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Practical Fluid Therapy in Large and
Small Ruminants: Part 1

Christine B. Navarre, DVM, MS, DACVIM
Extension Veterinarian Louisiana State University Agricultural Center
Baton Rouge, LA 70803
cnavarre@agcenter.lsu.edu

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Fluid Therapy for Calves
- Objectives
- Correct dehydration
- Correct acid/base abnormalities
- Correct electrolyte abnormalities
- Provide for maintenance and ongoing losses
- Nutritional support

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Catheters
- Calves
- 16 G 3.5 inch jugular
- 18-20 G 1.5 inch in ear
- Always make stab incision with blade for jugular catheters
- Hang head upside down off of table or bale of hay to distend vein

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Dehydration Deficit and Maintenance Rates
- Dehydration deficit
- BW(kg) x %dehydration = deficit in liters
- ex. 40 kg calf 8% dehydrated needs
- 40 x .08 = 3.2 L

- Maintenance
- 1 ml/lb/hr (2.2 ml/kg/hr)
- Increases with excess losses like diarrhea

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Bicarbonate Deficit
- Neonate
- BW(kg) x base deficit x 0.6 = mEq bicarbonate
- Some recommend using 0.7 as ECF space
- Can substitute (normal bicarbonate - measured bicarbonate) for BD
- mEq bicarb/12 = grams bicarbonate

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Fluids to Stock the Truck
- Isotonic fluids without lactate
- Bicarbonate
- Isotonic
- Hypertonic
- Oral electrolytes
- With and without bicarb
- High and low osmolarity
- 50% dextrose
- Potassium chloride
- Hypertonic saline

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Fluids for Calves
- Dystocia
- May look normal initially, but crash 2-4 hours later, so be aggressive in therapy
- If depressed: Measure bicarb and correct deficit or use BD of 10 (~250 mEq bicarbonate for normal size calf)
- Make sure breathing normally

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Fluids for Calves
- Dehydrated non-diarrheic (septic, hasn’t nursed, etc.):
- May be hypoglycemic
- If < 8 % dehydrated, mild depression, still walking:
- 2 L oral calf electrolytes without bicarbonate
- If > 8% dehydrated, depressed, recumbent
- Correct fluid deficit with balanced electrolyte solution
- Add: 20 mEq KCl/L and 20-40 mls 50% dextrose/L (will = 1-2% dextrose in solution)

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Fluids for Calves
- Dehydrated non-diarrheic
- Alternative to IV isotonic for severe dehydration
- 4 ml/kg hypertonic saline solution (administer over 5 min) followed by 2 L oral calf electrolytes without bicarbonate
- If no response, consider acidosis and treat like dystocia calf
- May need more glucose if severe hypoglycemia
- Follow up with milk

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Fluids for Calves
- Diarrhea
- Dehydrated
- Acidotic
- Hyperkalemic but whole body K+ depleted
- Not usually hypoglycemic
- Maybe with Cryptosporidium

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Oral Fluids for Calf Diarrhea
- <8% dehydrated
- Alert or only mildly depressed
- Still standing
- Have suckle reflex
- No ileus

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Oral Fluids for Calves
- Sodium, chloride, potassium
- Diarrheic calves usually depleted in these
- Sodium required for water absorption
- Amino acids
- Co-transport of sodium
- Glucose
- Co-transport of sodium
- Energy

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Oral Fluids for Calves
- Alkalizing agents
- Bicarbonate
- Acetate
- Citrate
- Proprionate

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Oral Fluids for Calves
- Bicarbonate
- High pH neutralizes abomasal acidity
- Bacterial overgrowth
- Interference with milk digestion
- Avoid in beef calves still on dam or dairy calves on whole milk

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Oral Fluids for Calves
- Acetate, proprionate, citrate
- Must be metabolized
- Appear to be metabolized even in severe dehydration
- Acidic in solution
- Facilitate sodium and water reabsorption and produce energy
- Bicarbonate does not
- Good choice for beef calves on dam

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Vet Clin N Am: FA, 2014

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Oral Fluids for Calves
- Bottle vs tube
- Type of diarrhea
- E. coli vs viral diarrheas
- Glucose solutions

