C. Langdon Fielding

Determination of body water compartments in neonatal foals by use of indicator dilution techniques and multifrequency bioelectrical impedance analysis

OBJECTIVE To determine values for total body water (TBW), extracellular fluid volume (ECFV), intracellular fluid volume (ICFV), and plasma volume (PV) in healthy neonatal (< 24 hours old) foals and to create a multifrequency bioelectrical impedance analysis (MF-BIA) model for use in neonatal foals. ANIMALS 7 healthy neonatal foals. PROCEDURES Deuterium oxide (0.4 g/kg, IV), sodium bromide (30 mg/kg, IV), and Evans blue dye (1 mg/kg, IV) were administered to each foal. Plasma samples were obtained following an equilibration period, and the TBW, ECFV, ICFV, and PV were calculated for each foal. An MF-BIA model was created by use of morphometric measurements from each foal. RESULTS Mean ± SD values were obtained for TBW (0.744 ± 0.024 L/kg), ICFV (0.381 ± 0.018 L/kg), ECFV (0.363 ± 0.014 L/kg), and PV (0.096 ± 0.015 L/kg). The 95% limits of agreement between the MF-BIA and indicator dilution techniques were within ± 2 L for TBW and ECFV. CONCLUSIONS AND CLINICAL RELEVANCE Fluid volumes in neonatal foals were found to be substantially larger than fluid volumes in adult horses. Multifrequency bioelectrical impedance analysis may be a useful technique for predicting TBW, ICFV, and ECFV in neonatal foals.

Application of the sodium dilution principle to calculate extracellular fluid volume changes in horses during dehydration and rehydration

OBJECTIVE To apply the principle of sodium dilution to calculate the changes in the extracellular fluid (ECF) volume (ECFV) and intracellular fluid volume (ICFV) that occur during dehydration and rehydration in horses. ANIMALS 8 healthy horses of various breeds. PROCEDURES Horses were dehydrated over 4 hours by withholding water and administering furosemide. Saline (0.9% NaCl) solution was administered IV during the next 2 hours (20 mL/kg/h; total 40 mL/kg). Horses were monitored for an additional hour following IV fluid administration. Initial ECFV was determined by use of multifrequency bioelectrical impedance analysis, and serum sodium concentration was used to calculate total ECF sodium content. Sodium and fluid volume losses were monitored and calculated throughout the study and used to estimate changes in ECFV and ICFV during fluid balance alterations. RESULTS Changes during dehydration and rehydration primarily occurred in the ECFV. The sodium dilution principle estimated an overexpansion of the ECFV beyond the volume of fluid administered, indicating a small contraction of the ICFV in response to fluid administration. Serum and urinary electrolyte changes were recorded and were consistent with those of previous reports. CONCLUSIONS AND CLINICAL RELEVANCE The sodium dilution principle provided a simple method that can be used to estimate the changes in ECFV and ICFV that occur during fluid administration. Results suggested an overexpansion of the ECFV in response to IV saline solution administration. The sodium dilution principle requires further validation in healthy and clinically ill horses, which could provide clinical applications similar to those in other species.

Estimation of acute fluid shifts using bioelectrical impedance analysis in horses.

BACKGROUND Multi-frequency bioelectrical impedance analysis (MF-BIA) has been used to evaluate extracellular fluid volume (ECFV), but not fluid fluxes associated with fluid or furosemide administration in horses. If able to detect acute changes in ECFV, MF-BIA would be useful in monitoring fluid therapy in horses. HYPOTHESIS The purpose of this study was to evaluate the ability of MF-BIA to detect acute fluid compartment changes in horses. We hypothesized that MF-BIA would detect clinically relevant (10-20%) changes in ECFV. ANIMALS Six healthy mares were used in the study. METHODS This is an original experimental study. Mares were studied in 3 experiments: (1) crystalloid expansion of normally hydrated subjects, (2) furosemide-induced dehydration followed by crystalloid administration, and (3) acute blood loss followed by readministration of lost blood. MF-BIA measurements were made before, during, and after each fluid shift and compared to known changes in volume calculated based on the intravenous fluids that were administered in addition to urinary fluid losses. Mean errors between MF-BIA estimated change and known volume change were compared using nonparametric analysis of variance. Estimated ECFV pre- and post-fluid administration similarly were compared. The level of statistical significance was set at P < .05. RESULTS Results of the study revealed a statistically significant change in ECFV and total body water during crystalloid expansion and dehydration. Statistically significant changes were not observed during blood loss and administration. Mean errors between MF-BIA results and measured net changes were small. CONCLUSIONS AND CLINICAL IMPORTANCE MF-BIA represents a practical and accurate means of assessing acute fluid changes during dehydration and expansion of ECFV using isotonic crystalloids with potential clinical applications in equine critical care.

