Term
| How does osmolality affect abomasal emptying? |
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Definition
| -hypertonicity delays emptying |
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Term
| Why is the rennin-clot formation important w/ milk ingestion? What does it depend on? |
|
Definition
-protein clumps and thus release small amounts of ingesta
-depends on Ca, Rennin, & pH |
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Term
| Milk is isosmotic. How does digestion alter that? |
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Definition
|
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Term
| Why does the osmolality of villi matter? |
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Definition
| -it creates a gradient similar to the kidneys so hyperosmolar fluids like milk can be absorbed |
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Term
| Na & glucose are cotransported in the gut pulling water with them. How is this affected by enterotoxins? HOw is this affected by villous atrophy? |
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Definition
-enterotoxins: doesn't affect electrolyte absorption
-villous atrophy: have to use lower osmolar fluids (Rota/Corona/Crypto) |
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Term
| What are the mechanisms of diarrhea? Give an example of each. |
|
Definition
-Hypersecretion: ETEC & Salmonella
-Malabsorption/maldigestion: rota/coronavirus, crypto
-inflammation: salmonella, AEEC
-osmotic: nutritional/inappropriate oral fluid |
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Term
| What are the metabolic derangements that occur due to diarrhea? |
|
Definition
-dehydration
-acidosis
-electrolyte imbalances
-energy deficits
-hypothermia |
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Term
| Describe the dehydration due to diarrhea. |
|
Definition
-dec CO & perfusion
-tissue hypoxemia
-cellular dehydration & dysfunction |
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Term
| Describe the acidosis due to diarrhea. |
|
Definition
-bicarb loss in feces
-colonic bacterial lactic acid absorbed |
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Term
| What electrolyte disturbances do we see w/ diarrhea? |
|
Definition
|
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Term
| What ECG changes do we see to make up for hyperkalemia? |
|
Definition
-absent P waves
-spiked T waves
-arrhythmia
-widened qRs complex |
|
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Term
| What physiologic changes do we see due to whole body K deficit w/ diarrhea? |
|
Definition
-altered membrane potentials
-bradycardia, weakness, arrhythmia |
|
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Term
| Describe the physiologic effects of the negative energy balance seen with diarrhea. |
|
Definition
-poor nutrient assimilation: anorexia, malabsorption
-little E reserves: needs inc w/ dz
-may manifest as hypoglycemia: late in dz |
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|
Term
| When are oral fluids useful when treating diarrhea? |
|
Definition
|
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Term
| What are the indications for oral fluids for diarrhea? |
|
Definition
-less valuable calf
-<8% dehydration
-owner compliance |
|
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Term
| What are the contraindications for oral fluids for diarrhea? |
|
Definition
->8% dehydration
-GIT stasis, distention, or obstruction |
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Term
| What caution do we have when using hyperosmolar fluids? When should we use them? |
|
Definition
-caution with malabsorptive dz
-use for hypersecretory |
|
|
Term
| What caution do we have when using isosmolar fluids? |
|
Definition
| -caution with E deficiency |
|
|
Term
| What are the two kinds of alkalinizing agents? |
|
Definition
-bicarb
-metabolizable bases: acetate, citrate |
|
|
Term
| What are the advantages of using bicarb as an alkalinizing agent?n Disadvantages? |
|
Definition
-A: most effective at correcting acidosis, doesn't requie metabolic conversion
-D: will inhibit rennin clot, inc abomasal pH |
|
|
Term
| When do we use bicarb as an alkalinizing agent? |
|
Definition
-early treatment of SEVERE cases
-don't use if on whole milk!! |
|
|
Term
| What are the advantages of using metabolizable bases as an alkalinizing agent? |
|
Definition
-potential E source
-does not raise abomasal pH
-not inhibit the rennin clot as much |
|
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Term
| What are the disadvantages of using metabolizable bases as an alkalinizing agent? |
|
Definition
-require hepatic metabolism
-metabolized very slowly w/ severe dehydration & poor hepatic perfusion |
|
|
Term
| What are the indications of using metabolizable bases as an alkalinizing agent? Contraindications? |
|
Definition
-Indications: maintenance therapy, while on whole milk, less severe cases
-Contraindication: severe acidosis & dehydration |
|
|
Term
| Describe the energy given by hyperosmolar & isosmotic fluids. |
|
Definition
-hyperosmolar only provides 50% maintenance E
-isosmotic only provides 20-25% maintenance E |
|
|
Term
| Since no form of fluids gives enough E for maintenance, what are our options? |
|
Definition
-give more electrolytes: feed 3 X a day
-keep on milk (2-5% BW): don't mix w/ oral electrolytes or bicarb |
|
|
Term
| What do we give for initial resuscitation of diarrhea cases? |
|
Definition
-bicarb base
-high glucose: hypersecretry dz
-lower glucose: malabsorptive dz |
|
|
Term
| What do we give for maintenance therapy of diarrhea cases? |
|
Definition
-metabolizable base
-high glucose: hypersecretory dz
-lower glucose: malabsorptive dz |
|
|
Term
| Is milk withdrawal useful for diarrhea? Explain. |
|
Definition
-minimal benefit if alert & nursing
-if you can keep the calf well hydrated, keep it on some milk
-ONLY WITHHOLD MILK FOR 24 HRS |
|
|
Term
| What are the disadvantages of IV fluids? |
|
Definition
-expensive
-labor intensive
-facilities
-ambition/knowledge |
|
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Term
| What are the objectives of giving fluids to diarrhea cases? |
|
Definition
-replace fluid deficits
-correct acidosis
-correct electrolytes
-nutrient supplementation |
|
|
Term
| How do we estimate dehydration on PE? |
|
Definition
-globe recession
-eyelid pinch
-corneal moisture
-oral mucosa moisture
-temp of extremities |
|
|
Term
| What fluid rate is a safe rate? What does this accmplish? |
|
Definition
-30-40 ml/kg/hour safe rate
-replace deficit in 2-4h |
|
|
Term
| How do we determine the severity of acidosis due to diarrhea? |
|
Definition
-blood gas analysis
-harleco CO2 apparatus
-clinical assessment |
|
|
Term
| What pH counts as mild acidosis due to diarrhea? What fluids do we give? |
|
Definition
-pH > 7.2
-polyionic fluids: NaCL, Plasmalyte, Lactated Ringer's |
|
|
Term
| What pH counts as severe acidosis? What fluids do we give? |
|
Definition
-pH < 7.2
-isotonic NaHCO3, replace half bicarb in 2-4h & remainder over next 2-h
-cautious if you suspect concurrent resp acidosis |
|
|
Term
| What do we give for replacement of lost electrolytes due to diarrhea? |
|
Definition
-sodium & chloride rich: isotonic saline, Ringer's solution
-additional K |
|
|
Term
| What is our caution when giving extra K in fluids w/ diarrhea cases? |
|
Definition
| -don't add K unless you are aggressively treating the acidosis |
|
|
Term
| How to we nutritionally support diarrhea cases? |
|
Definition
-keep on some milk: normal feeding is 10-12% BW
-additional dextrose: get back on enteral feeding ASAP |
|
|
Term
| What do we add to nutritional support of diarrhea cases if hypoglycemia is present? |
|
Definition
| -give dextrose & maintain |
|
|
Term
| What effects does hypertonic saline know? |
|
Definition
-rapid expansion of plasma volume from intracellular fluid space
-does not correct the acidosis
-must give oral electrolytes for rehydration of ICF |
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