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TDK conference 2020Somlai Júlia Eszter - year 6 University of Veterinary Medicine Budapest, Department of Internal Medicine Supervisor: Dr. Ferenc Manczur Accurate assessment of the hydration status is critical in order to adjust fluid therapy to the patients’ needs as precisely as possible. Physical examination and the measurement of certain laboratory values are the most widely used methods to evaluate hydration status in everyday clinical practice. However, these methods are neither sensitive nor specific enough to draw exact conclusions about the animals’ fluid homeostasis. In both human and veterinary medicine ultrasound measurements of the caudal vena cava and aorta diameters have recently emerged as potentially valuable parameters in assessing dehydration, fluid overload or acute volume loss. The aim of my study was to reveal possible associations between the subjective estimation of hydration status, laboratory values and indices calculated from the sonographic measurements of vessel diameters. We included 21 clinically ill dogs in our research. We established a subjective scale for characterising the patients’ hydration status, based on physical examination and the sonographic appearance of the heart and the caudal vena cava. Subsequently, we measured the diameters of the caudal vena cava and the aorta in both longitudinal and transverse views along with the changes of caudal vena cava diameters during respiration, known as the collapsibility index. Wherever possible, we also obtained the renal resistive indices (RI) by Doppler ultrasonography. Then we measured hematocrit values, total protein levels and calculated osmolality values from the collected blood samples. Lastly, we compared the obtained sonographic and laboratory parameters to the subjective evaluation of hydration status previously established. Our results suggest that none of the acquired laboratory values and the measured vessel diameters were accurate enough to assess the animals’ hydration status on their own. However, by measuring and calculating the ratios of caudal vena cava and aorta diameters as well as the changes in caudal vena cava diameters during respiration, we could evaluate the actual hydration status with greater certainty. Based on our results and previously published studies, we recommend the sonographic assessment of the caudal vena cava along with physical examination and blood analysis in guiding and monitoring fluid resuscitation in small animals. List of lectures |