Body fluids and diarrhoes: dynamics of dysfunction.
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Biomedical subjects
Publications and source records attributed to A R Michell.
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Three commercial oral rehydration solutions (Effydral ('E'), Lectade ('L') and Lectade Plus ('LP')) were evaluated in young calves with diarrhoea following the administration of E. coli. Twenty calves with non-fatal diarrhoea were included in each group and examined for electrolytes, acidosis (pH, PCO2 and TCO2), PCV and selected biochemical parameters. Faecal consistency and clinical state were also assessed. Eight calves were examined for plasma and ECF volume. Calves were treated with the appropriate ORS only for 2 days and with ORS plus milk substitute for a further 2 days. No other treatments were given. Solutions E, L and LP were chosen specifically to test the hypothesis that their ability to repair extracellular volume would depend on their sodium content (E > L > LP) and their ability to correct metabolic acidosis would reflect their content of bicarbonate precursor (E > LP > L). Both hypotheses were confirmed as was the fact that the higher sodium content of E helps it to repair ECF volume without predisposing to hypernatraemia. The importance of correcting hyponatraemia as well as ECF volume is emphasized. Direct measurement of such changes proved much more sensitive than traditional clinical parameters such as weight loss, skin elasticity, etc. Although this study was not designed to examine mortality, it is noted that nine treated calves died, none in the E-treated group.
With the growing variety of solutions available for oral and parenteral fluid therapy it is increasingly important to define the adverse changes in plasma associated with diarrhoea, particularly those associated with a fatal outcome. The effects of E. coli-induced diarrhoea in week-old Jersey calves were measured, comparing survivors with those that died. The main effects of diarrhoea were dehydration, metabolic acidosis, pre-renal uraemia and hyponatraemia. Hypernatraemia was unusual and mild. Calves which survived tended to be hypokalaemic whereas those which died showed intensifying metabolic acidosis and hyperkalaemia. Hypoglycaemia developed, but it was not generally worse in calves which failed to survive, though there were exceptions.
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