Introduction. Table of Contents

Transcription

1 Introduction In wildlife rehabilitation, basic math calculations are needed when determining drug dosages, fluid therapy, feeding amounts, caloric intake and when evaluating diets. In addition to being able to formulate and solve mathematical problems, the wildlife rehabilitator needs to be proficient in the use of several instruments of measure such as the weight scale and syringes. Also, an understanding of the metric system and the ability to covert to and from the US customary units is essential to proficiency in medical math. In part 1, we will cover all of the necessary skills to calculate accurate drug dosing and fluid therapy for animals. The course is broken down into 5 sections: Comparative (Ratio) Math the basis of proficient calculations Drug dosage calculations Understanding the metric system Tools of the trade Fluid Therapy Table of Contents Introduction... 1 Ratio Mathematics... 2 Solving Ratio Equations... 2 Mastering Drug Dosing... 3 The One-Step Calculation... 3 The Two-Step Calculation... 3 The Three-Step Calculation... 4 Easy System Conversions (Standard vs. Metric Systems)... 4 Easy Chart Method... 5 Metrics Made Easy for the Wildlife Rehabilitator... 7 The Metric Scale... 7 Temperature conversion... 9 Mathematical Tools for Accurate Measure Syringes Needle Gauges Drug Labeling Drug Strength Listed as a Percentage Combination Drugs Diluting Medications Cutting Tablets and Pills Diluting Liquid Drugs Label Your New Drug Prescription Abbreviations Scales Formulary The Power of Percentages Calculating Straight Percentages Stomach Capacity Daily Fluid Requirements Fluid Replacement Calculations Step by Step Rehydration Finding the Whole of a Percentage (Normal Body Weight) Three Day Rehydration Protocol Red Creek Wildlife Center, Inc Page 1 of 18

2 Ratio Mathematics A math problem is simply a story in steps and can be broken down into several small, easily solved problems. This equation is the simplest: This is not a fraction but a way to write a RATIO. Ratios can also be written in other formats: Let s make it easier by using something very common. We know that 1 quarter equals 5 nickels. They both equal 25 cents. If we replace the equation s numbers with coins it would now look like the following: is the same as Because coins are something we work with every day and we are instinctively familiar with how the ratios of coins work, most people will now automatically say the answer is 10 - which is correct. Labeling the numbers immediately gives clarity to the problem. It now makes sense. Labeling is important to keep you from making errors. Get in the habit of labeling from the start. This will be important later for drug dosing when we start working with milligram and cc measurements. Like items always go on the same level such as we have the quarters on the top and nickels on the bottom. Now we know the answer to this is the number 10, but how do we get there? I want to introduce you to one mathematical concept, and if you learn it well, you will be able to solve all your drug dosing problems accurately. It s called comparative or ratio math. Solving Ratio Equations The magic of this is that diagonal numbers, multiplied together, will get the same answer. But how do you mathematically discover the missing number? You multiply the diagonal that has 2 numbers and divide the answer by the odd number. 5 X 2 = = 10 And it works with all numbers. Try this same equation with different numbers missing: Remember: multiply the 2 diagonals that you have and divide by the odd one. On Your Calculator 7 X 12 3 = 7 X = 3 X = 3 X 28 7 = Practice problems ? Answer ? Answer ? Answer ? 600 Answer ? 7 Answer ? 820 Answer 2012 Red Creek Wildlife Center, Inc Page 2 of 18

