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Introduction

These guidelines will provide practical recommendations for fluid choice, rate, and route of administration. They are organized by general considerations, followed by specific guidelines for perianesthetic fluid therapy and for treatment of patients with alterations in body fluid volume, changes in body fluid content, and abnormal distribution of fluid within the body. Please note that these guidelines are neither standards of care nor American Animal Hospital Association (AAHA) accreditation standards and should not be considered minimum guidelines. Instead these guidelines are recommendations from an AAHA/American Association of Feline Practitioners (AAFP) panel of experts.

Therapy must be individualized and tailored to each patient and constantly re-evaluated and reformulated according to changes in status. Fluid selection is dictated by the patient’s needs, including volume, rate, and fluid composition required, as well as location the fluid is needed (interstitial versus intravascular). Factors to consider include the following:

  • Acute versus chronic conditions
  • Patient pathology (e.g., acid-base balance, oncotic pressure, electrolyte abnormalities)
  • Comorbid conditions

A variety of conditions can be effectively managed using three types of fluids: a balanced isotonic electrolyte (e.g., a crystalloid such as lactated Ringer’s solution [LRS]); a hypotonic solution (e.g., a crystalloid such as 5% dextrose in water [D5W]); and a synthetic colloid (e.g., a hydroxyethyl starch such as hetastarch or tetrastarch).

 


 

From the University of California Davis, Veterinary Medical Teaching Hospital, Davis, CA (H.D.); Wellington Veterinary Clinic, PC, Wellington, CO (T.J.); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN (A.J.); WestVet Animal Emergency and Specialty Center, Garden City, ID (P.K.); Mississippi State University College of Veterinary Medicine, Mississippi State, MS (R.M.); Mid Atlantic Cat Hospital, Cordova, MD (R.R.); and Veterinary Anesthesia Specialists, LLC, Milwaukie, OR (H.S.).

Correspondence: shafford@vetanesthesiaspecialists.com (H.S.) and arpest7@ hotmail.com (R.R)

AAFP American Association of Feline Practitioners; AAHA American Animal Hospital Association; BP blood pressure; D5W 5% dextrose in water; DKA diabetic ketoacidosis; K potassium; KCl potassium chloride; LRS lactated Ringer’s solution

*This document is intended as a guideline only. Evidence-based support for specific recommendations has been cited whenever possible and appropriate. Other recommendations are based on practical clinical experience and a consensus of expert opinion. Further research is needed to document some of these recommendations. Because each case is different, veterinarians must base their decisions and actions on the best available scientific evidence, in conjunction with their own expertise, knowledge, and experience. These guidelines are supported by a generous educational grant from Abbott Animal Health.

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