Is there sufficient evidence to show surgical fluid therapy delivered at the recommended 3 mL/kg/hour for cats and 5 mL/kg/hour for dogs leads to a better outcome compared with widely accepted rates of 10 mL/kg/hour for both cats and dogs?
Clinical bottom line
Category of research question
The number and type of study designs reviewed
Five studies were appraised. Two of these were opinion pieces, with one non-comparative prospective study, one randomised controlled trial, and one case control study.
Strength of evidence
Currently there is limited evidence to show that the surgical fluid therapy recommendations made by the 2013 Journal of the American Animal Hospital Association guidelines (Davis et al., 2013) for cats and dogs lead to a better outcome than accepted fluid therapy rates used. Fluid overload in humans can cause long-term adverse effects, however the same effects have yet to be shown specifically in veterinary patients
No evidence was found that provides strong, conclusive evidence that the 2013 recommendations by the American Animal Hospital Association and American Association of Feline Practitioners leads to a better outcome for both cats and dogs. The resulting research outlined below identifies a need to conduct clinical studies on the effects of fluid therapy on cats and dogs, and identify clear monitoring protocols to minimise and ideally avoid, fluid overload. When adequate, valid clinical studies have been carried out, this will provide sufficient information for the development of evidence-based recommended rates of fluid therapy for veterinary medicine, in a range of contexts
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision-making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
Borland, K. & Bennett, R. C. (2018). Perianaesthetic fluid therapy: an update. Companion Animal, 23(7), 406–411. DOI: https://doi.org/http://dx.doi.org/10.12968/coan.2018.23.7.406
Brodbelt, D. (2010). Feline anesthetic deaths in veterinary practice. Topics in Companion Animal Medicine. DOI: https://doi.org/10.1053/j.tcam.2010.09.007
Brodbelt, D. C., Pfeiffer, D. U., Young, L. E. & Wood, J. L. N. (2007). Risk factors for anaesthetic-related death in cats: results from the confidential enquiry into perioperative small animal fatalities (CEPSAF). British Journal of Anaesthesia, 99, 617–623. DOI: https://doi.org/10.1093/bja/aem229
Celeita-Rodríguez, N., Teixeira-Neto, F. J., Garofalo, N. A., Dalmagro, T. L., Girotto, C. H., Oliveira, G. C. V. & Santos, I. F. (2019). Comparison of the diagnostic accuracy of dynamic and static preload indexes to predict fluid responsiveness in mechanically ventilated, isoflurane anesthetized dogs. Veterinary Anaesthesia and Analgesia. DOI: https://doi.org/10.1016/j.vaa.2018.12.004
Coeckelenbergh, S., Delaporte, A., Ghoundiwal, D., Bidgoli, J., Fils, J. F., Schmartz, D. & Van Der Linden, P. (2019). Pleth variability index versus pulse pressure variation for intraoperative goal-directed fluid therapy in patients undergoing low-to-moderate risk abdominal surgery: A randomized controlled trial. BMC Anesthesiology, 19(1), 1–7. DOI: https://doi.org/10.1186/s12871-019-0707-9
Davis, H., Jensen, T., Johnson, A., Knowles, P., Meyer, R., Rucinsky, R. & Shafford, H. (2013). 2013 AAHA/AAFP Fluid Therapy Guidelines for Dogs and Cats. Journal of the American Animal Hospital Association. DOI: https://doi.org/10.5326/JAAHA-MS-5868
den Boogert, W. J., van Elteren, H. A., Goos, T. G., Reiss, I. K. M., de Jonge, R. C. J. & van den Berg, V. J. (2018). Reproducibility of the Pleth Variability Index in premature infants. Journal of Clinical Monitoring and Computing, 32(3), 457–464. DOI: https://doi.org/10.1007/s10877-017-0058-3
Doherty, M. & Buggy, D. J. (2012). Intraoperative fluids: How much is too much? British Journal of Anaesthesia, 109(1), 69–79. DOI: https://doi.org/10.1093/bja/aes171
Driessen, B. & Brainard, B. (2006). Fluid therapy for the traumatized patient. Journal of Veterinary Emergency and Critical Care. DOI: https://doi.org/10.1111/j.1476-4431.2006.00184.x