3 Mastering Drug Dosing The One-Step Calculation Now let s see how this can be put into practice. A prescription is actually a story that can be set up as a calculation. You have a worm medicine that the labeling says to give 2 tablets per 10 pounds. Your animal weighs 35 pounds. Now let s lay out the calculation. The line in the fraction can be considered the same as the word per. You have 2 tablets per 10 pounds. Remember to keep like comparisons on the same level SO LABEL! Your animal weights 35 lb Worm medicine directions: 2 tablets for every 10 lbs This is a 1 calculation problem. You only need to find the quantity to give. 2 X = The Two-Step Calculation What if the dosing instructions said 20 mg for every 10 lb and each tablet is 10 mg? You now have a 2 step problem. You must now figure out the dosage and then the quantity. Dosage - How many mg do I need? Quantity - How many tabs does that equal? We figure out the dosage the same way we did in the last calculation. First we set up the problem with labels. Then we fill in what we know. We know we need 20mgs per 10 pounds. We also know our animal weighs 35 pounds. Multiply the 2 diagonal numbers and divide by the odd one. Your answer is the number you carry through to the next step. Your animal weights 35 lb Worm medicine directions: 20 mg for every 10 lb Each tablet is 10 mg lay out your calculation here Now we need to figure out the quantity. Set up the problem and label it! We know there are 10 mg per tablet and we know we need 70 mg. We need to discover how many tablets that is. lay out your calculation here Step Practice problems Remember: LABEL all of your equations Problem Dosage Quantity Answer Animal weight = 5 pounds Dosage is 15 mg per pound You have 25 mg tablets Animal weight = 2.5 pounds Dosage is 15 mg per pound You have 5 mg tablets Animal weight = 5 pounds Dosage is 15 mg per 10 pounds You have a liquid with 30 mg per ml 2012 Red Creek Wildlife Center, Inc Page 3 of 18

4 The Three-Step Calculation What if the dosing instructions give you a dose per kilogram? Now you have a problem. You must always make sure you are working in the same system. Whether it is pounds, ounces, kilograms or grams, the weight you have must be the same as the weight mentioned in the directions. These are the three steps you need for any drug dosing question: The Three Steps To Accurate Drug Dosing If you start from the top and work your way down, skipping steps you don t need, you won t make mistakes. System Dosage Quantity Am I using the same system? What is the dose? How many mg do I need? What quantity do I measure? How many tabs does that equal? This mnemonics device will help you remember the steps: Safe Drug Questions Easy System Conversions (Standard vs. Metric Systems) There are several ways to convert back and forth between standard measures (pounds and ounces) and metrics (grams and kilograms). You can use these to do the first step of a 3 step drug dosage calculation, and it is quite easy. Mass (Weight) Conversion Ratio Chart Volume 1 lb = 16 oz = 454 gm =.454kg 1 tsp = 0.33 Tbsp = fl oz = 0.5 ml 1 oz = 28 gm = kg = lb 1 Tbsp = 3 tsp = 0.5 fl oz = 15mL 1 kg = 1000 g = 2.2 lb = 35.2 oz 1 fl oz = 2 Tbsp = 6 tsp = 30 ml 1 g = oz = kg = 1000mg 1 ml = 0.2 tsp = Tbsp = fl oz Mass (Weight) Convert From: Convert To: Do This: pounds (lb) grams (g) multiply by 454 pounds (lb) kilograms (kg) divide by 2.2 pounds (lb) ounces (oz) multiply by 16 ounces (oz) grams (g) multiply by 28 ounces (oz) kilograms (kg) divide by 35.2 ounces (oz) pounds (lb) divide by 16 grams (g) kilograms (kg) divide by 1000 grams (g) pounds (lb) divide by 454 grams (g) ounces (oz) divide by 28 kilograms (kg) grams (g) multiply by 1000 kilograms (kg) pounds (lb) multiply by 2.2 kilograms (kg) ounces (oz) multiply by 35.2 Conversion Calculation Chart Volume Convert From: Convert To: Do This: fluid ounces (fl oz) milliliters (ml) multiply by 30 fluid ounces (fl oz) teaspoons (tsp) multiply by 6 fluid ounces (fl oz) tablespoons (Tbsp) multiply by 2 teaspoons (tsp) milliliters (ml) multiply by 5 teaspoons (tsp) tablespoons (Tbsp) divide by 3 teaspoons (tsp) fluid ounces (fl oz) divide by 6 tablespoons (Tbsp) milliliters (ml) multiply by 15 tablespoons (Tbsp) teaspoons (tsp) multiply by 3 tablespoons (Tbsp) fluid ounces (fl oz) divide by 2 milliliters (ml) teaspoons (tsp) divide by 5 milliliters (ml) tablespoons (Tbsp) divide by 15 milliliters (ml) fluid ounces (fl oz) divide by Red Creek Wildlife Center, Inc Page 4 of 18