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Oral Fluids for Calves
- Beef calves:
- If nursing-leave with cow
- Non-bicarbonate alkalizing solutions of about 350 mOsm/L
- 4-6 liters per day first day
- 2-4 liters per day if diarrhea continues
- Can switch to non-alkalizing solutions
- +/- high energy solutions

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Oral Fluids for Calves
- Dairy calves:
- Switch from milk replacer to whole milk?
- Biosecurity
- Alternate small feedings of milk with non-bicarbonate containing alkalizing solutions with 400-600 mOsm/L
- Same as for beef calves

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Oral Fluids
- Make sure mixed correctly
- Hypernatremia
- Hyponatremia

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IV Fluids
- > 8 % dehydrated
- Depressed
- Recumbent
- No suckle

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IV Fluids for Calf Diarrhea
- Sodium, chloride, potassium
- Glucose
- Alkalizing agents
- Bicarbonate is best
- No metabolism needed
- Immediately effective
- Calves > 1 week get more acidotic than calves < 1 week

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IV Fluids for Calf Diarrhea
%dehydr BD bicarb deficit (mEq) sodium bicarb (grams)
5 5 120 10
7 10 240 20
9 15
12 20
estimations on estimations

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IV Fluids for Calf Diarrhea
- Bicarbonate
- Calculate bicarbonate needs if blood work available or use BD of 10-20
- Normal size calf should need about 240 - 480mEq
- 8.4 %bicarbonate in 500 ml bottles = 1 mEq/ml so give about 250-500 mls of 8% bicarbonate

- Fluid
- Make up fluid deficit with balanced electrolyte solution
- Add: 20 mEq KCl/L and 20-40 mls 50% dextrose/L (will = 1-2% dextrose in solution)
- Give half first hour then other half over 2 hours

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Calf with Diarrhea
Calf standing- Calf weak Calf unable to stand
Calf less than Calf greater than
1 week of age 1 week of age

5 litres of saline 5 litres of saline
with 250 mEq of with 500 mEq of
bicarbonate added bicarbonate added

Oral electrolyte solution (high SID)
Vet Clin N Am: FA, 2014

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IV Fluids for Calf Diarrhea
- Alternative
- 4 ml/kg hypertonic saline solution (administer over 5 min) followed by 2 L oral calf electrolytes with bicarb
- Do not use HSS if suspect mixing error of oral electrolytes

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Administration of Hypertonic Bicarbonate (HBS) vs. HSS
- HBS effective in trials at correcting dehydration and acidosis
- Follow-up with non-alkalinizing oral solution
- May be superior to HSS
- Don’t use in calves with concurrent respiratory disease

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IV Fluids for Calf Diarrhea
- Alternative solution
- 2 liters 1.3% sodium bicarbonate
- 2 liters balanced electrolytes with potassium and dextrose added as before

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IV Fluids for Calf Diarrhea
- Follow up with 2-4 liters oral calf electrolytes without bicarb (if available, if not use with bicarb) per day as long as diarrhea continues
- Leave on milk or milk replacer unless chronic diarrhea and use of TPN
- Feces may look worse, but calf should look better

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Alternative Routes
- Intraosseous
- Inside of proximal tibia
- Subcutaneous fluids
- Calves don’t have as much SQ space as dogs and cats
- Substitute for oral but not IV
- Isotonic, non-glucose containing solutions
- Intraperitoneal fluids
- Total/partial parenteral nutrition
- Consider for cases of chronic diarrhea, esp. cryptosporidiosis
- Continue to offer some milk

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TPN/PPN
- TPN in calves
- Good for chronic diarrhea, septicemia with severe weight loss
- See proceedings for technique
- I rarely get to target rate, but benefits are still substantial
- Need fluid pump

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Tips
- If electrolytes are labeled for multiple ages, including weaned calves and can be mixed with milk, not good choice for calf diarrhea

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Tips
- 1 level teaspoon is approximately 5 grams of most salts
- NaHCO3
- 1 gm = 12 mEq so 240 mEq = 20 grams or ~ 4 tsp.
- Isotonic saline
- 9gms/L non-iodized table salt,
- ~ 2 tsp NaCl/L water is isotonic saline
- Supplement potassium
- 10-20mEq/L or 1gm/L(14mEq/L)
- ~ half a tsp. lite salt/L water (lite salt is half sodium chloride and half potassium chloride)

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