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Advances in Fluid, Electrolyte, and Acid-Base Disorders
In recent years, the fields of veterinary critical care and nephrology have experienced significant growth, bringing renewed attention to the science of fluid therapy, electrolyte balance, and acid-base disorders. As we now have evidence showing the poten... moreIn recent years, the fields of veterinary critical care and nephrology have experienced significant growth, bringing renewed attention to the science of fluid therapy, electrolyte balance, and acid-base disorders. As we now have evidence showing the potential harms of inappropriate fluid therapy, the association between electrolyte imbalances and patient mortality, and the valuable diagnostic and prognostic insights offered by acid-base analysis, this field has emerged as a critical focus in veterinary medicine. less
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Quick Reference on Metabolic Alkalosis
This article reviews metabolic alkalosis in small animals, a condition characterized by increased blood pH and elevated serum bicarbonate, most commonly resulting from vomiting, diuretic therapy, or hypoalbuminemia. It differentiates between chloride-resp... moreThis article reviews metabolic alkalosis in small animals, a condition characterized by increased blood pH and elevated serum bicarbonate, most commonly resulting from vomiting, diuretic therapy, or hypoalbuminemia. It differentiates between chloride-responsive and chloride-resistant forms and emphasizes the importance of identifying and addressing the underlying cause. Management focuses on fluid therapy and correction of electrolyte abnormalities, particularly chloride and potassium. Careful monitoring and restoration of circulatory volume and electrolyte balance are essential to reestablish normal acid-base status and prevent complications. less
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Complications of Fluid Therapy in Companion Animals
This article emphasizes the importance of personalized fluid therapy in veterinary medicine, highlighting the need to tailor fluid plans based on individual patient needs, species-specific vulnerabilities, and advanced monitoring techniques. It discusses ... moreThis article emphasizes the importance of personalized fluid therapy in veterinary medicine, highlighting the need to tailor fluid plans based on individual patient needs, species-specific vulnerabilities, and advanced monitoring techniques. It discusses the physiology of water movement, types of fluids, and strategies for safe fluid administration, including careful assessment of hydration, electrolyte balance, and potential complications such as fluid overload and local catheter issues. The use of clinical evaluation and point-of-care ultrasound is stressed to optimize fluid management, minimize risks, and improve patient outcomes. Overall, the article advocates for flexible, patient-specific approaches supported by vigilant monitoring and diagnostic tools. less
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A Quick Reference on Hyponatremia
Hyponatremia, characterized by low serum sodium and hypoosmolality, commonly results from excess water relative to sodium, often due to conditions like syndrome of inappropriate antidiuretic hormone secretion, dehydration, or fluid shifts. Accurate diagno... moreHyponatremia, characterized by low serum sodium and hypoosmolality, commonly results from excess water relative to sodium, often due to conditions like syndrome of inappropriate antidiuretic hormone secretion, dehydration, or fluid shifts. Accurate diagnosis involves assessing serum and urine parameters alongside volume status. Treatment emphasizes identifying and addressing underlying causes, restricting fluid intake, and gradually correcting sodium concentration to prevent neurologic complications such as brain edema. While sodium deficits are rarely calculated, they may be needed in specific cases like cerebral salt wasting. Effective management relies on comprehensive history, physical examination, laboratory testing, and careful monitoring to ensure optimal patient outcomes. less
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A Quick Reference on Hypernatremia
Hypernatremia occurs when water loss exceeds sodium, leading to increased serum sodium and hyperosmolality, primarily affecting the brain. It often results renal losses, water evaporation, hypodipsia or restricted water intake. Clinical signs range from s... moreHypernatremia occurs when water loss exceeds sodium, leading to increased serum sodium and hyperosmolality, primarily affecting the brain. It often results renal losses, water evaporation, hypodipsia or restricted water intake. Clinical signs range from subtle neurologic changes to severe neurologic impairment. Management requires slow and careful correction of water deficits using hypotonic fluids, with frequent monitoring of serum sodium and osmolality to prevent complications like brain edema. Accurate diagnosis involves assessing water and sodium balance, understanding underlying causes, and implementing a tailored treatment plan, making effective management both challenging and critical for patient safety. less
