Page 945 - Small Animal Internal Medicine, 6th Edition

CHAPTER 53 Electrolyte Imbalances 917

TABLE 53.1
VetBooks.ir Parenteral Fluid Solutions

ELECTROLYTE
CONCENTRATION (mEq/L) BUFFER OSMOLALITY CALORIES
SOLUTION Na K Cl (mEq/L) (mOsm/L) (kcal/L)

Electrolyte Replacement Solutions
Lactated Ringer’s 130 4 109 Lactate 28 273 9
Ringer’s 147 4 156 — 310 —
Normal saline 154 — 154 — 308 —
Normosol R 140 5 98 Acetate 27 296 18
Plasmalyte 148* 140 5 98 Acetate 27 295 —
Maintenance Solutions

1
2 2 Dextrose/0.45% 77 — 77 — 203 85
saline
2 2 Dextrose/ 65 2 55 Lactate 14 265 89
1
1 2 strength LRS
Normosol M* 40 13 40 Acetate 16 112 —
Normosol M in 5% 40 13 40 Acetate 16 364 175
dextrose*
Plasmalyte 56* 40 13 40 Acetate 16 110 —
Colloidal Solutions
Dextran 70 (6% w/v 154 — 154 — 310 —
in 0.9% saline)
Hetastarch /Hespan 154 — 154 — 310 —
6% 670/0.75
Hextend 6% 670/0.75 143 3 124 Lactate 28 307 9
Vetstarch 6% 130/0.4 154 — 154 — 308
Plasma (average 145 4 105 24 300 —
values, dog)

Other
5% Dextrose in water — — — — 252 170
Cl, Chloride; K, potassium; LRS, lactated Ringer’s solution; Na, sodium.
*Contains magnesium 3 mEq/L.
Modified from DiBartola SP, Bateman S: Introduction to fluid therapy. In DiBartola SP, editor: Fluid, electrolyte and acid-base disorders in
small animal practice, ed 4, St Louis, 2012, Saunders Elsevier.

administration, is important in the successful management of HYPONATREMIA
hypernatremia.
On rare occasions, a hypernatremic animal presents with Etiology
an increase in ECF volume. Such animals are difficult to Hyponatremia is present if the serum sodium concentration
treat. The goal is to lower the serum sodium concentration is less than the reference interval (145 mEq/L, although ref-
without exacerbating an increase in ECF volume and causing erence ranges may vary between laboratories). It can result
pulmonary congestion and edema. To slowly correct hyper- from excessive sodium loss, primarily through the kidney, or
natremia in these animals, the clinician should administer from increased water conservation, or both. The latter condi-
loop diuretics (e.g., furosemide, 1-2 mg/kg orally or intrave- tion may be an appropriate response to a reduction in ECF
nously q8-12h) to promote sodium loss in the urine; this is volume or may be inappropriate (e.g., syndrome of inap-
done in conjunction with the judicious administration of propriate antidiuretic hormone secretion [SIADH]). In most
D 5 W. cases hyponatremia results from abnormalities in water