5 Let s return to our problem. Since we know the pounds but the prescription is in kilograms, we need to convert to kilograms. Your animal weights 35 lb Worm medicine directions: 4.4 mg per kg Each tablet is 10 mg Easy Chart Method We have the animal s weight in pounds but we need kilograms. Following the chart instructions we take the animal s weight in pounds (35) and divide by 2.2. Round the answer off and you get what? Convert From: Convert To: Do This: pounds (lb) grams (g) multiply by 454 pounds (lb) kilograms (kg) divide by 2.2 pounds (lb) ounces (oz) multiply by 16 ounces (oz) grams (g) multiply by lb 2.2 = kg Let s do the same thing but this time with the Conversion Ratio Chart. We have pounds but we need kilograms, so we look for the comparison between the two. We find that on the first line where both are present This is a ratio problem just like we ve been doing. Mass (Weight) Volume 1 lb = 16 oz = 454 gm =.454kg 1 tsp = 0.33 Tbsp = fl oz = 0.5 ml 1 oz = 28 gm = kg = lb 1 Tbsp = 3 tsp = 0.5 fl oz = 15mL 1 kg = 1000 g = 2.2 lb = 35.2 oz 1 fl oz = 2 Tbsp = 6 tsp = 30 ml 1 g = oz = kg = 1000mg 1 ml = 0.2 tsp = Tbsp = fl oz Real Life Problem Class Example System Dosage Quantity 1.36 kg 13.6 mg 0.59mL So we set up the problem and we label the components. We put in the ratio from the chart on one side and we add what we know to the other. Dosage System = Dosage = Quantity = System Quantity lay out your calculation here lay out your calculation here lay out your calculation here lay out your calculation here 2012 Red Creek Wildlife Center, Inc Page 5 of 18

6 Practice Problems 10. You have a 3 pound animal recovering from a car accident. You are to give it 10mg/kg of Amikacin. The bottle of Amikacin reads Amikacin 50mg/mL. How many ml does it receive? 11. You have a 80 gram bunny that was attacked by a cat. You are to give it Bactrim at a rate of 30mg/kg. The bottle says there is 240mg of medication in 5mL. How many ml do you give? 12. You are treating a 28 pound coyote for mange. You are to give 0.3mg/Kg of ivermectin. Your ivermectin is 10 mg/ ml. How much do you give? 2012 Red Creek Wildlife Center, Inc Page 6 of 18

7 Metrics Made Easy for the Wildlife Rehabilitator Welcome to the Metric System: an easy, understandable measure of volume, weight and distance. The metric system is set up on a scale of ten. The simplicity of the system is the lack of confusion between units with different conversion factors. Each type of measurement (length, volume and weight) has a base unit: distance (length) = meter volume = liter weight = gram The prefix before the unit is uniform throughout each type of measurement and tells you the number of units you are working with. For example: a kilogram equals 1000 grams. The Metric Scale (BOLDED is most commonly used by wildlife rehabilitators) Prefix Symbol Multiplier exa E 1,000,000,000,000 giga G 1,000,000,000 mega M 1,000,000 Scale range used in wildlife rehabilitation kilo k 1000 hecto h 100 deka da 10 BASIC UNIT ( meter, liter, gram ) deci d 0.1 centi c 0.01 milli m micro nano n pico p Try this mnemonic device: kilo hecto deka (unit) deci centi milli Kangaroos Hop Down Under Dodging Crocodile Mouths 2012 Red Creek Wildlife Center, Inc Page 7 of 18

