Читать книгу Canine and Feline Epilepsy - Luisa De Risio - Страница 99

Treatment is aimed at restoring normal extra-cellular fluid volume, decreasing sodium serum levels and treating the underlying cause of the hypernatraemia. Serum sodium concentration should be corrected at a rate of less than 0.5 mEq/l/h (0.5 mmol/l/h) to minimize the risk of cerebral cellular swelling, cerebral oedema and increased intracranial pressure. Free water deficit can be calculated based on the formula in equation 4.2 at bottom of page.

Oral water administration is the preferred method to correct water deficits in normovolaemic animals. Isotonic intravenous fluids should be used in normovolaemic animals that cannot drink and in hypovolaemic animals. Once the extracellular fluid volume has been restored, hypotonic fluids can be administered as maintenance treatment. Normovolaemic animals with pure water deficits can be administered 5% dextrose in water intravenously. Hypernatraemia secondary to excessive sodium gain can be treated with 5% dextrose in water intravenously and a loop diuretic to promote natriuresis (Benitah, 2010). Mental status, hydration and electrolytes (particularly serum sodium concentration) need to be monitored frequently (e.g. every 4–6 h) during correction of hypernatraemia. Seizures can be treated as described in Chapters 12 and 24; however, dosage and choice of AEMs will vary depending on the underlying aetiology of hypernatraemia.