Original Research
Enteral Fluid Therapy: Biochemical Profile of Horses Treated with Hypotonic Enteral Electrolyte Solutions Associated with Energy Sources

https://doi.org/10.1016/j.jevs.2014.01.004Get rights and content

Abstract

The present study evaluated the biochemical profile of horses that received hypotonic electrolyte solutions associated with energy sources by enteral route in continuous flow using a small caliber tube for naso-esophageal administration. Experimental design was a latin square 3 × 3 with two replicates and three periods. The assays were carried out with “six adult females horses”, divided into three groups submitted to the following treatments each: electrolyte solution containing dextrose (ESDext)—“5 g sodium chloride, 0.5 g potassium chloride”, 1 g of calcium gluconate, 200 mg of magnesium pidolate, and 15 g of dextrose diluted in 1,000 mL of water with measured osmolarity of 264 mOsmol/L; electrolyte solution containing maltodextrine (ESMalt)—5 g of sodium chloride, 0.5 g of potassium chloride, 1 g of calcium gluconate, 200 mg of magnesium pidolate, and 15 g of maltodextrin diluted in 1,000 mL of water with measured osmolarity of 203 mOsmol/L; and electrolyte solution containing sucrose (ESSucr)—“5 g sodium chloride, 0.5 g potassium chloride”, 1 g of calcium gluconate, 200 mg of magnesium pidolate, and 15 g of sugar diluted in 1,000 mL of water with measured osmolarity of 234 mOsmol/L. The electrolyte solutions were administered at the dosage 15 mL/kg/h during 12 hours. Hypotonic enteral electrolyte solutions that contain maltodextrin (ESMalt) and dextrose (ESDext) were effective to increase glycemia in horses without causing any adverse effects, whereas ESSucr presented slight effect on blood glucose, but without causing electrolyte imbalances.

Introduction

Fluid, electrolyte, and acid–base imbalances usually appear associated with important clinical problems in horses, such as diarrhea, colic, and exhausting physical exercise, among others. Corrections of these disorders are commonly performed by administration of enteral electrolyte solutions (EES) through nasogastric route. Indeed, enteral fluid therapy with appropriate solutions is an important therapeutic option in equine medicine and can be considered the most righteous choice because of its effectiveness, practical use, and especially the reduced cost [1].

Enteral electrolyte solutions for horses are usually composed by elements that assist in fast and effective restoration of homeostasis, such as sodium, chloride, potassium, calcium, magnesium, and an additional source of energy. Some energy sources such as glucose, dextrose, or maltodextrin in association with isotonic and hypotonic enteral electrolyte solutions (HypoEES) have already been tested in horses [2], [3], [4], [5].

The osmolarity of electrolyte solutions influences the effectiveness of intestinal absorption of water and electrolytes. Historically, it was presumed that solutions with an osmolarity similar to plasma would improve intestinal absorption; however, recent studies demonstrate that modifications in tonicity of enteral rehydration solutions result in different effects on water and electrolyte absorption. Clinical trials in children with diarrhea [6], [7] and laboratory animals [8] confirmed that hypotonic are more effective than isotonic enteral electrolyte solutions for treatment of hypoglycemia, hydroelectrolyte and acid–base imbalances, reducing the diarrhea and the internment length of patients.

Reduction in sodium from 90 mmol/L to 75 mmol/L and glucose from 111 mmol/L to 75 mmol/L resulted in decrease of osmolarity from 311 mOsm/L to 245 mOsm/L that was able to reduce by 33%, the need for intravenous therapy for rehydration without any risk of hyponatremia, demonstrating a significant reduction of diarrhea and fecal loss when compared with conventional isotonic solution [9].

The composition of EES is a controversial matter, despite several experimental studies, especially regarding electrolyte concentration, energy source, and osmolarity. Several studies in horses evaluated isotonic enteral electrolyte solutions [2], [4], [5], [10], but only Farias et al [3] tested a hypotonic solution associated to an energy source, registering increase in the concentration of plasma glucose and higher expansion of plasma volume in animals treated with hypotonic enteral solutions, when compared with those treated with isotonic enteral solution. Therefore, little is known about the effects of HypoEES with added energy sources on biochemical profile in horses.

In fact, studies on this subject still are scarce in equine species, especially regarding the beneficial and adverse effects of the HypoEES associated to energy sources. It is presumed that the use of HypoEES containing dextrose, maltodextrin, and sucrose affects positively blood glucose without causing electrolyte imbalances. The purpose of the present study was to evaluate the effects of hypotonic electrolyte solutions associated with sucrose, dextrose, or maltodextrin administered in continuous flow during 12 hours by enteral route through a naso-esophageal tube of small caliber on biochemical profile of horses.

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Materials and Methods

This work was approved by the Ethics Committee of the Veterinary Department of the Universidade Federal de Viçosa (Process no. 198/2011) in accordance with the Veterinary Professional Ethics Code, the Ethical Principles for Animal Research established by the Brazilian College for Animal Experimentation and current Brazilian legislation.

The assays were carried out with six healthy female horses, aged 3-year-old and averaging 300 kg in weight, with good body condition score. Animals were housed

Results

The results for biochemical parameters, expressed as average ± standard deviation are reported in Tables 2 and 3, respectively.

None of the three treatments altered (P > .05) the average serum concentration of sodium and osmolarity when compared between treatments or within treatments during the experimental period (Tables 2 and 3). However, there was a decrease (P < .05) in concentration of potassium during the hydration period of animals from ESMalt and ESDext treatments (Table 2), although no

Discussion

Based on concentrations of sodium and osmolarity, hypotonic electrolyte solutions containing 5 g/L of NaCl did not (P < .05) cause hyponatremia or decrease the values of serum osmolarity in horses (Tables 2 and 3). This finding is important because it shows that the administration of this type of solution provided absorption of water and electrolytes without causing decreases in serum sodium and osmolarity. Although the World Health Organization recommends a new oral rehydration solution with

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