TECHNIQUE

Fluid Therapy for Hedgehogs (Disease Investigation & Management)

Summary Information
Type of technique Health & Management / Disease Investigation & Control / Techniques:
Synonyms and Keywords See also: 
Description Before performing any clinical technique, the associated legal and ethical considerations should be consulted, knowledge of the potential complications/ limitations/ risk should be gained, and the level of expertise and qualification required must be ascertained.

All persons administering fluid therapy in the hedgehog, as with other species, must be familiar with the basic principles of fluid therapy which are beyond the remit of this section. Experience of the types of replacement fluids and the indications for which they should be used along with their appropriate routes, rates and volume for administration is essential. Knowledge of the potential complications associated with fluid therapy is required. Where the operator does not have sufficient expertise or qualification, consultation with a veterinary professional is essential.

General:

  • Hedgehog casualties should all be assessed for evidence of Dehydration (e.g. skin tenting, sunken eyes.)
  • However it is generally safest to assume that all casualty hedgehogs are dehydrated to some degree on arrival and fluid therapy should be given accordingly.
    • It is generally reasonable to assume 10-15% (in terms of body weight) dehydration for casualty wildlife presenting in a debilitated state. (B197.15.w15, B284.2.w2)
  • Fluid therapy should be given to all casualty hedgehogs on arrival via either the subcutaneous, intravascular or intraosseous routes (B151, D92); and/ or oral route.(V.w26)
  • All fluids given by injection must be sterile and should be warmed prior to administration (e.g. water bath).

Oral fluid therapy:

  • Appropriate commercial rehydration (electrolyte) solutions should be made available on admission to all hedgehog casualties. 
    • A basic oral rehydration (electrolyte) solution may be made by dissolving one tablespoon of sugar and one teaspoon of salt in one litre of water. (B203, B337.5.w5)
  • Some individuals will drink rehydration (electrolyte) solutions but will not drink water, for others the reverse is true. Both should be made available initially.
  • Hedgehog casualties which will drink fluids readily on arrival may not need injectable fluid therapy but should be monitored closely in the short term.(V.w26)
  • Oral fluids may be given by syringe, always ensuring that the hedgehog is given time to swallow; this may be tolerated reasonable well if the fluid or liquid food is palatable. (D107)
  • If in any doubt, injectable fluid therapy should be administered.

Subcutaneous route: (See: Subcutaneous Injection of Hedgehogs)

  • The subcutaneous route is the most commonly used route for fluid administration to hedgehog casualties on arrival. (B284.6.w6, J60.1.w1, P8.3.w2, V.w26)
  • Fluid types often selected for the subcutaneous route include dextrose/saline or Hartmann's solution with 5% added Duphalyte (Fort Dodge Animal Health) solution.(P8.3.w2)
  • Large volumes of (isotonic: 270-310 mOsm/l) fluids can be given quickly and easily.
  • Recommendations for the volume of fluids that can be administered subcutaneously varies between authors; no more than 50 ml/kg at one time, preferably in split sites (V.w26, V.w44); 100 ml/kg. (D92)
  • Large volumes of fluids can be given at a slow continuous rate using an infusion pump.
  • Large volumes of fluids should be split by injection at multiple sites to avoid excessive skin distension at a single site and to the increase efficiency of absorption.
  • The frequency with which fluid therapy via the subcutaneous route should be given will vary according to the condition of the casualty and whether they are / begin taking fluids by mouth.
  • Subcutaneous fluids are absorbed slowly over a period of several hours. However, large volumes divided between several sites can be given at the same time.(B150.w1)
  • Reduced efficacy in casualties with poor peripheral circulation (peripheral vasoconstriction) e.g. due to shock, hypothermia or severe dehydration.(D92)
  • Large volumes of fluids may be uncomfortable or painful on injection.
  • Over-distension of the skin with fluids may disrupt the blood supply to the skin and therefore decrease the rate of fluid absorption.

