7. what is normal TPR for bovine? where do you look to collect this information?
    • T: 101.5 -102.5 (rectal)
    • P: 60-80 (coccygeal Artery or auscult heart)
    • R:12-36 (auscult lungs, watch thorax move)
  8. what is normal TPR for ovine?
    • T:102.5 -103.5
    • P:60-90 (auscult heart)
    • R:30-72
  9. what is normal TPR for caprine?
    • T:102.0 -103.5
    • P: 70-90 (auscult heart)
    • R:16-40
  10. what is normal TPR for camelid?
    • T: 99.0-101.5
    • P:60-90 (auscult heart)
    • R:10-30
  11. what does it mean if the cow does not lordose when you pinch the withers?
    cow is too painful to move or you didnt pinch hard enough/cow doesnt care
  12. what is on the top of your differential list if your get a positive grunt test?
    hardware disease
  13. what lymph nodes should you specifically be palpating/evaluating?
    • prefemoral
    • supramammary
    • prescapular
  14. where is it normal to see some distention of the jugular vein in cattle? is it normal to observe a "pulse" in the jugular vein of cattle?
    • caudal 1/3 of neck, esp. if lowered head
    • yes, normal for cattle due to proximity of carotid a.
    • (this is NOT normal in small ruminants!)
  15. what are some differentials for jugular vein that is distended throughout the neck?
    • right atrial pressure increase
    • increased central venous pressure
    • thrombosis from multiple IV injections
  16. how old is fetus when detectable via ballotment?
    about 7 months
  17. what CBC/chem parameters to expect to be abnormal with dehydration?
    • elevated PCV/TP
    • elevated BUN/Crea
    • hyperNa
    • elevated SG
    • increased blood osmolality
  18. in a 5% dehydrated calf with no GI obstruction, what is the best route for rehydration?
    oral fluids
  19. what is an indication for rectal administration of fluids?
    grass tetany seizures --> Mg rectally
  20. beyond what % dehydration is oral route not adequate? what 3 things to you want to know about the GI before you give oral fluids?
    • >8%
    • adequate motility/no obstruction
    • no mucosal irriation
    • not hypoCa
  21. why can you not give oral sucrose to adult ruminants?
    lack the enzyme to break it down --> osmotic diarrhea
  22. What body space do crystalloids expand the most?
    interstitial space more than plasma
  23. what species is prone to hypoproteinemia and edema when administered IV fluids?
    camelids and neonates
  24. which direction do you expect K to go in a patient who is off feed and on IV fluids?
    low K levels due to lack of food and kidney excretion from fluids
  25. what is most common vein for IV fluids in cattle? what about for pot bellied pigs?
    • jugular vein
    • pigs: lateral thoracic v
    • *never use milk veins for fluids or injections*
  26. which route of fluid administration in cattle has to be sterile?
    intraosseous and intraperitoneal (rarely used)
  27. where would you place the IO catheter?
    tibial tuberosity or ilial shaft
  28. what is an option for administering fluids long term to esophageal/pharyngeal trauma cow?
    through rumen fistula
  29. of the isotonic crystalloids, which is NOT indicated for treatment of respiratory acidosis?
    sodium bicarb bc metabolizes to create more CO2, thus worsening resp. acidosis
  30. what is 50% dextrose primarily used for in cattle?
    ketosis, added to isotonic crystalloids when energy/glucose support is needed
  31. which species seems to be most sensitive to coagulopathies associated with hetastarch?
  32. what are 2 indications for using plasma?
    • failure of passive transfer
    • need clotting factors
  33. what is the general rule of thumb for dosage of colloids?
    10-30ml/kg IV
  34. what is the milequivalent for Na, K, and NaHCO3?
    • Na = 17 mEq
    • K = 14
    • NaHCO3 = 12
  35. how many liters are in 1 gallon?
    1gall = 3.785 L
  36. what is the formula for fluid deficit?
    body weight (kg) x deficit (% as decimal) = Liters deficient
  37. what is the adult ruminant maintenance fluid rate?
    • 50-60ml/kg/day
    • (~1-2ml/lb/hr)
  38. when calculating all the fluids you need to replace, what factors are you considering?
    fluid deficit + ongoing losses (diarrhea/milk,etc) + maintenance = total you need to give for that day
  39. what is shock RATE of administering fluids to ruminant? what is aggressive rate? maintenance rate?
    • 80ml/kg/hour
    • 40ml/kg/hour
    • 1-2ml/kg/hour
  40. what are two common causes of metabolic acidosis in food animals? how do you treat?
    • diarrhea
    • esophageal choke
    • give bicarb solution (do NOT add Ca++, forms limestone)
  41. why is it important to make sure animal can breathe normally before you administer bicarb?
    metabolizes to form CO2, pt needs to be able breathe this off or will perpetuate acidosis
  42. what is the formula to know how much bicarb you need to administer?
    • mEq of bicarb needed = BW(kg) x 0.6 x base deficit
    • base deficit = 25 - bicarb level of patient
  43. when administering potassium to patient, what is the rate you do not want to excede?
    not to excede 0.5mEq/kg/hour
  44. what is status of potassium in calf with diarrhea for a few days?
    calves with diarrhea --> acidosis --> body tries to correct by putting H into cells and switching with K (bradycardia)
  45. what conditions usually lead to hypernatremia? why should you NOT just let these patients have free access to water?
    • chronic water deprivation or milk replacer not properly mixed
    • with established hyperNa, body forms idiogenic osmoles; hypotonic solution (free water intake) would lead to brain swelling/edema, cell swelling
  46. what clinical signs are seen in pigs with hyperNa?
    blindness, staggering, walk backwards, tremors, head pressing
  47. If you didn't realize patient was hypernatremic and you started isotonic fluids, what will happen to patient and then what should you do?
    • seizures from lowering vascular Na levels too quickly
    • stop fluids! give dexamethasone
    • tx seizures with diazepam
    • mannitol
    • small frequent doses of water and tailor fluid therapy to lower Na by 1/2 to 1mEq/hour