Comparison of oral, intravenous, and subcutaneous fluid therapy for resuscitation of calves with diarrhea

摘要

Neonatal diarrhea remains the primary cause of mortalityin dairy calves around the world, and optimaltreatment protocols are needed. The main goals oftherapy are to restore hydration and electrolyte concentrations,correct strong ion (metabolic) acidemia,and provide nutritional support. Administration of oralelectrolyte solutions (OES) has long been the primarymethod used to treat neonatal diarrhea in humans andcalves because OES are capable of addressing each ofthe primary goals of therapy. In calves with moderatedehydration, we hypothesized that oral electrolyteswould be as good as or better than small volumes of intravenous(Ⅳ) or subcutaneous (SC) fluids. Therefore,the main goal of this study was to compare the ability ofa commercially available oral electrolyte solution (OES)administered alone or in combination with hypertonicsaline with small volumes of Ⅳ or SC fluid therapy toresuscitate calves with diarrhea. Thirty-three Holsteincalves from 5 to 14 d of age were utilized in this clinicaltrial. Diarrhea and dehydration were induced by addingsucrose to the milk replacer. In addition, hydrochlorothiazideand spironolactone were given orally andfurosemide intramuscularly. Depression status, clinicalhydration scores, fecal consistency, and body weightwere recorded at regular intervals. Treatment beganwhen calves had severe diarrhea and had a decrease inplasma volume of at least 10%. Calves were randomlyassigned to 1 of 4 treatment groups of 8 to 9 calvesper group: (1) OES; (2) OES with hypertonic saline (4mL/kg, Ⅳ); (3) IV fluids (lactated Ringer’s, 2 L); or(4) SC fluids (lactated Ringer’s, 2 L). Treatments weregiven at 0 and 12 h. Changes in plasma volume, bloodpH, electrolyte levels, and physical examination scoreswere determined before therapy and again at 1, 2, 4, 8,and 12 h after each treatment. All 4 treatments wereultimately successful in improving hydration as well asincreasing blood pH; however, animals in both groupsthat received OES had much faster resuscitation thanthose in either the Ⅳ or SC fluid group. In conclusion,oral electrolyte products remain the gold standardfor resuscitating diarrheic calves with moderate dehydrationand acidemia and will likely perform betterthan small volumes of Ⅳ lactated Ringer’s solution.Subcutaneous fluids by themselves are a poor treatmentoption and should be only be used as supportivetherapy following the initial correction of hypovolemiaand metabolic acidosis.