Monitoring
It is recommended to monitor blood glucose at least every 4 to 6 hours when starting PN and to adjust the rate to try to maintain blood glucose within or close to the established normal ranges.
If significant hyperglycemia (>180 mg/dL) develops and persists for more than 2 to 4 hours, the infusion should be slowed or insulin infusion begun. If costs are a concern, blood values may be monitored less frequently once steady state has been achieved. In addition, daily assessment should include serum electrolytes (especially potassium and phosphorus), TCO2, blood urea nitrogen, triglycerides (depending on species), and ammonia and liver function during the acclimation period. If possible, the patient should be weighed daily. Once a steady state has been reached, the frequency of blood monitoring can be decreased. The same approach should be used when discontinuing PN.The most common reason for instituting PN is the unwillingness or inability of a patient to ingest feed. For patients with decreased appetite, palatable feeds should be offered even during PN therapy to try to stimulate appetite. Once a patient has begun to readily ingest and tolerate a reasonable amount of food (25% normal intake or more) and has a steady appetite, PN can be gradually discontinued. Decreasing the supplement by 25% every 4 to 8 hours is generally well tolerated. Frequent monitoring of blood glucose during withdrawal (every 4 hours) is warranted, particularly in foals due to the risk of transient hypoglycemia.
More on the topic Monitoring:
- CHALLENGES OF PAEDIATRIC MEDICINE
- Vogelnest L., Portas T. (Eds.). Current Therapy in Medicine of Australian Mammals. CSIRO,2025. — 848 p., 2025
- Fluid Therapy for Renal Failure in Horses (Box 44.4)
- REFERENCES
- Cardiac Catheterization in Large Animals
- THE PAEDIATRIC CONSULTATION AND CLINICAL CONSIDERATIONS
- The Doe
- Surveillance
- REFERENCES
- Compartment, Downer, and Muscle Crush Syndromes of Cattle