8 The Ladder Method i To easily convert numbers within the system, you need only count the number of jumps towards the level you wish to convert to, and move a number s decimal point the same jumps in the direction as our scale. KILO 1000 HECTO 100 To convert to a larger unit move the decimal point to the left DEKA 10 BASIC UNIT gram liter meter DECI 0.01 To convert to a smaller unit move the decimal point to the right CENTI MILLI You have 1.5 liters of liquid and you need to know how many milliliters that equals. 1. Determine your starting point. (What you know) 2. Count the jumps to your ending point. (What you want to know) 3. Move the decimal the same number of jumps in the same direction. 4. If you run out of room, add 0s to fill the space kg g KILO 1000 HECTO 100 To convert to a larger unit move the decimal point to the left DEKA 10 BASIC UNIT gram liter meter DECI 0.01 To convert to a smaller unit move the decimal point to the right CENTI MILLI According to your scale, a baby bunny weighs 30 grams. Your medication s dosage specifies kilograms. 1. Determine your starting point. (What you know) 2. Count the jumps to your ending point. (What you want to know) 3. Move the decimal the same number of jumps in the same direction. 4. If you run out of room, add 0s to fill the space g. 0 3 kg 2012 Red Creek Wildlife Center, Inc Page 8 of 18

9 KILO 1000 HECTO 100 To convert to a larger unit move the decimal point to the left DEKA 10 BASIC UNIT gram liter meter DECI 0.1 To convert to a smaller unit move the decimal point to the right CENTI MILLI Using the ladder method, convert the following: mg = g L = ml cm = mm g = kg kg = g dal = L Temperature conversion Celsius Fahrenheit Celsius Fahrenheit To convert exactly use these calculations: Celsius x = Fahrenheit (Fahrenheit - 32) 1.8 = Celsius 2012 Red Creek Wildlife Center, Inc Page 9 of 18

10 Mathematical Tools for Accurate Measure Reading dosing directions and converting those directions into usable numbers is essential for administering medication to wildlife. Accurately measuring the result requires complete understanding of the basic devices of measure, such as syringes and scales, as well as the ability to accurately read drug labels. Syringes A variety of hypodermic syringes are in common clinical use. We use all different sizes of syringes in wildlife rehabilitation, from drug and fluid administration to feeding; we use more sizes than most medical professionals. Recognizing the types of syringes and how they measure is a chief safety concern. You can do all the calculations accurately, but if you measure incorrectly, it means nothing. Most syringes are calibrated in ml. However, these various capacity syringes contain calibrations that differ from each other requiring particular care in dosage measurement. When very small dosages are required they are measured with a 1 ml syringe calibrated in hundredths. The long numbered lines are 1/10th of an ml. The shorter lines centered between these are 1/20th of an ml. And the tiny lines are each 1/100th of an ml. The amount used in a 1 ml syringe will always be a fraction of a milliliter written as a decimal. It must always have a leading zero to assure that the decimal point is not overlooked. If your amount is larger than 1 ml, then use a 3cc syringe to avoid multiple injections. On the 3 ml Syringe, The longer calibrations identify zero (0), and each ½ and full ml. These longer calibrations are numbered: ½, 1, 1½, 2, 2½, and 3. Next, notice the number of calibrations in each ml, which is 10, indicating that on this syringe each ml is calibrated in tenths. There are no 1/100th markings like on the 1 ml syringe above, so although you can give larger volumes with one injection, your dosing cannot be as exact. Larger syringes are reserved for bolus fluids and feeding. Here the longer lines are single milliliters, and in between we can only measure down to 1/5 th of an ml. Look closely at the syringe you are using and double check the measure. Some do not measure ml or will have multiple measures. Look for the ml or cc marking below the scale to avoid errors. This syringe also measures teaspoons. Minim markings can still be found on some 3 and 1 ml syringes. This is an old apothecary measurement. Because of the M, these are sometimes confused with milliliters but it actually stands for Minim. ii U-100 and U-40 insulin syringes are not calibrated the same as metric syringes. Great care must be taken when using these syringes. These are labeled in units rather than cc or ml. U-100 syringes can be easily converted by imagining a decimal point before the number. U-40 syringes are not easily converted and should be discarded. Insulin syringes usually come with colored tops (orange for U-100, and red for U-40). The calibration scale should be clearly labeled on the back of the syringe Red Creek Wildlife Center, Inc Page 10 of 18

