Journal Scan: Is an oral electrolyte solution an effective way to treat dehydration in dogs with severe diarrhea?
Why they did it
Traditionally, intravenous fluid therapy has been the treatment of choice for correcting dehydration. In this study, researchers sought to determine whether administration of an oral electrolyte solution (OES) would safely and effectively correct dehydration in dogs with acute onset hemorrhagic diarrhea and decrease the cost of care.
What they did
As part of a nonrandomized trial, the authors enrolled 20 dogs seen between December 2010 and May 2012 that were presented for acute onset of hemorrhagic diarrhea (median duration of two days). Dogs with > three episodes of vomiting in the previous 24 hours, hypotension (< 100 mm Hg systolic pressure), < 1 year of age, parvovirus infection, concurrent illness, or an incomplete vaccination history were excluded. Baseline laboratory data tests including packed cell volume (PCV), a serum chemistry profile, a lactate concentration, and venous blood gas were performed at the time of admission and every eight hours during hospitalization. In addition, all dogs received a 1 mg/kg subcutaneous dose of maropitant for control of emesis.
All enrolled dogs were offered an OES ≤ five hours after admission and every four hours thereafter. The amount of OES was based on the calculated fluid deficit plus maintenance fluid requirements and estimated ongoing losses. There were 13 dogs in the oral replacement therapy (ORT) group, while those patients that refused the OES or had persistent vomiting or evidence of worsening dehydration based on laboratory parameters (n=7) were treated with intravenous (IV) crystalloid therapy (IVT group). The median time from admission to IV therapy was 5.5 hours (range = two to eight hours).
What they found
Among the 13 dogs in the ORT group, improvement in hydration parameters (PCV and serum total protein and blood urea nitrogen concentrations) was noted eight and 16 hours after admission. The median duration of hospitalization was the same between the two groups (21 hours vs. 20 hours for the IVT and ORT group, respectively; P = 0.45); however, the cost of treatment was lower among the ORT group compared with the IVT group (median $433 vs. $589; P = 0.006).
The authors acknowledge limitations of the study, such as the fact that assessment of hydration was subjective and that dogs were not offered water, only OES. Further studies are needed using objective measures of hydration and those that compare water, OES, and IVT for correction of hydration.
The goal of ORT is to promote “physiologic water and electrolyte absorption in the gastrointestinal tract” to safely correct hydration in patients with diarrhea. This method has been used successfully for years in human and large-animal medicine. ORT can be considered for dogs with mild to moderate dehydration secondary to diarrhea, but careful patient selection is key. Physical assessment of the patient as well as laboratory parameters should be used to assess hydration status.
Reineke EL, Walton K, Otto C. Evaluation of an oral electrolyte solution for treatment of mild to moderate dehydration in dogs with hemorrhagic diarrhea. J Am Vet Med Assoc 2014;243:851-857.
Jennifer L. Garcia, DVM, DACVIM, is a veterinary internal medicine specialist at Sugarland Veterinary Specialists in Houston, Texas.