Comparison of oral, intravenous, and subcutaneous fluid therapy for resuscitation of calves with diarrhea

Abstract

Neonatal diarrhea remains the primary cause of mortality in dairy calves around the world, and optimal treatment protocols are needed. The main goals of therapy are to restore hydration and electrolyte concentrations, correct strong ion (metabolic) acidemia, and provide nutritional support. Administration of oral electrolyte solutions (OES) has long been the primary method used to treat neonatal diarrhea in humans and calves because OES are capable of addressing each of the primary goals of therapy. In calves with moderate dehydration, we hypothesized that oral electrolytes would be as good as or better than small volumes of intravenous (IV) or subcutaneous (SC) fluids. Therefore, the main goal of this study was to compare the ability of a commercially available oral electrolyte solution (OES) administered alone or in combination with hypertonic saline with small volumes of IV or SC fluid therapy to resuscitate calves with diarrhea. Thirty-three Holstein calves from 5 to 14 d of age were utilized in this clinical trial. Diarrhea and dehydration were induced by adding sucrose to the milk replacer. In addition, hydrochlorothiazide and spironolactone were given orally and furosemide intramuscularly. Depression status, clinical hydration scores, fecal consistency, and body weight were recorded at regular intervals. Treatment began when calves had severe diarrhea and had a decrease in plasma volume of at least 10%. Calves were randomly assigned to 1 of 4 treatment groups of 8 to 9 calves per group: (1) OES; (2) OES with hypertonic saline (4 mL/kg, IV); (3) IV fluids (lactated Ringer's, 2 L); or (4) SC fluids (lactated Ringer's, 2 L). Treatments were given at 0 and 12 h. Changes in plasma volume, blood pH, electrolyte levels, and physical examination scores were determined before therapy and again at 1, 2, 4, 8, and 12 h after each treatment. All 4 treatments were ultimately successful in improving hydration as well as increasing blood pH; however, animals in both groups that received OES had much faster resuscitation than those in either the IV or SC fluid group. In conclusion, oral electrolyte products remain the gold standard for resuscitating diarrheic calves with moderate dehydration and acidemia and will likely perform better than small volumes of IV lactated Ringer's solution. Subcutaneous fluids by themselves are a poor treatment option and should be only be used as supportive therapy following the initial correction of hypovolemia and metabolic acidosis.

Effects of Short Chain Fatty Acids (SCFAs) Modulation on Potentially Diarrhea Causing Pathogens in Yaks Through Metagenomics Sequencing

“…Diarrhea in yaks was signi cantly higher in yak calves (Fig. 2), which was in line with the widely accepted knowledge that morbidity and mortality of diarrhea in calves is more serious [35]. Therefore, discovering the potential causes of this emerging diarrhea is urgent and meaningful, especially on the remote plateau.…”

Changes in fluid and acid-base status of diarrheic calves on different oral rehydration regimens

“…The administration of ORS remains the gold standard for resuscitating diarrheic calves with moderate dehydration and acidemia ( Taylor et al, 2017 ; Doré et al, 2019 ). Worldwide, diarrhea caused by C. parvum is one of the most important diseases of young ruminant livestock, particularly in neonatal calves.…”

“…Without free water access, acute hypernatremia might be the consequence when dehydrated calves are treated with hypertonic ORS ( Kirchner et al, 2014 ; Trefz et al, 2017 ). In a recent study in calves with osmotic diarrhea, a slightly hypertonic ORS, alone and combined with intravenous hypertonic saline infusion, was superior in expanding plasma volume compared with intravenous Ringer lactate infusion ( Doré et al, 2019 ). The increase in plasma osmolality, in particular [Na + ], causes thirst and leads to higher consumption of water ( Sen et al, 2009 ; Thornton, 2010 ; Wenge et al, 2014 ).…”

“…For animal welfare reasons, every diarrheic calf should be treated promptly to replace fluid and electrolyte losses properly. Diarrheal calves without impaired suckle reflex can easily be provided with electrolytes and buffer substances by administration of oral rehydration solutions ( ORS ; Doré et al, 2019 ; Sayers et al, 2016 ).…”

Short communication: Effects of different blood buffers administered in electrolyte solution to grain-fed veal calves experiencing diarrhea

“…There is also concern that bicarbonate may interfere with milk clotting in the abomasum as previous studies identified that OES with a bicarbonate concentration >40 mEq/L has negative effects on milk clotting (Miyazaki et al, 2019). Newer OES formulations contain acetate, propionate, and citrate, which have been shown to have similar alkalinizing effects to bicarbonate (Doré et al, 2019). They are considered bicarbonate precursors because they produce water and bicarbonate ions when metabolized.…”