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A Quick Reference on High Anion Gap Metabolic Acidosis
High anion gap metabolic acidosis is marked by decreased blood pH and bicarbonate concentration, with normal chloride levels and compensatory hypocapnia. It results from the accumulation of strong acids such as ketoacids, lactic acid (L- and D-isoforms), ... moreHigh anion gap metabolic acidosis is marked by decreased blood pH and bicarbonate concentration, with normal chloride levels and compensatory hypocapnia. It results from the accumulation of strong acids such as ketoacids, lactic acid (L- and D-isoforms), uremic acids, or toxins like ethylene glycol. Elevated inorganic phosphate may also contribute. Clinical manifestations typically reflect the underlying disorder rather than the acidosis itself. Management focuses on identifying and treating the primary disease process. less
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A Quick Reference on Hyperchloremic Metabolic Acidosis
This article reviews hyperchloremic metabolic acidosis in small animals, a condition characterized by decreased blood pH and bicarbonate concentration, accompanied by a compensatory increase in PCO₂. Hyperchloremic metabolic acidosis arises from chloride ... moreThis article reviews hyperchloremic metabolic acidosis in small animals, a condition characterized by decreased blood pH and bicarbonate concentration, accompanied by a compensatory increase in PCO₂. Hyperchloremic metabolic acidosis arises from chloride retention, excessive sodium loss relative to chloride, or excessive chloride gain relative to sodium. Clinical manifestations are typically related to the underlying disease causing the acidosis. Management focuses on identifying and correcting the primary disorder, while alkalinizing therapy may be considered in severe or refractory cases. less
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Fluid and Electrolyte Therapy in the Patient with Cardiac Disease
Using a framework of understanding the pathophysiology of heart disease, this article discusses considerations for prescribing fluids in patients with cardiac disease as well as those with heart failure. It highlights the importance of recognizing electro... moreUsing a framework of understanding the pathophysiology of heart disease, this article discusses considerations for prescribing fluids in patients with cardiac disease as well as those with heart failure. It highlights the importance of recognizing electrolyte and volume abnormalities, which are common in congestive heart failure, and the need for goal-directed, individualized fluid therapy to maintain balance and prevent worsening of heart failure or renal impairment. The article covers fluid management strategies, including resuscitation, rehydration, maintenance, and considerations during congestive heart failure, along with the significance of monitoring electrolytes – especially sodium potassium, chloride, and magnesium – to optimize patient outcomes. less
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Therapy of Potassium Disorders
A wide variety of underlying disease processes in dogs and cats can be associated with potassium disorders. Both moderate-to-severe hypokalemia and hyperkalemia can have immediately life-threatening consequences and veterinary clinicians must be adept at ... moreA wide variety of underlying disease processes in dogs and cats can be associated with potassium disorders. Both moderate-to-severe hypokalemia and hyperkalemia can have immediately life-threatening consequences and veterinary clinicians must be adept at rapid recognition and correction of dyskalemias. The mainstay of hypokalemia therapy is the treatment of the underlying disease process with concurrent parenteral and/or enteral replacement of potassium. Hyperkalemia therapy aims at stabilizing the cardiac membrane potential to prevent life-threatening complications, transiently increasing intracellular potassium uptake to mitigate the effects of high extracellular potassium concentrations, and enhancing or re-establishing urinary potassium excretion. less
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A Quick Reference on Phosphorus
In the body, phosphorus exists primarily as phosphate, an essential ion involved in many metabolic processes, including the production of nucleotide energy carriers such as adenosine triphosphate (ATP). The majority of phosphate is stored in bone as hydro... moreIn the body, phosphorus exists primarily as phosphate, an essential ion involved in many metabolic processes, including the production of nucleotide energy carriers such as adenosine triphosphate (ATP). The majority of phosphate is stored in bone as hydroxyapatite, forming a slowly exchangeable pool that is available to maintain extracellular phosphate concentration during periods of reduced intake. The pool of phosphate readily available for use in the extracellular fluid accounts for less than 1% of total body phosphate. The most common causes of severe hypophosphatemia requiring treatment are intensive insulin therapy and refeeding syndrome, whereas chronic or acute renal failure is the most common cause of hyperphosphatemia. less