Pulse pressure variation and systolic pressure variation in horses undergoing general anesthesia

Introduction Changes in arterial pressure due to respiratory phases have been used to predict fluid responsiveness in a number of species and pulse pressure variation (PPV) and systolic pressure variation (SPV) are commonly used. The relationship between PPV and SPV has not been described in horses. Objectives To describe and compare PPV and SPV values of horses under general anesthesia. Methods Twenty-six horses undergoing general anesthesia and receiving mechanical ventilation were enrolled in the study. Recordings of maximal and minimal values of pulse pressure and systolic pressure were calculated every 15 minutes throughout surgery. Results Initial PPV was 15.6% (7.9, 33.8) and decreased over the first 30 minutes to 10.7 ± 7.2% (P = 0.03). Initial SPV was 10.3 ± 2.6% and decreased over the first 30 minutes to 7.3 ± 3.3% (P = 0.004). PPV and SPV had a correlation coefficient of 0.52 (P < 0.0001) and a 95% limits of agreement from −7.1% to 14.4%. Conclusion PPV and SPV measurements in horses do not have strong agreement.INTRODUCTION Changes in arterial pressure due to respiratory phases have been used to predict fluid responsiveness in a number of species and pulse pressure variation (PPV) and systolic pressure variation (SPV) are commonly used. The relationship between PPV and SPV has not been described in horses. OBJECTIVES To describe and compare PPV and SPV values of horses under general anesthesia. METHODS Twenty-six horses undergoing general anesthesia and receiving mechanical ventilation were enrolled in the study. Recordings of maximal and minimal values of pulse pressure and systolic pressure were calculated every 15 minutes throughout surgery. RESULTS Initial PPV was 15.6% (7.9, 33.8) and decreased over the first 30 minutes to 10.7 ± 7.2% (P = 0.03). Initial SPV was 10.3 ± 2.6% and decreased over the first 30 minutes to 7.3 ± 3.3% (P = 0.004). PPV and SPV had a correlation coefficient of 0.52 (P < 0.0001) and a 95% limits of agreement from -7.1% to 14.4%. CONCLUSION PPV and SPV measurements in horses do not have strong agreement.

Equine fluid therapy.

Description: Equine Fluid Therapy is the first reference to draw equine–specific fluid therapy information together into a single, comprehensive resource. Offering current information unique to horses on the research and practice of fluid, electrolyte, and acid–base disorders, the book is designed to be clinically oriented yet thorough, providing detailed strategies tailored to equine practice. With information ranging from physiology and acid–base balance to fluid therapy for specific conditions, Equine Fluid Therapy covers fluid treatments in both adult horses and foals, highlighting the unique physiologic features, conditions, and differences in foals.

Evaluation of potential predictor variables for PCR assay diagnosis of Anaplasma phagocytophilum infection in equids in Northern California

OBJECTIVE To identify clinical or clinicopathologic variables that can be used to predict a positive PCR assay result for Anaplasma phagocytophilum infection in equids. ANIMALS 162 equids. PROCEDURES Medical records were reviewed to identify equids that underwent testing for evidence of A phagocytophilum infection by PCR assay between June 1, 2007, and December 31, 2015. For each equid that tested positive (case equid), 2 time-matched equids that tested negative for the organism (control equids) were identified. Data collected included age, sex, breed, geographic location (residence at the time of testing), physical examination findings, and CBC and plasma biochemical analysis results. Potential predictor variables were analyzed by stepwise logistic regression followed by classification and regression tree analysis. Generalized additive models were used to evaluate identified predictors of a positive test result for A phagocytophilum. RESULTS Total lymphocyte count, plasma total bilirubin concentration, plasma sodium concentration, and geographic latitude were linear predictors of a positive PCR assay result for A phagocytophilum. Plasma creatine kinase activity was a nonlinear predictor of a positive result. CONCLUSIONS AND CLINICAL RELEVANCE Assessment of predictors identified in this study may help veterinarians identify equids that could benefit from early treatment for anaplasmosis while definitive test results are pending. This information may also help to prevent unnecessary administration of oxytetracycline to equids that are unlikely to test positive for the disease.

Ability of clinicopathologic variables and clinical examination findings to predict race elimination in endurance horses

OBJECTIVE To compare results of point-of-care laboratory testing with standard veterinary clinical examination findings at a single time point during endurance competition to identify horses at risk for elimination. ANIMALS 101 endurance horses participating in the 2013 Western States 160-km (100-mile) endurance ride. PROCEDURES At the 58-km checkpoint, blood samples were collected from all horses. Samples were analyzed for pH, Pco2, base excess, anion gap, PCV, and whole blood concentrations of sodium, potassium, chloride, total carbon dioxide, BUN, glucose, and bicarbonate. Corrected electrolyte and PCV values were calculated on the basis of plasma total protein concentration. Immediately following the blood sample collection, each horse underwent a clinical examination. In addition to standard examination variables, an adjusted heart rate was calculated on the basis of the variable interval between entry into the checkpoint and heart rate recording. A combination of stepwise logistic regression, classification and regression tree analysis, and generalized additive models was used to identify variables that were associated with overall elimination or each of 3 other elimination categories (metabolic elimination, lameness elimination, and elimination for other reasons). RESULTS Corrected whole blood potassium concentration and adjusted heart rate were predictive for overall elimination. Breed, plasma total protein concentration, and attitude were predictive for elimination due to metabolic causes. Whole blood chloride concentration and corrected PCV were predictive for elimination due to lameness. Corrected PCV was predictive for elimination due to other causes. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that for horses in endurance competition, a combination of breed and clinical examination and laboratory variables provided the best prediction of overall elimination.