11 Practice problems = ml = ml = ml = ml = ml = ml = ml = ml Needle Gauges Needle thickness is categorized by gauge. Any gauge needle can come in various lengths but the gauge indicates its thickness. The larger the number, the finer the needle. Although these can vary depending on the viscosity of the medication, the following is a guide of recommended needle gauge according to an animal s body weight. Body Weight Needle Gauge grams 26 gauge grams 25 gauge grams 23 gauge grams 22 gauge 500+ grams gauge 2012 Red Creek Wildlife Center, Inc Page 11 of 18

12 Drug Labeling Drugs are also tools and understanding how to interpret labels is essential to accurate dosing. Determining how much of a drug is available in what amount of volume is a drug per volume ratio and it indicates the drug s strength. With the per written as the fraction line in our ratio equation: Amikacin has 50 mg per 1 ml. Atropine contains 15 mg per 1 ml. Benedryl has 12.5 mg per 5ml Amount of Drug Volume Drug Strength Listed as a Percentage Drug percentage strength ALWAYS refers to mg per centiliter! That s the rule! Drug percentage strength ALWAYS refer to mg per centiliter. Since our syringes measure in milliliters, that s what we want so it must be converted. KILO 1000 HECTO 100 Drug Percentages DEKA 10 To convert to a larger unit move the decimal point to the left BASIC UNIT To convert to a smaller unit move the decimal point to the right DECI 0.1 Unit percentages ALWAYS refer to mg per centiliter CENTI 0.01 Unit MILLI Unit our syringes measure in milliliters We start with centiliters - And we go toward what we want to know, which is milliliters. Count the steps. This is only 1 step. The decimal point given in the percentage is moved accordingly (review page 8 for reference). Don t forget to add a zero because we have no room. A 1% label means there is 10 mg per 1 ml. When faced with a drug listed as a percentage, just move the decimal point one place to the right. Combination Drugs Calculating combination drugs (containing more than one active medication) is guided by your prescription orders (the directions you receive from the vet or from your pharmacology book). There are 3 common instructions for dosing combination drugs: Prescription knows the strength and states the measured amount to give Prescription states to use only one ingredient to calculate dosage Prescription states to combine the ingredients to calculate (In this case you would add the milligrams of drugs and make the total the strength in your equation) Read - Re-Read - And Follow the Instructions! 2012 Red Creek Wildlife Center, Inc Page 12 of 18

13 Diluting Medications Because we so often need to treat tiny animals, drugs may need to be diluted. Capsules can be opened and tablets can be crushed so that you are working with a powder. The powder can then be added to liquids such as saline, dextrose, water or syrup for oral administration of tiny amounts. The math of this is quite easy because it s based, again, on our ratio calculation. Cutting Tablets and Pills Determine how many milligrams of medication are in one capsule or tablet. Next: Determine how many milligrams of drug you need PER DOSE. Then estimate what volume you can comfortably get that animal to drink. Cross multiply and your answer gives you exactly how many milliliters of fluid to put the powder in. Milligrams you Pill Strength need for 1 dose = Volume you can comfortably give the animal? Diluting Liquid Drugs Put in the drug strength listed (per volume) Determine how many milligrams of drug you need PER DOSE Then estimate what volume you can comfortably get that animal to drink. Cross multiply and use your answer for the next step (your answer gives you the total how medication you will make). Choose a syringe large enough for the full amount you will make Pull 1 measure of the medication (the per volume amount of the strength) Fill syringe with liquid until it reaches the total of how much solution you will make. Milligrams you Drug need for 1 dose Strength = Volume you can comfortably give the animal? When diluting injectables, much care must be taken choosing what to use as the additional liquid. It must be sterile and must mix with the drug properly. Common choices are: Sterile water Sterile saline Propylene glycol If you don t know which to use, ask your veterinarian, pharmacist or consult written material that accompanies the drug. You can t just mix in anything. For example: diazepam is insoluble in water; propylene glycol which is a solvent in its clinical, injectable form is appropriate. iii Label Your New Drug You want to label your new dilution as number of milligrams per 1 milliliter. You do this by doing a second calculation: Keep one side of your original equation On the opposite side put the number 1 on the bottom Cross multiply again. This gives the milligrams per 1 milliliter. On the label, write the name of the drug, the new strength and the date. Milligrams you need for 1 dose? = Volume you can comfortably give the animal Red Creek Wildlife Center, Inc Page 13 of 18

