Outcome and complications in horses administered sterile or non-sterile fluids intravenously

Background: Obtaining commercial fluids for intravenous administration (IVF) was challenging during a recent shortage. This necessitated use of custom-made non-sterile fluids for intravenous administration (JUGs) in some hospitals. There are no studies comparing outcome of horses treated with JUG versus IVF and limited information is available about adverse effects of JUGs.

Hypothesis/objectives: To evaluate death, complications, blood pH, and plasma electrolyte concentrations of horses that received JUG versus IVFs.

Animals: One hundred eighty-six horses that received IVFs and 37 that received JUGs.

Methods: A retrospective review of medical records was performed to identify horses that received IVFs or JUGs during hospitalization. Information including survival to discharge, complications (fever [>38.5°C], jugular vein phlebitis/thrombosis, arrhythmia, or laminitis), blood pH, and plasma electrolyte concentrations were obtained.

Results: There was no difference (P = .67) in survival to discharge for horses that received JUGs (78%) compared to horses that received IVFs (87%). Horses that received JUGs were more likely to develop a jugular vein complication (3 of 37 versus 1 of 186, odds ratio 17.2 [95% CI 1.9-389.8], P = .04). Horses that received JUGs were more likely to have electrolyte abnormalities consistent with hyperchloremic metabolic acidosis.

Conclusion and clinical importance: Veterinarians using JUGs should obtain informed client consent because of a potential increased risk of jugular vein complications. Chloride content of JUGs should be considered to limit development of hyperchloremic metabolic acidosis.