ِ‫يم‬

ِ ‫ح‬ِ ‫نِ ٱل َّر‬

ِ ‫م‬
ِ ْ
‫ح‬ َّ
‫ر‬ ‫ٱل‬ ِ ٰ
‫ٱّلل‬
ِ ‫م‬
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‫س‬ ِ‫ب‬
Group Members
 Sheryar
 Hassan Nawaz
 Azan
 Zubaria
 Aliyan
 Noman
 Table of Contents

1. Dehydration

2. Types of dehydration

3. Causes

4. Signs and Symptoms

5. Differential diagnosis

6. Tests

7. Treatment
 Dehydration

 Dehydration occurs when your body loses more fluid than you
take in.
 When the normal water content of your body is reduced, it upsets
the balance of minerals (salts and sugar) in your body, which
affects the way it functions.
 Water makes up over two-thirds of the healthy human body. It
lubricates the joints and eyes, aids digestion, flushes out waste
and toxins, and keeps the skin healthy.
 Dehydration—excessive loss of fluid from the body—occurs when
the loss of fluid exceeds the fluid intake.
Dehydration
 Types of Dehydration

1- hypotonic (hyponatremic)dehydration
 Occurs in acute diarrhea in calves due to excessive loss of sodium in
feces from extracellular tissues..... Severe dehydration

2- isotonic (isonatremic) dehydration

 Occurs when there is a parallel loss of sodium and water in case of
simple enteritis, copious sweating and nephrosis..... Mild dehydration

3-hypertonic (hypernatremic) dehydration

 Loss or deprivation of water with minor loss of sodium

Occurs in animals unable to drink due to esophageal obstruction

Mild dehydration
 Causes
• Hemorrhage
• Excessive perspiration
• Acute renal failure with polyuria
• Abdominal surgery
• Vomiting or diarrhea
• Nasogastric drainage
• Excessive GI suctioning
• Diabetes mellitus with polyuria or diabetes insipidus
• Fistulas
• Excessive use of laxative
• Saggressive diuretic therapy
• Fever
• Excessive fluid removal with hemodialysis or peritoneal dialysis
therapy
 Possible causes of reduced fluid :intake include

• Dysphagia
• Coma
• Environmental conditions preventing fluid intake
• Psychiatric illness.
• Fluid shifts may be related to:
• Initial phase of a burn
• Acute intestinal obstructions
• Acute peritonitis
• Pancreatitis
• Crushing injuries
• Pleural effusion
• Ascites
• Accumulation of blood around a hip fracture.
 The pathophysiology of dehydration

• The pathophysiology of dehydration involves a number of

mechanisms. The loss of body fluids causes an increase in blood
solute concentration that increases osmolality.

• Serum sodium levels rise. In an attempt to regain fluid balance

between intracellular and extracellular spaces, water molecules
shift out of the cells into the concentrated blood

• This process, combined with increased water intake and increased

water retention in the kidneys, usually restores fluid balance. But
without sufficient water in the extracellular space, fluid continues
to shift out of the cells into the extracellular space, causing the
cells to shrink and impairing cellular function
 Complication

• Complications include hypotension, risk of falls related to

hypotension, and decreased cardiac output and perfusion to
tissues and organs. Severe dehydration can progress to
hypovolemic shock

• Other complications include renal failure from decreased renal

perfusion and, without intervention, death
What happens in hypovolemic shock in hypovolemic
shock
• vascular fluid volume loss causes extreme tissue hypoperfusion
• Internal fluid losses can result from hemorrhage or third-space
fluid shifting
• External fluid loss can result from severe bleeding or from severe
diarrhea, diarrhea, or vomiting.
• Inadequate vascular volume leads to decreased venous return
and cardiac output
• The resulting drop in arterial blood pressure activates the body's
compensatory mechanisms in an attempt to increase vascular
volume
• If compensation is unsuccessful, decompensation and death may
occur.
 Internal or external Fluid loss
Decreased intravascular fluid volume
Diminished venous return
Reduced preload (filling pressure)
Decreased stroke volume
Lowered cardiac output
Reduced mean arterial blood pressure
Decreased tissue perfusion
Reduced oxygen and nutrient delivery to cells
Multiple organ dysfunction syndrome
 Signs