14 Prescription Abbreviations Carefully following the directions in a prescription is imperative, and you need to understand the language. Prescription abbreviations are broken down into 3 categories: Amounts, Frequency and Administration. (Note Amounts were previously covered in the metric section Refer to page 7) Frequency b.i.d. twice a day q.i.d. four times a day s.i.d. once a day t.i.d. three times a day q4h every 4 hours q6h every 6 hours q1d every day q1w every week q2w every 2 weeks ad.lib. freely as wanted p.r.n. as needed to effect until you reach an effective result Route of Administration im intramuscular in a muscle ip Intraparitoneal in the perineum iv intravenous in a vein po orally by mouth sq subcutaneous under the skin Scales Postal Scales - Small Postal Scales - Large Up to 5 kg in 1 g increments Up to 55 lb will measure in 5 or 10 g increments Ebay Seller - ravenscalesonline Ebay Seller ravenscalesonline Jewelry Scales Up to 100 g in 0.01 g increments Ebay Seller ravenscalesonline Formulary Exotic Companion Medicine Handbook for Veterinarians (Acrobat PDF Instant Download) by Linda Harrison exoticdvm.com $ Plumb's Veterinary Drug Handbook: by Donald C. Plumb $ $ Kindle edition available Exotic Animal Formulary (3rd edition) Edited by James W. Carpenter, MS, DVM Exotic Animal Formulary [Hardcover] by James W. Carpenter, MS, DVM nwrawildlife.org $ Available in April Pre-order now for $ Red Creek Wildlife Center, Inc Page 14 of 18

15 Practice Problem You have a juvenile fox with skin infection from mange. The animal weighs 1800 gm. You are to give 15 mg of sulfa/trimethoprin per kg PO BID for 10 days and ivermectin 0.2mg/kg, IM, Repeat in 2 weeks. Your ivermectin solution is 1%. 27. How many ml of sulfa/trimethoprim will it receive each dose? 28. How will the sulfa/trimethoprim be administered? 29. How many doses of the sulfa/trimethoprim will it receive total before treatment is stopped? 30. How many ml of ivermectin will it receive? 31. How will the ivermectin be administered? 2012 Red Creek Wildlife Center, Inc Page 15 of 18

16 The Power of Percentages Percentages are used heavily in 2 critical areas of wildlife rehabilitation: Stomach Capacities & Fluid Therapy A percentage means PARTS PER HUNDRED A percentage can be written several ways: with the percent symbol 10% as a decimal 0.10 or as a ratio _10_ 100 Calculating Straight Percentages To find the percentage of any number, set up a ratio calculation: Label the calculation as whole and percent (or part) The left is your control side and the bottom whole is always one hundred The top is the percent you want to find On the right, the whole is the number you know Cross multiply to find the percentage of that number For example, The ratio to discover 5% of the number 250 would be: As in any other ratio problem, you then multiply the 2 diagonals that you have and divide by the remaining number Straight Percentages are used to determine stomach capacity as well as daily fluid needs. Stomach Capacity Baby animals have a defined stomach capacity according to species and age. Underfeeding may result in malnutrition, while overfeeding can cause severe distress and diarrhea. Calculating stomach capacity is a necessary component of wildlife rehabilitation. Daily Fluid Requirements The daily requirement for MOST animals is between 5 and 10 percent of their NORMAL body weight. MOST stable adults need about 5 percent, and some animals such as raptors will get this amount in their food. Growing babies need more, about 10 percent. Animals actively losing fluids, such as happens with diarrhea, will require more. Fluid Replacement Calculations Fluid requirements are based on the NORMAL weight of the animal and calculation MUST be based on this number. When an animal is dehydrated, its NORMAL weight has been reduced by a percentage directly related to the fluid loss. Finding the normal (pre-dehydration) weight is necessary for accurate fluid replacement and maintenance Red Creek Wildlife Center, Inc Page 16 of 18