Drozdzynska, M. J., Chang, Y.-M., Stanzani, G. & Pelligand, L. (2018). Evaluation of the dynamic predictors of fluid responsiveness in dogs receiving goal-directed fluid therapy. Veterinary Anaesthesia and Analgesia, 45(1), 22–30. DOI: https://doi.org/10.1016/j.vaa.2017.06.001
Fantoni, D. & Shih, A. C. (2017). Perioperative Fluid Therapy. The Veterinary Clinics of North America. Small Animal Practice, 47(2), 423–434. DOI: https://doi.org/10.1016/j.cvsm.2016.11.004
Fantoni, D. T., Ida, K. K., Gimenes, A. M., Mantovani, M. M., Castro, J. R., Patricio, G. C. F., Ambrósio, A. M. & Otsuki, D. A. (2017). Pulse pressure variation as a guide for volume expansion in dogs undergoing orthopedic surgery. Veterinary Anaesthesia and Analgesia, 44(4), 710–718. DOI: https://doi.org/http://dx.doi.org/10.1016/j.vaa.2016.11.011
Gonçalves, L. A., Otsuki, D. A., Pereira, M. A., Nagashima, J. K., Ambrósio, A. M. & Fantoni, D. T. (2020). Comparison of pulse pressure variation versus echocardiography-derived stroke volume variation for prediction of fluid responsiveness in mechanically ventilated anesthetized dogs. Veterinary Anaesthesia and Analgesia, 47(1), 28–37. DOI: https://doi.org/10.1016/j.vaa.2019.08.047
Gurney, M. (2018). A procedure-specific approach to recovery after surgery.
Hopper, K., Garcia Rojas, A. & Barter, L. (2018). An Online Survey of Small Animal Veterinarians Regarding Current Fluid Therapy Practices in Dogs and Cats. Journal of the American Veterinary Medical Association, 252(5), 553–559. DOI: https://doi.org/10.2460/javma.252.5.553
Kehlet, H. (1997). Multimodal approach to control postoperative pathophysiology and rehabilitation. British Journal of Anaesthesia, 78(5), 606–617. DOI: https://doi.org/10.1093/bja/78.5.606
Kehlet, H. (2015). Enhanced Recovery After Surgery (ERAS): good for now, but what about the future? Canadian Journal of Anesthesia, 62(2), 99–104. DOI: https://doi.org/10.1007/s12630-014-0261-3
Licker, M., Triponez, F., Ellenberger, C. & Karenovics, W. (2016). Fluid therapy in thoracic surgery: A zero-balance target is always best! Turk Anesteziyoloji ve Reanimasyon Dernegi Dergisi, 44(5), 227–229. DOI: https://doi.org/10.5152/TJAR.2016.006
Lunn, K. F. (2011). The kidney in critically ill small animals. Veterinary Clinics of North America - Small Animal Practice, 41(4), 727–744. DOI: https://doi.org/10.1016/j.cvsm.2011.03.020
Marshall, K., Thomovsky, E., Johnson, P. & Brooks, A. (2016). A review of available techniques for cardiac output monitoring. Topics in Companion Animal Medicine, 31(3), 100–108. DOI: https://doi.org/10.1053/j.tcam.2016.08.006
McDermid, R. C., Raghunathan, K., Romanovsky, A., Shaw, A. D. & Bagshaw, S. M. (2014). Controversies in fluid therapy: Type, dose and toxicity. World Journal of Critical Care Medicine, 3(1), 24. DOI: https://doi.org/10.5492/wjccm.v3.i1.24
Myburgh, J. A. & Mythen, M. G. (2013). Resuscitation Fluids. New England Journal of Medicine, 369(13), 1243–1251. DOI: https://doi.org/10.1056/NEJMra1208627
O’Dwyer, L. (2011). How to perform central venous pressure measurement. The Veterinary Nurse, 2(10), 600–603.
Ostermann, M., Straaten, H. M. O. & Forni, L. G. (2015). Fluid overload and acute kidney injury: cause or consequence? Critical Care (London, England), 19, 443. DOI: https://doi.org/10.1186/s13054-015-1163-7
Sano, H., Barker, K., Odom, T., Lewis, K., Giordano, P., Walsh, V. & Chambers, J. P. (2018). A Survey of Dog and Cat Anaesthesia in a Sample of Veterinary Practices in New Zealand. New Zealand Veterinary Journal. DOI: https://doi.org/10.1080/00480169.2017.1413959
Siemionow, K., Cywinski, J., Kusza, K. & Lieberman, I. (2012). Intraoperative Fluid Therapy and Pulmonary Complications. Orthopedics, 35(2), 184–191. DOI: https://doi.org/10.3928/01477447-20120123-06
Silverstein, D. C., Cozzi, E. M., Hopkins, A. S. & Keefe, T. J. (2014). Microcirculatory effects of intravenous fluid administration in anesthetized dogs undergoing elective ovariohysterectomy. American Journal of Veterinary Research, 75(9), 809–817. DOI: https://doi.org/10.2460/ajvr.75.9.809
Stanzani, G. & Chan, D. L. (2010). Controversies in Fluid Therapy. European Journal of Companion Animal Practice, 24(2), 14–23.
