Figure 19-1
Figure 19-2A
Figure 19-2B
Figure 19-3
Figure 19-4A1
Figure 19-4A2
Figure 19-4B
Figure 19-4C
Figure 19-4D
Figure 19-5
Figure 19-6A
Figure 19-6B
A Figure 19-7A
B Figure 19-7B
C Figure 19-7C
D Figure 19-7D
Figure 19-8
Figure 19-9
Figure 19-10
Figure 19-11A
Figure 19-11B
Drip chamber Clamp Protective cap Emesis basin Figure 19-11C
Figure 19-11D
Figure 19-12
A Figure 19-13A
B Figure 19-13B
Table 19-1 Estimating Level of Dehydration Dehydration Percentage Physical Exam Findings <5% History of vomiting or diarrhea, but no abnormalities noted on PE History of not eating or drinking well or at all prior to presentation 5% Tacky mucous membranes; Abdomen feels doughy (free peritoneal fluid has been reabsorbed) 6 8% Mild to moderate decrease in skin turgor; Dry mucous membranes; Slight tachycardia; Corneas appear dull (less tear production) 10 12% Marked decrease of skin turgor; Dry mucous membranes Weak and rapid pulse; Tachycardia; Slow capillary refill time; Sunken eyes; Mild CNS depression >12% Severe dehydration can lead to death Table 19-1
Table 19-2 Types of Crystalloid Solutions Crystalloid Solution [Na ± ] (meq/l) Osmolality (moml /L) [Cl ] (meq/l) [K + ] (meq/l) [Mg +2 ] (meq/l) [Ca +2 ] (meq/l) Lactate (meq/l) Acetate (meq/l) Gluconate (meq/l) Dextrose (g/l) *Isotonic Saline (0.9% NaCl) *Lactated Ringer s 155 310 155 0 0 0 0 0 0 130 273 109 4 0 4 28 0 0 *Normosol 140 295 98 5 3 0 0 27 23 # D 5 W 253 50 # 1/4 Normal Saline # 1/2 Normal Saline + 0.9% Normal Saline with 5% Dextrose + 3% Normal Saline 34 69 34 0 0 0 0 0 0 77 155 77 0 0 0 0 0 0 77 405 77 0 0 0 0 0 0 50 513 1030 513 0 0 0 0 0 0 *isotonic solutions # hypotonic solutions + hypertonic solutions Table 19-2
Table 19-3 Common Fluid Component Abbreviations Abbreviation D W S NS NaCl RL LRS Solution Component Dextrose Water Saline Normal Saline (0.9% NaCl) Sodium Chloride Ringer s Lactate Lactated Ringer s Solution Table 19-3
Table 19-4 Guide to Potassium Supplementation in Animals Serum Potassium Levels 3.5 5.5 (normal) 3.0 3.4 2.5 2.9 2.0 2.4 <2.0 Amount of Potassium to Add to a 250 ml 5 meq 7 meq 10 meq 15 meq 20 meq Amount of Potassium to Add to a 1000 ml 20 meq 28 meq 40 meq 60 meq 100 meq Table 19-4
Table 19-5 Emergency Drugs Drug When Used Canine and Feline Dosage Shorthand Dosage Concentration Atropine Bradycardia; repeat every three to five minutes for a maximum of three doses 0.04 mg/kg IV, IO; 0.08 mg/kg IT 0.8 ml per 10 kg; 1.6 ml per 10 kg 0.5 mg/ml Crystalloid solution To correct shock; give in aliquots of fluid (1/4 to 1/3 shock dose as a bolus first, reassess patient, then repeat) 90 ml/kg/hr (dog); 60 ml/kg/hr (cat) Dexamethasone diazepam Use only for severe allergic reaction To control status epilepticus 4 mg/kg IV 20 ml per 10 kg 2 mg/ml 0.5 mg/kg IV 1.0 ml per 10 kg 5 mg/ml epinephrine Asystole (no heartbeat); repeat doses should be given every three to five minutes 0.1 mg/kg IV, IO; 0.2 mg/kg IT 1 ml per 10 kg; 2 ml per 10 kg 1:1000 hemoglobin glutamer-200 (Oxyglobin ) If animal is anemic, this drug is used to increase systemic oxygen content. This product is a hemoglobin-based, oxygen-carrying fluid that increases plasma and total hemoglobin concentration. Also given as colloid and for pressor support (to maintain adequate mean arterial pressure) 10 30 ml/kg IV at a rate of up to 10 ml/kg/hr (dogs); 2.5 5 ml/ kg IV (cats). If given too rapidly or to an animal with congestive heart failure, it may result in circulatory overload lidocaine Ventricular arrhythmias 2.0 4.0 mg/kg IV IO (dog); 4.0 10 mg/kg IT (dog); 0.2 mg/kg IV, IO, IT (cats use with caution) 1 2 ml per 10 kg; 2 5 ml per 10 kg; 1 ml per 5 kg 20 mg/ml mannitol Use only for cerebral edema 250 mg/kg IV 50 ml per 10 kg 5% = 50 mg/ml naloxone Opioid reversal 0.02 0.04 mg/kg IV; 0.04 0.1 mg/ kg IT 0.5 1.0 ml per 10 kg; 1.0 2.5 ml per 10 kg 0.4 mg/ml prednisone sodium Use only for severe allergic reaction 30 mg/kg IV 30 ml per 10 kg 100 mg/10 ml or 500 mg/10 ml Table 19-5