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Complications Across Disciplines: Improving Outcomes in Equine Practice
Complications remain a significant concern in equine practice, affecting a wide range of medical and surgical disciplines. Despite advances in diagnostic modalities, therapeutic interventions, and perioperative care, equine patients present unique challen... moreComplications remain a significant concern in equine practice, affecting a wide range of medical and surgical disciplines. Despite advances in diagnostic modalities, therapeutic interventions, and perioperative care, equine patients present unique challenges that predispose them to unfavorable outcomes. The occurrence of complications has direct implications for patient welfare, case management, and client communication, underscoring the importance of understanding both the risk factors and the strategies available to mitigate adverse events. less
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Complications in Theriogenology
This article explores key complications in equine reproduction, focusing on their causes, diagnosis, treatment, and prevention. It emphasizes the risks associated with common procedures, particularly those that are iatrogenic, meaning caused by medical in... moreThis article explores key complications in equine reproduction, focusing on their causes, diagnosis, treatment, and prevention. It emphasizes the risks associated with common procedures, particularly those that are iatrogenic, meaning caused by medical intervention. The discussion highlights how understanding these risks can help in early detection and management, ultimately improving reproductive success and animal welfare. The article also provides insights into best practices to minimize complications, ensuring safer procedures and better outcomes for breeding horses. less
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Adverse Effects of Antimicrobial Drugs Use in Horses
Antimicrobial drug therapy in horses can lead to adverse effects across multiple body systems, with specific age groups, such as foals, at particular risk. Certain antimicrobial drugs, such as penicillins, aminoglycosides, macrolides, tetracyclines, and t... moreAntimicrobial drug therapy in horses can lead to adverse effects across multiple body systems, with specific age groups, such as foals, at particular risk. Certain antimicrobial drugs, such as penicillins, aminoglycosides, macrolides, tetracyclines, and trimethoprim-sulfonamide combinations, are commonly implicated. This review explores the mechanisms behind these adverse reactions, emphasizing the importance of judicious antimicrobial drug use. This review also underscores the need for a centralized pharmacovigilance system to improve drug safety and adverse event reporting for veterinary medicine. less
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Complications of the Recumbent Horse
This issue focuses on the potential complications caused by prolonged recumbency in horses. It discusses how managing a recumbent horse involves treating the primary illness while also preventing and addressing secondary issues that can arise from recumbe... moreThis issue focuses on the potential complications caused by prolonged recumbency in horses. It discusses how managing a recumbent horse involves treating the primary illness while also preventing and addressing secondary issues that can arise from recumbency itself. The authors explore the underlying pathophysiology of these complications, along with strategies for prevention and treatment. By understanding these aspects, veterinarians can improve care and outcomes for horses that are immobilized for extended periods. The issue provides insights into the most common complications and emphasizes the importance of a comprehensive approach to managing recumbent horses, aiming to minimize risks and promote recovery. less
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Complications in Wound Management
Over 25% of all emergencies are classified as wounds, making them the most common health conditions treated by veterinarians. While equine wounds may heal with minimal intervention, many complications associated with wound management can occur, thereby de... moreOver 25% of all emergencies are classified as wounds, making them the most common health conditions treated by veterinarians. While equine wounds may heal with minimal intervention, many complications associated with wound management can occur, thereby delaying wound healing and leading to chronic non-healing wounds. Wounds should be closed primarily when possible; however, numerous factors influence the risk of complications. Infection and biofilm production are common causes of delayed wound healing. Other causes of non-healing wounds include the presence of foreign material, sequestrum formation, the development of exuberant granulation tissue, neoplastic transition, and habronemiasis. less
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Complications in the Critically Ill Equine Patient
