SAEVA Congress 2018 Proceedings | 12-15 February 2018 | ATKV Goudini Spa
individual variation in FEs of Na , K , Cl , and Ca exists . The formula for calculation of FE is :
FE x = Ux / Px X 100 = Ux X Pcr X 100 Ucr / Pcr
Ucr X Px
where x = the electrolyte being assessed . The diagnostic value of these calculations is regarded as equivocal by some clinicians .
Normal values : FE Na = 0.01 - 0.70 % FE PO4 = 0.00 - 4.0 % FE K = 20 - 60 % ( could be higher with high potassium diets ) FE Cl = 0.2 - 1.6 %
Therapy –
The therapeutic objectives for ARF are : 1 ) Correction of fluid , electrolyte and acid base abnormalities ; 2 ) Treatment of underlying disease processes ; 3 ) Discontinuation and modification of nephrotoxic drug administration ; 4 ) Patient support while renal tissue regenerates .
The correction of fluid and electrolyte deficits is the foundation of therapy and requires regular ( preferably daily ) monitoring of serum concentrations of electrolytes , blood gases , and hydration status . Emphasis is usually placed on caloric support via glucose administration and Na and Cl replacement , as K abnormalities are uncommon . Such initial therapy often goes hand-in-hand with the treatment of any concurrent disease . The method of fluid administration is determined by the hydration status . If the horse does not appear overly dehydrated and gastrointestinal motility is normal and gastric distention is not obvious , 6 – 8 litres of isotonic electrolyte solution can be given every 1-2 hours via a nasogastric tube . When more intensive therapy is required , intravenous fluid administration is indicated . If the patient is oliguric , fluid and electrolyte administration must be done carefully and the patient ’ s condition closely monitored for marked decreases in packed cell volume and plasma protein concentrations , or central venous pressure increases . Following replacement of fluid and electrolyte deficits ( i . e ., the patient is NO LONGER DEHYDRATED ), further stimulation of diuresis may be attempted via the administration of 20 % mannitol ( 0.25 to 1 gm per kg ) or furosemide ( 1.0 mg / kg every 2 hours ). There is no value in repeatedly giving a diuretic if the fully hydrated horse does not respond to the initial dose . Once oliguria has been corrected , the horse
113