17 Step by Step Rehydration Finding the Whole of a Percentage (Normal Body Weight) 1. Weigh the animal (IN GRAMS) and save the number: We use grams to calculate fluid replacement because it is easily converted to ml (most common measure of fluids). 2. Determine the percentage of dehydration: Skin Turgor Mouth Eyes Other Degree Seriousness Dry Mucous 1-2 seconds Normal to Dull 5% Moderate Membranes Dull and Sunken Mucous Membranes 2-5 seconds Cataract-like Depression 8% Severe are red, dry, tacky appearance in pupils Tongue dried and Lethargic 5+ seconds Sunken eyes 12 % Life Threatening cracked Skin Wrinkled No Return Tongue white, dried and cracked Sunken eyes might not be visible Shock Skin Dry and Wrinkled 15% Death Imminent 3. Subtract the percentage from 100. This is your (percentage of normal weight): 100 (degree of dehydration) = 4. Set up your calculation: You now have the animal s pre-dehydration NORMAL weight. It is this weight that you must use to calculate BOTH Daily Fluid Requirements and Rehydration Fluids in the next steps. Three Day Rehydration Protocol iv As we stated on the previous page, the daily requirement for MOST animals is between 5 and 10 percent of their NORMAL body weight. This amount must be supplied daily IN ADDITION TO the extra fluids given to rehydrate an animal. Because a compromised animal may not be able to absorb a huge amount of fluids all at once, and trying this may even overburden the systems, the additional rehydration fluids are replaced slowly over a period of three days. After the needed amount is calculated, half is given the first day, and the remaining amount is again divided and given on days two and three. 1. Calculate the daily fluid requirement for the animal. Save this number as daily need. Animal s NORMAL weight in grams X Needed daily percentage (5-10%) 2. Calculate the total replacement fluid needed to counteract the dehydration. Save this number as replacement total. Animal s NORMAL weight in grams X Percentage of fluid loss (from chart) 3. Divide the replacement total number in half. Add the daily need to the resulting answer. This is the total amount of fluids you will give the first day in MILLILITERS. Divide this by how many times you will administer the fluids throughout the first day. ( Replacement total 2 ) + Daily need ( from step 5 ) = Total 4. Divide the replacement total number by 4. Add the daily need to the resulting answer. This is the total amount of fluids you will give on both days two and three in MILLILITERS. Divide this by how many times you will administer the fluids throughout each of the days. ( Replacement total 4 ) + Daily need ( from step 5 ) = Total 2012 Red Creek Wildlife Center, Inc Page 17 of 18

18 Practice Problem You have an adult squirrel that weighs 500 grams. According to the chart it is suffering from 5% dehydration. You will rehydrate him over 3 days also supplying his 5% daily needed fluids. 32. What is his normal (non-dehydrated) weight? 33. What is the total fluid amount he will receive the first day? 34. What is the total fluid amount he will receive the second day? 35. What is the total fluid amount he will receive the third day? This course is also available online at Part 2 of this series will debut on the website in April including: Caloric intake calculations Zoo diet evaluation Understanding milk formulas i T. Trimpe ii Foundations of nursing, Lois White, Cengage Learning, 2005 iii Janusz Szajewski, MD, Warsaw Poison Control Centre (August, 1991). "Propylene glycol (PIM 443)." IPCS INChem. Retrieved July 2, iv The three day rehydration protocol is the standard we at Red Creek Wildlife Center have been using for over twenty years. This is the protocol I learned when I first began rehabbing. I did not develop this protocol but do not have the original information for whom to credit Red Creek Wildlife Center, Inc Page 18 of 18