Thomovsky, E., Brooks, A. & Johnson, P. (2016). Fluid Overload in Small Animal Patients. Topics in Companion Animal Medicine, 31(3), 94–99. DOI: https://doi.org/10.1053/j.tcam.2016.08.007
Valverde, A., Gianotti, G., Rioja-Garcia, E. & Hathway, A. (2012). Effects of high-volume, rapid-fluid therapy on cardiovascular function and hematological values during isoflurane-induced hypotension in healthy dogs. Canadian Journal of Veterinary Research (Revue Canadienne de Recherche Veterinaire), 76(2), 99–108.
Voldby, A. W. & Brandstrup, B. (2016). Fluid therapy in the perioperative setting-A clinical review. Journal of Intensive Care, 4(1). DOI: https://doi.org/10.1186/s40560-016-0154-3
Wang, N., Jiang, L., Zhu, B., Wen, Y. & Xi, X.-M. (2015). Fluid balance and mortality in critically ill patients with acute kidney injury: a multicenter prospective epidemiological study The Beijing Acute Kidney Injury Trial (BAKIT) Workgroup. Critical Care (London, England), 19(371). DOI: https://doi.org/10.1186/s13054-015-1085-4
Yozova, I. D., Howard, J., Sigrist, N. E. & Adamik, K.-N. (2017). Current Trends in Volume Replacement Therapy and the Use of Synthetic Colloids in Small Animals-An Internet-Based Survey (2016). Frontiers in Veterinary Science, 4, 140. DOI: https://doi.org/10.3389/fvets.2017.00140
Copyright (c) 2020 Kristina Naden
This work is licensed under a Creative Commons Attribution 4.0 International License.
Veterinary Evidence uses the Creative Commons copyright Creative Commons Attribution 4.0 International License. That means users are free to copy and redistribute the material in any medium or format. Remix, transform, and build upon the material for any purpose, even commercially - with the appropriate citation.
- Lesca Monica Sofyan, Are glucocorticoids or NSAIDs more effective in reducing idiopathic feline urinary tract disease signs than no treatment or placebo? , Veterinary Evidence: Vol. 6 No. 3 (2021): The third issue of 2021
- Ffion Lloyd, Pamela Murison, For horses undergoing general anaesthesia, are rope recoveries or free recoveries better? , Veterinary Evidence: Vol. 6 No. 3 (2021): The third issue of 2021
- Erina Leask, Efficacy of EMLA™ cream for reducing pain associated with venepuncture in felines , Veterinary Evidence: Vol. 6 No. 3 (2021): The third issue of 2021
- Karen Pickering, Joanne Ireland, Continuous digital hypothermia in the prevention and treatment of acute equine laminitis , Veterinary Evidence: Vol. 5 No. 4 (2020): The fourth issue of 2020
- Rebecca Littlehales, In dogs undergoing elective procedures is medetomidine superior to acepromazine when used as a premedication? , Veterinary Evidence: Vol. 5 No. 4 (2020): The fourth issue of 2020
- Thomas Smith-Uchotski, In cats which treatment, meloxicam or prednisolone, most quickly reduces clinical signs of feline interstitial cystitis? , Veterinary Evidence: Vol. 7 No. 1 (2022): The first issue of 2022
- David Mackenzie, Gastric dilatation volvulus in dogs: utility of lactate as a predictor of survival , Veterinary Evidence: Vol. 7 No. 4 (2022): The fourth issue of 2022
- Lesca Monica Sofyan, Fernando Martinez-Taboada, Comparison of alfaxalone versus propofol as anaesthetic induction agents in increasing the rate of survival and vigour of neonates , Veterinary Evidence: Vol. 6 No. 2 (2021): The second issue of 2021
You may also start an advanced similarity search for this article.