Fluid Volume And Fluid Type During Anesthesia
Bindu writes: We had my 13 year old canine companion’s teeth cleaned today since his breath had been foul for a while. His kidney numbers were bad a few months ago and didn’t improve much despite daily fluid therapy. His numbers did come down impressively after a 3 week herbal treatment! It’s been good for about 3 months now, so we thought it might be an ideal time to tackle the bad breath which had, predictably, gotten worse. And his bloodwork seemed to be more or less normal (BUN was 15! But creatinine was 2.3) But after the cleaning, he was only given one and a half bottles of fluid. Is that sufficient?Congratulations, Bindu, on success in getting your aging friend doing better. To answer the question about quantity of fluids administered I would have to know your dog’s body weight and the size of each container. Bottles have been out of vogue for several decades, are you sure they weren’t bags of fluids? In any case they come in 100 mL, 250 mL, 500 mL, 1000 mL and larger bags. The type of fluids also matters, as well as whether your pup was dehydrated or fully hydrated at the time the procedure began.
Another factor is acid-base balance, which would be determined by the preanesthesia laboratory testing. Those results would affect not only the amount of fluid administered, but also the type of fluids (Lactated Ringer’s Solution, also called Ringer’s Lactate; normal saline; D5W, which is dextrose 5% in water; Normosol R; there are many more options).
Bindu writes back: Thanks for your reply, Dr. Randolph. Yes, sorry, they were bags! Krish weighs about 65 pounds. And he had close to 750 ml of RL altogether; 500 ml was given to him either during or right after dental cleaning and the rest, while I was sitting with him after the procedure.
He’s been coughing.. almost like he’s trying to get something out of his throat. He used to do do this a while ago when his kidney numbers were highest, so is it acidity perhaps? Other than that he seems okay.
Thanks for the reply, Bindu. The amount of fluids given was a little over 10 mL per pound of body weight. This would represent more than usually administered for a “normal” patient, but your pet’s doctor knew that he was in renal failure, so he gave more to give a “flushing action” to the body. That would be appropriate.
Because patients under anesthesia are intubated (a tube is placed into the trachea to administer oxygen mixed with anesthetic gas), it is not unusual for them to have a soft cough for a few days after the procedure.
You asked about acidity, and all renal failure patients need to be on gastric protection from hyperacidity. Ask your veterinarian which acid controller he likes to use.
See you tomorrow, Dr. Randolph.