• May include headaches similar to what is experienced during a

hangover
• A sudden episode of visual snow
• Dizziness or fainting when standing up due to orthostatic
hypotension

Untreated dehydration generally results in delirium,

unconsciousness, swelling of the tongue and, in extreme
cases, death.
 Symptoms

• Thirst
• Dryness of mucous membrane
• Loss of skin turgor
• Orthostatic hypotension or tachycardia
• Reduced jugular venous pressure(JVP) or central venous
pressure(CVP)
• Decreased urine output
Symptoms
 Differential Diagnosis
In humans, dehydration can be caused by a wide range of diseases
and states that impair water homeostasis in the body.
These include:
A .External or stress-related causes
 Prolonged physical activity with sweating without consuming
adequate water, especially in a hot and/or dry environment
 Blood loss or hypotension due to physical trauma
 Diarrhea
 Hyperthermia
 Shock(hypovolemic)
 Vomiting
 Burns
 Lacrimation
 Use of methamphetamine, amphetamine, caffeine and other
stimulants
 Excessive consumption of alcoholic beverages
 Differential Diagnosis

B. Malnutrition
 Electrolyte disturbance
 Hypernatremia (also caused by dehydration)
 Hypernatremia, especially from restricted salt diets
 Fasting
 Recent rapid weight loss may reflect progressive depletion of fluid
volume (the loss of 1 L of fluid results in a weight loss of 1 kg
(2.21b)).
 Patient refusal of nutrition and hydration
 Inability to swallow (obstruction of the esophagus)
 Differential Diagnosis

C. Infectious Disease
 Cholera
 Gastroenteritis
 Shigellosis
 Yellow fever
D. Other causes of obligate water loss
 Severe hyperglycemia, especially in diabetes mellitus
-Glycosuria
-Uremia
 Diabetes insipidus
 Acute emergency dehydration event
 Food borne illness
 Tests

 Blood chemistries(to check electrolytes, especially sodium,

potassium, and bi carbonate levels)
 Blood urea nitrogen(BUN)
 Complete blood count(CBC)
 Creatinine
 Urine specific gravity

Other tests may be done to determine the cause of the

dehydration (for example, blood sugar level to check for
diabetes
 Treatment

 For some dehydration oral fluid is the most effective to replenish

fluid deficit.
 In more severe cases, correction of fluid deficit is best by
intravenous therapy. Solutions used for intravenous rehydration
must be isotonic or hypotonic.
 For severe cases of dehydration where fainting, unconsciousness,
or other severely inhibiting symptom is present (the patient is
incapable of standing or thinking clearly), emergency attention is
required. Fluids containing a proper balance of replacement
electrolytes are given intravenously with continuing assessment
of electrolyte status.
 Treatment

Fluid and electrolyte thrapy

Isotonic saline (0.9% NaCl) to expand blood volume
• 5% sodium bicarb in severe acidosis
Lactated ringers in metabolic acidosis
• Hypertonic NaCl 7.2% in endotoxic shock
 Amount of Fluids

Skin Remain
% Dehydrated Eyeball Position
Tented(sec)

Normal Normal <1

1-5 Normal 1-4

6-8 Slightly Sunken 5-10

9-10 Gap between eyeball and surrounding tissue 11-15

11-12 Large gap and very sunken 16-45

 Amount of Fluids

 A simple calculation can be done to identify how

much fluid is required.
 Take the % dehydrated and multiply by the calf's
body weight in kg.
 For example, (36 kg) calf is determined to be 9%
dehydrated.
 .09 X 36 kg = 3.24 - This means that 3.24 liters of
fluid (oral electrolytes, or IV fluid) are required to
replace what has been lost.
 Oral Fluid Administration: Oral fluids should only be
used in calves that are 1- 5% dehydrated
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