Fluid Therapy for Horses With Hypoproteinemia
K. Gary Magdesian
Horses with concurrent hypovolemia and significant hypoproteinemia (e.g., plasma, if plasma alone is not enough.
Numerous commercial equine plasma products are currently available.
Many include antibodies to salmonella, endotoxin, and clostridial organisms; these are unlabeled claims and are largely unstudied in terms of efficacy. Another advantage of plasma, especially for the hypoproteinemic horse, includes provision of albumin, antithrombin, and additional clotting factors. Because albumin has multiple functions, including as a carrier protein (drugs, toxins) and physiologic buffer, plasma cannot be entirely replaced with synthetic colloids. Concentrated albumin has been used in neonatal foals, but its use in adult horses may be limited by cost. The potential side effects of human plasma products in horses are largely unknown and require further study. For horses with continual protein losses, such as with protein-losing enteropathies (e.g., acute enterocolitis), a continuous low rate infusion of plasma (e.g., 0.4 to 0.5 mL/kg/h) can be used.In one study evaluating the response of hypoproteinemic horses with gastrointestinal disease to hetastarch, it was determined that the oncotic benefit lasted 24 hours; in contrast, hetastarch raised the oncotic pressure of healthy horses for up to 5 days.1,6 Nevertheless, in some cases even a short-term benefit in oncotic pressure may be preferable to the further dilutional effects of crystalloids.
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