Fluid Therapy Case Studies

Case 1   Case 2  Case 3   Case 4   Case 5

Case 1

History:
A 4-month-old male Yellow Labrador  with a history of profuse vomiting and diarrhea for two days.

parvo.gif (89657 bytes)


Physical Examination:
Temperature = 102.3oF (39.1 C),  pulse = 190/min, respirations = 100 breaths/minute,  weight = 22 lb (10 kg).  Mucous membranes are pale and tacky; skin turgor appears to be decreased; assessment of dehydration is 7%.

 
 
Working Diagnosis:
Viral enteritis

 

Calculate the following parameters for "Sage":
Maintenance fluid requirements for 24 hours.
Deficit volume requirements based upon 7% dehydration.
Total fluid requirements for 24 hours. 

Which of the following fluids would you initially choose for Sage?

Ringer's lactate  Normosol-R 0.9% Sodium chloride 0.45% NaCl + 2.5% dextrose Whole Blood Plasma Hetastarch Oxyglobin

 

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Case 2

History:
A 9-year-old spayed female Doberman pinscher ("Dobie") with a history of anorexia, depression, and periodic vomiting for 4 days is presented.

dobie.jpg (225690 bytes)

Physical Examination:
Normal temperature, pulse, and respiration; weight = 55 lb (25 kg).  Mucous membranes appear icteric.  The dog is very depressed and somewhat emaciated.

 

Working Diagnosis:
Chronic active hepatitis
 
 
 

Calculate the following parameters for "Dobie":
Maintenance fluid requirements for 24 hours.
Deficit volume requirements based upon 7% dehydration.
Total fluid requirements for 24 hours. 


Which of the following fluids would you choose for "Dobie"?
 

Ringer's lactate  Normosol-R 0.9% Sodium chloride 0.45% NaCl + 2.5% dextrose Whole Blood Plasma Hetastarch Oxyglobin

 

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Case 3

History:
An 11-year-old, castrated male Persian cat ("Cotton") with a history of depressed appetite, polyuria, and polydipsia for five days.

cotton.jpg (459273 bytes)
 
 

Physical Examination:
Temperature = 100.8oF (38.2 C), pulse = 220 beats/minute, respiration = 60 breaths/minute, weight = 9 lb (4.1 kg).  Mucous membranes are somewhat tacky; (assessment of dehydration is 5%).

 

Biochemical Profile:
Elevated blood urea nitrogen, creatinine, and phosphorus; urine specific gravity = 1.012.

 

Working Diagnosis:
Chronic renal failure

 
 

Calculate the following parameters for "Cotton":
Maintenance fluid requirements for 24 hours.
Deficit volume requirements based upon 7% dehydration.
Total volume of fluids over 24 hours? 


Which of the following fluids would you choose for "Cotton"?  

Ringer's lactate  Normosol-R 0.9% Sodium chloride 0.45% NaCl + 2.5% dextrose Whole Blood Plasma Hetastarch Oxyglobin

 

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Case 4

History:
An 11-year-old spayed female miniature poodle ("Chloe") with a history of mitral insufficiency is presented. Current medications include furosemide and enalapril. The dog has been anorectic for 3 days. Two episodes of vomiting have been observed. Increased frequency of a moist cough has also been noted.

chloe.jpg (187755 bytes)

Physical Examination:
Normal temperature and pulse, respiration = 66 breaths/minute, weight = 13.5 lb (6.1 kg).  Grade IV/VI systolic ejection murmur is auscultated over the left cardiac apex.

 

Biochemical Profile:
Mildly elevated blood urea nitrogen and creatinine; urine specific gravity = 1.030.

 

Working Diagnosis:
Mitral insufficiency progressing to congestive heart failure; mild prerenal azotemia

 
 
 

Calculate the following parameters for "Chloe":
Maintenance fluid requirements for 24 hours.
Deficit volume requirements based upon 7% dehydration.
Total fluid volume for 24 hours? 


Which of the following fluids would you choose for "Chloe"?  

Ringer's lactate  Normosol-R 0.9% Sodium chloride 0.45% NaCl + 2.5% dextrose Whole Blood Plasma Hetastarch Oxyglobin

 

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Case 5

History:
A 5-year-old castrated male cat ("Cosmo") with a history of straining to urinate for two days.

cosmo.jpg (181664 bytes)
 

Physical Examination:
Temperature = 97oF (36.1 C), pulse = 80 beats/minutes, respirations = 100 breaths/minute, weight = 10.5 lb (4.8 kg).  "Cosmo" is extremely depressed.  Mucous membranes are tacky; skin turgor is decreased; eyes appear sunken; assessment of dehydration is 10%.The urinary bladder is grossly distended and cannot be expressed manually.

 

Working Diagnosis:
Urethral obstruction with postrenal azotemia and possible hyperkalemia

hyperk.jpg (125152 bytes)
Urine Sample From "Cosmo"


What is the most immediate emergency with "Cosmo"? 


Calculate the following parameters for "Cosmo":
Maintenance fluid requirements for 24 hours.
Deficit volume requirements based upon 10% dehydration. 

Follow-Up:
A closed system for urine collection should be established. Urine output for the next 8-hour period should be quantitated and "ins and outs" fluid administration instituted because of the development of postobstructive diuresis.   Urine production for the first 8 hours of collection was 315 ml. The fluid volume necessary for the next 8-hour period is then equal to insensible losses [maintenanceX 0.33/3] plus sensible losses (urine output) from the previous 8-hour period.


How much fluid should "Cosmo" receive over the next 8 hours?  

Which of the following fluids would you choose for "Cosmo"?  

Ringer's lactate  Normosol-R 0.9% Sodium chloride 0.45% NaCl + 2.5% dextrose Whole Blood Plasma Hetastarch Oxyglobin

 

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Copyright, 1998, Wayne E. Wingfield, DVM, Colorado State University.
This page was last edited: 11/11/98