Oral vs. IV Fluids: Which is Better for Your Pet?
Fluid therapy can be a life-saver, and in less extreme cases, it can still make sick animals feel a whole lot better. I had firsthand experience with this one time when I came down with a rip-roaring case of food poisoning. I eventually felt so terrible that I checked myself in at the nearest hospital. They ran a few tests, didn’t find anything too out of the ordinary, and proceeded to give me three liters of intravenous (IV) fluids. The doctor warned me, “You will feel like a million bucks for a few hours and then you’ll be flat on your back again.” He was right.
I’ve witnessed much the same in my patients. If I’m treating a pet that has some combination of diarrhea, vomiting, excessive urination, and/or poor water intake, fluid therapy will always be a part of my treatment protocol. Sometimes that may be as simple as encouraging the pet to drink or eat water-infused foods. At other times, I’ll give a bolus of fluids underneath the patient’s skin that they can draw from on an as-needed basis. But when a pet’s symptoms are severe enough and are combined with a clinical level of dehydration, I generally resort to IV fluids.
Pets obviously feel so much better after receiving fluids no matter the route that I’m not about to change the frequency with which I recommend them, but it turns out that the intravenous route may not be required as often as I’ve thought.
A paper published in the September 15, 2013, issue of the Journal of the American Veterinary Medical Association (JAVMA) demonstrated the effectiveness of oral rehydration in dogs suffering from bloody diarrhea with or without mild vomiting. Twenty dogs were enrolled in the study and underwent routine testing, received an injection of a medication to control vomiting, and then were offered a commercially available, over the counter, oral electrolyte/rehydration product. If the dogs failed to drink the electrolyte solution or had a worsening of their physical or laboratory parameters, they were put on intravenous fluids.
Thirteen (65%) of the dogs drank the solution while seven (35%) did not. All 13 of the dogs that drank did so within five hours of admission and had significant improvements in the laboratory parameters that are most commonly used to assess dehydration in dogs.
I’m going to have to think about moving my “line in the sand” that determines which dogs are eligible for oral rehydration and which need subcutaneous or intravenous fluid therapy. The paper also discusses the significant cost savings associated with treating dogs with oral fluids in comparison to IV fluids, which is certainly of interest to most owners.
Keep in mind, however, that the dogs in this study all received an injection of an anti-vomiting drug that is available only through veterinarians or by prescription. For this reason, the results should not be taken to mean that dogs with significant GI distress can be treated at home with an oral rehydration product alone. I suspect that without the benefits of nausea relief, far fewer dogs would have drank the electrolyte solution and their conditions would have worsened over time.
Dr. Jennifer Coates
Evaluation of an oral electrolyte solution for treatment of mild to moderate dehydration in dogs with hemorrhagic diarrhea. Reineke EL, Walton K, Otto CM. J Am Vet Med Assoc. 2013 Sep 15;243(6):851-7.