Current Concepts in Fluid Therapy in Horses.
Authors: Crabtree Naomi E, Epstein Kira L
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: Current Concepts in Fluid Therapy in Horses Fluid therapy is commonplace in equine practice yet remains largely based on physiological theory and extrapolation from human and small animal medicine rather than robust equine-specific evidence. Crabtree and Epstein (2021) reviewed the current body of equine fluid therapy research, drawing parallels with evolving controversies in human medicine—particularly regarding fluid type, volume, and administration route—to synthesise recommendations for adult horses receiving crystalloids, synthetic colloids, or plasma. Their examination reveals significant departures from traditional assumptions: for instance, 0.9% saline is increasingly questioned as the replacement fluid of choice, and the theoretical advantages of colloids have failed to materialise clinically whilst adverse effects exceed original predictions. The synthesis identifies substantial gaps between theory-driven practice and evidence-based outcomes, suggesting many current protocols warrant reconsideration in light of recent research. For equine professionals, this review underscores the need to critically evaluate fluid therapy decisions and remain alert to emerging evidence that may challenge established protocols, particularly regarding fluid type selection and the balance between volume replacement and risk mitigation.
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Practical Takeaways
- •Question the routine use of normal saline alone—consider balanced crystalloid solutions that more closely match plasma electrolyte composition to reduce iatrogenic acidosis
- •Be cautious with synthetic colloid use in horses; the theoretical advantages do not reliably translate to better clinical outcomes and carry unexpected risks
- •Recognize that current equine fluid therapy protocols are borrowed from human medicine rather than validated in horses—stay informed as the evidence base evolves
Key Findings
- •Equine fluid therapy recommendations are largely based on extrapolation from human medicine and other species rather than equine-specific evidence
- •Use of 0.9% NaCl as standard replacement fluid is being questioned in human medicine with emerging concerns about hyperchloremic metabolic acidosis
- •Theoretical benefits of synthetic colloids have not translated to improved clinical outcomes and are associated with greater adverse effects than predicted
- •Limited high-quality equine-specific clinical studies exist to guide evidence-based fluid therapy protocols in horses