Fluid Therapy

Fluid therapy in horses is divided into replacement and maintenance phases, each addressing distinct fluid compartments and physiological needs. Replacement therapy restores extracellular fluid volume using balanced isotonic crystalloids. Fluid choice depends on clinical context – for example, acetated solutions are preferred when calcium avoidance is necessary, while lactated solutions are indicated for hypochloremia. Plasma and hypertonic saline are used for rapid volume expansion or severe hypoproteinemia, whereas synthetic colloids are used sparingly due to adverse effects. Maintenance therapy preserves total body water and osmotic balance, often requiring hypotonic fluids or enteral water supplementation. Patient-specific factors, such as age (foals vs. adults) and comorbidities, must guide therapy to minimize complications. Electrolyte management, including sodium, potassium, calcium, magnesium, and phosphorus, is essential, with supplementation tailored to laboratory findings and disease states to prevent arrhythmias and neuromuscular dysfunction. Applying these principles ensures evidence-based fluid therapy and improved outcomes in equine medicine.