Complications in critically ill equine patients are often related to the underlying disease process but can also be a consequence of diagnostic and therapeutic interventions. Complications can be specific to the affected organ or body system; however, in ... moreComplications in critically ill equine patients are often related to the underlying disease process but can also be a consequence of diagnostic and therapeutic interventions. Complications can be specific to the affected organ or body system; however, in critically ill patients, they frequently affect the vasculature, acid–base, electrolyte, and fluid balance, energy homeostasis, and coagulation, with systemic consequences. Infrequent monitoring, late detection, failure to adapt therapies, hematologic and biochemical abnormalities, coagulopathies, and systemic inflammation can all contribute to processes that worsen the prognosis. Reducing the impact of complications through accurate clinical evaluations as well as a good understanding of physiology, pathophysiology, data interpretation, and therapeutics ultimately improve the outcome of the critically ill equine patient. less
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Complications of Equine Musculoskeletal Surgery and Procedures
Complications of equine musculoskeletal procedures and surgery are an inevitable occurrence. This article summarizes complications principally encountered by primary equine veterinarians who perform and manage musculoskeletal procedures and surgeries. Top... moreComplications of equine musculoskeletal procedures and surgery are an inevitable occurrence. This article summarizes complications principally encountered by primary equine veterinarians who perform and manage musculoskeletal procedures and surgeries. Topics discussed include complications of musculoskeletal diagnostic procedures, angular/flexural limb deformities, and muscle, tendon, and ligament surgery; surgery of the foot, orthopedic and arthroscopic surgery, and cast management. Each section lists complications encountered and includes diagnostic and treatment considerations. Awareness of these complications will empower equine veterinarians to identify and manage these adversities to result in the best possible outcomes for their patients. less
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Complications of Respiratory Surgery in the Horse
Respiratory surgery and procedures typically focus on conditions of the upper airway that restrict airflow at rest or exercise. This article focuses on respiratory anatomy and common surgeries of the trachea and larynx in horses. The trachea serves as the... moreRespiratory surgery and procedures typically focus on conditions of the upper airway that restrict airflow at rest or exercise. This article focuses on respiratory anatomy and common surgeries of the trachea and larynx in horses. The trachea serves as the airway conduit from the larynx to the bronchi. A variety of upper airway disorders can lead to obstruction and in these instances, tracheotomy is typically utilized to bypass these obstructions and maintain airway patency. Emergency and permanent tracheotomy procedures are discussed. Other common upper airway operations, such as laryngotomy, prosthetic laryngoplasty, and others, are also examined. less
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Complications in Equine Anesthesia
General anesthesia in equine patients is associated with a higher risk of mortality despite improved monitoring equipments and anesthetic techniques most likely due to their large body size, unique physiology and anatomy, behavioral tendencies, and theref... moreGeneral anesthesia in equine patients is associated with a higher risk of mortality despite improved monitoring equipments and anesthetic techniques most likely due to their large body size, unique physiology and anatomy, behavioral tendencies, and therefore the challenging recovery. Larger body mass, increased age, higher American Society of Anesthesiologists (ASA) status, out-of-hours surgery, and longer duration of anesthesia have been identified as contributing factors increasing the risk of perioperative mortality in equine patients. Especially the recovery period remains a critical time in equine anesthesia. With vigilant monitoring and timely therapeutic support, intra-anesthetic complications can be quickly identified and managed, ultimately leading to improved outcomes. less
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Accidents, Injuries, and Complications in Equine Sports Medicine Practice
The physical stresses on equine athletes are unique and differ across various disciplines. Recognizing these differences is essential for early detection of injuries and effective management of the competition horse’s health. Equine sports medicine involv... moreThe physical stresses on equine athletes are unique and differ across various disciplines. Recognizing these differences is essential for early detection of injuries and effective management of the competition horse’s health. Equine sports medicine involves specific challenges and risks that can be reduced through proper care, careful attention to technique, and a deep understanding of the demands of each sport. Proper training, regular monitoring, and sport-specific expertise are crucial in preventing injuries and ensuring optimal performance. By focusing on these aspects, veterinarians and trainers can help maintain the health and longevity of horses. less
