Sub-Q Fluids

[tonyb286]

Sooner or later, just about all kidney disease dogs will need IV and Sub-Q Fluids. I was reading about how human kidney disease is treated with fluid therapy and found it interesting that the fluids used are "patient specific" in content. What usually happens is the individual patient's fluids are created for them, so they correct any particular failing electrolyte or mineral imbalance, while at the same time offering hydration. Disorders of sodium, chloride, potassium, calcium, and phosphorus are commonly encountered in renal failure and can be life threatening.
Basically the problems that require IV fluids are not only to do with hydration, but also the electrolyte balance and acidosis and the fluids used are based on any predicted problems and lab results. So in polyurea you could predict a low sodium level, oligurea high sodium, there might also be the need to correct acidosis ... but basically it's an individual treatment plan.

I'm not so sure this human kidney treatment plan transfers into veterinary practice. Do dogs get individually tailored fluids - or do they just get an "off the shelf" bag of fluids? Anyone that's currently giving their dog fluids, please ask their vets about this, if you get the chance. I would be very interested in how things are done and whether, in fact, we can encourage a different approach to potentially improve the treatment prognosis.

Tony

[Suzopedia]

I will ask my vet. Buffy gets lactated ringers. And Sippiesmom, they always recommend I get a new line along with the new needles. I think they charge me $0.50 for the line.

[tonyb286]

Well this is interesting ... I had a messaged reply from a vet about fluid therapy and this is what she tells me:

"They (dogs) would generally get a standard saline or Hartmanns solution of iv fluids but then these would be spiked with appropriate amounts of specific electrolytes if your dog was deficient in any. That and the proportions would be decided on blood results."

There are a couple of things about this that concern me. First, saline solution is not a good thing for any dog or cat suffering from renal failure. The salt content is likely to do more harm than good. There is quite a debate about this between vets, but there is also some excellent research that proves saline solutions are best avoided with this illness.

Second, I'm wondering just how many vets just use the standard Hartmanns solution without actually spiking with additional electrolytes and minerals assessed as being deficient when undertaking blood levels? Many of us are familiar with "buying in" Sub-Q packs to undertake fluid therapy at home ... but how many vets tell us these also need spiking with suitable electrolytes and minerals?

I feel another article developing ...

Tony

[Sippiesmom]

That's so interesting in light especially of the question of whether to use saline solution or Veterinary Lactated Ringer's for my beloved dog Sippie.  Both are "off the shelf" and I don't think any tests (urine?) have been done to make that choice--it's one vet's shelf vs. another's. Can't be too hard to test for poly- vs. olig-urea, can it?  I will definitely ask.  

Also, should the vet offer a new delivery apparatus with a new bag of fluid?  Seems so, but mine didn't (only new needles), so I'm off soon in search of a pharmacy that will sell me one on a Saturday--unless it doesn't matter?  Does it? If not, you can save my Saturday for the yard work!

My hunch is that individually tailored fluids for dogs will be hard to come by unless it's at a teaching hospital.  Prove me wrong, people!