Review of oral rehydration solutions for horses with diarrhoea

Enteral fluid therapy in large animals

Enteral fluids administered alone, or in conjunction with intravenous fluids, are reported to be useful for the treatment of dehydration and electrolyte loss associated with diarrhoea in a number of species, following exercise in horses and for feed impaction of the large intestine of horses. Enteral fluids are suitable for treatment of mild to moderately dehydrated patients with some intact intestinal epithelium and motile small intestine. In patients that will drink voluntarily or tolerate nasal intubation the use of enteral fluids may avoid the complications associated with intravenous fluid administration. However the labour costs associated with repeated nasal intubation in intensively managed patients requiring large volumes of fluids may make the use of enteral fluids less economical than intravenous fluid administration. Enteral fluid use alone is contraindicated in patients that are severely dehydrated and/or in hypovolaemic shock, however, if used in conjunction with intravenous fluids, the effects of villous atrophy and malnutrition may be ameliorated and the duration of hospitalisation shortened. There is a variety of commercially available enteral fluids available to veterinary practitioners. While the key components of these fluids are sodium, chloride and carbohydrates, the amounts of ions and other ingredients such as potassium, alkalising agents, amino acids and shortchain fatty acids may vary. The species of the animal, the underlying condition, and the constituents of the fluid, should influence the choice of an enteral fluid.

Effect of oral administration of electrolyte pastes on rehydration of horses

OBJECTIVE

To determine whether the composition of electrolyte pastes formulated for oral administration influences voluntary water intake (WI) by horses recovering from furosemide-induced dehydration.

ANIMALS

6 horses.

PROCEDURES

Voluntary WI, body weight, and blood and urine constituents were measured before and after induction of dehydration by furosemide administration and overnight withholding of water; these same variables also were measured during a 36-hour rehydration period. Each horse was evaluated 4 times with random application of 4 treatments (electrolyte pastes) that provided 0.5 g of KCl/kg of body weight, 0.5 g of NaCl/kg, 0.25 g of NaCl and 0.25 g of KCl/kg, or no electrolytes (control treatment). Electrolyte pastes were administered 3 times (4, 8, and 12 hours after start of the rehydration period).

RESULTS

Administration of all electrolyte pastes resulted in significantly greater voluntarily WI, compared with the control treatment, and was accompanied by significantly greater recovery of body weight when NaCl was a component of the paste. Administration of NaCl and NaCl-KCl pastes tended to produce a state of transient hyperhydration; however, electrolyte administration also resulted in significantly greater urine production and electrolyte excretion during the final 24 hours of the rehydration period. Adverse effects of oral administration of hypertonic electrolyte pastes were not observed.

CONCLUSIONS AND CLINICAL RELEVANCE

Oral administration of electrolyte pastes to dehydrated horses increases voluntary WI and improves rehydration during the rehydration period. Rehydration is more rapid and complete when NaCl is a component of the electrolyte paste.