Читать книгу Blackwell's Five-Minute Veterinary Consult: Reptile and Amphibian - Javier G. Nevarez - Страница 123

 Hemorrhagic anemia: control bleeding by applying pressure. Efficacy of blood replacers or transfusions has not been well studied.

 Use of hemostatic agents such as D‐aminocaproic acid or ethamsylate has not been reported in reptiles; doses are empirical (0.1 ml/kg).

 Fluid therapy: isotonic fluids should be administered at a rate of 20–30 ml/kg IV, IO, or SC for maintenance.

 Fluid losses can be replaced but be careful not to overhydrate the patient.

 Colloids may also be used at a rate 10–20 ml/kg with a bolus of 3–5 ml/kg IV or IO as needed.

 Blood transfusion: homologous transfusions are preferred over heterologous. Blood volume of up to 1% body weight is extracted from the donor, by means of syringes and needles filled with anticoagulant at a ratio of 1:6 to 1:9 anticoagulant to blood. The blood is administered to the recipient by means of an infusion pump at 5 ml/hour flow rate. True efficacy is not well documented but clinical experience suggests some short‐term benefits.

 Maladaptation syndrome: treatment consists of fluid therapy and stimulation of blood regeneration by means of iron dextran (12 mg/kg, IM every 7 days) and cyanocobalamin (vitamin B12; 0.5 mg/kg or 10–2000 iu according to the animal weight as single IM or SC dose).

 Availability of blood replacers varies across the world. If available, products like Oxyglobin® (bovine hemoglobin glutamer) 1 ml/100 g IV for 5 minutes by means of perfusion; repeat 4 hours later) may improve success in severe anemia.

 Epoietin alfa (EPOGEN®, Amgen Inc., Thousand Oaks, CA) erythropoeisis stimulating agent is reported as safe and effective in Chelonia mydas and Caretta caretta when used at 100 U/kg SC 3 times weekly over 2 weeks. Similar dosing has not been useful in Testudo hermanni.