Replacement fluids therapy in horses

Replacement of blood volume and interstitial deficits is the cornerstone of replacement fluid therapy. The need for replacement fluids stems from the importance of fluid volume as it relates to stroke volume and cardiac output. Lactated Ringer's solution (LRS) is commonly administered to horses; it is a balanced electrolyte solution meaning it is closer to plasma in composition, and contains less chloride and sodium, than saline. For horses with botulism LRS is an excellent fluid choice because it lacks magnesium and contains calcium. The primary goal of fluid administration during the replacement phase is to re-establish tissue perfusion. Specific goals during replacement fluid therapy include normalization of clinical perfusion parameters: mentation, heart rate, extremity temperature, pulse quality, mucous membrane color, capillary refill time, and urine production. Hypertonic saline has several hemodynamic and physiologic benefits and is useful as an adjunct to isotonic fluids in volume resuscitation of horses.