Intravenous route: (See: Intravenous Access (Venepuncture) of Hedgehogs)

  • Intravenous access can be difficult in the hedgehog (J15.21.w1, B284.6.w6), particularly with small individuals. (V.w26)
  • Fluid therapy is not frequently administered in the hedgehog by the intravenous route. (V.w26)
  • The intravenous route has been suggested for fluid administration to collapsed or unconscious hedgehog casualties on arrival.(J60.1.w1)
  • Fluid administration by the intravenous route potentially can be performed using either a bolus or infusion.
  • Intravenous infusion is reported to be unpractical in hedgehogs because of the difficulties in keeping an intravenous catheter in place in the conscious hedgehog which folds its hind limbs as it curls into a ball. (B284.6.w6, V.w26
    • Catheterisation of hedgehog veins is not thought to be possible or practical because of their small size and fragile nature.(D92)

Intraosseous route: (See: Intraosseous Injection of Hedgehogs)

  • Intraosseous injection is a technique, rarely used in the hedgehog, described in the literature as a possible route for fluid therapy in shocked or seriously injured individuals.
  • Fluids given via this route are rapidly absorbed into the circulation, even in collapsed and shocked patients. (B284.6.w6, D92)
  • Infusion pumps should be used to control the rate of fluid administration to the hedgehog casualty. (D92)
  • Administration of fluids such as plasma volume expanders, Hartmanns Solution, corticosteroids, antibiotics can be performed by the intraosseous route in shocked hedgehogs.(D92)

Intraperitoneal route: (See: Intraperitoneal Injection of Hedgehogs)

  • Fluid therapy can be given by the intraperitoneal route to hedgehog casualties with severe injury or shock. (P8.3.w2)
    • Whilst this route may not provide such optimal fluid therapy as the intraosseous or intravenous routes in some respects, the technique may be more frequently used in practice where the subcutaneous route is not used, owing to the difficulty with the former techniques in animals of small body size. 
  • Absorption of fluids given the intraperitoneal route is rapid.(B284.6.w6)
Appropriate Use (?)
  • Fluid therapy is required in individuals with Dehydration.
  • Fluid therapy should be given to all casualty hedgehogs on arrival via either the subcutaneous, intravascular or intraosseous routes (B151, D92); intraperitoneal and/or oral route.(V.w26)
    • The route of fluid therapy chosen should be appropriate for the condition of the individual hedgehog casualty and the expertise of the operator.
Notes
  • --
Complications/ Limitations / Risk For Complications/ Limitations / Risk associated with each technique, consult the relevant individual technique page.
  • Fluids given by parenteral routes (i.e. other than orally must be sterile: sterile fluids may be given by mouth but solutions intended only for oral use must not be injected (B337.5.w5)
  • Oral fluids will not be absorbed if the individual is vomiting. (B337.5.w5)
  • Large volumes of subcutaneous fluids may be uncomfortable or painful on injection.
  • Subcutaneous fluids may have reduced efficacy in casualties with poor peripheral circulation (peripheral vasoconstriction) e.g. due to shock, hypothermia or severe dehydration.(D92)
  • Over-distention of the skin with subcutaneous fluids may disrupt the blood supply to the skin and therefore decrease the rate of fluid absorption.
  • Intravenous access can be difficult in the hedgehog (J15.21.w1, B284.6.w6), particularly with small individuals.(V.w26)
  • Intravenous infusion is reported to be unpractical in hedgehogs because of the difficulties in keeping an intravenous catheter in place in the conscious hedgehog which folds it hind limbs as it curls into a ball. (B284.6.w6, V.w26
    • Catheterisation of hedgehog veins is not thought to be possible or practical because of their small size and fragile nature.(D92)
  • Monitor for signs of fluid overload if giving a bolus of fluids (increased respiratory rate, cardiac dysrhythmia, agitation or collapse) by the intravenous or intraosseous route.
    • Care should be taken to avoid fluid overload, particularly with the small body size of the hedgehog.(D92)
Equipment / Chemicals required and Suppliers
  • Appropriate disposables.
  • Appropriate fluids / medication.
Expertise level / Ease of Use Procedure should only be undertaken by an individual with appropriate clinical training and practical experience; this would usually be a veterinarian or someone with advanced veterinary technician training.
Cost/ Availability
  • Cost of needle, catheter, syringe and drugs.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons)

Use of Drugs (Medication):

  • Many drugs are not registered for use in particular species and care should be taken in their use, with proper regard for possible toxic effects. Consideration should be give to relevant legislation regarding the use of drugs.
  • In the UK, guidelines regarding the use of drugs are set out in the Royal College of Veterinary Surgeons Guide to Professional Conduct 2000: (see: LCofC1 - RCVS Guide to Professional Conduct 2000 - Choice of Medicinal Products).
Authors Becki Lawson (V.w26)
Referee Debra Bourne (V.w5), Suzanne I. Boardman (V.w6), Tiffany Blackett (V.w44)
References B150.w1, B151, B156.7.w7, B197.15.w15, B203B284.2.w2, B284.6.w6, B337.5.w5, J15.21.w1, J60.1.w1, D92, P8.3.w2, V.w26, V.w44

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