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Definition

Severe electrolyte abnormalities

Risk factors

 Use of tap water (hyponatremia) [57]

 Custom‐made electrolyte solutions with low sodium concentrations

Pathogenesis

If large amounts of tap water are administered over a prolonged period of time, plasma sodium concentrations will decrease due to dilution. Inadvertent administration or false mixing of fluids and electrolytes of fluids, e.g. 9% NaCl, can also lead to severe hypernatremia and neurological signs. Additional electrolyte abnormalities reported after excessive doses include hypomagnesemia and hypocalcemia [52].

Prevention

If no abnormalities are present, a balanced isotonic solution containing sodium, chloride and potassium similar to equine plasma should be chosen. Osmolality should also be similar to equine plasma. Electrolytes should be monitored daily during enteral fluid administration or whenever the solution is changed.

Treatment

Discontinue or adjust the enteral fluid. Treatment depends on the electrolyte abnormality present; see prior recommendations in this chapter.

Expected outcome

If signs are detected early and enteral fluid therapy is adjusted, prognosis is good.