# Dextrose IP for hypothermia. New to me!



## Trysta (Apr 5, 2011)

Hey, I went to this 'birth management' clinic for small ruminants yesterday and that was time well spent. It was organized by MSU, with their small ruminant specialist, who also has a sheep farm, running the clinic. Very, very helpful, and amongst other things I learned something that was completely new to me. Maybe you have already heard of or used this system, but I hadn't and i thought I'd share it:

He gave us his protocal for treatment of lambs/kids with hypothermia, which included of course that you have to warm up the kid to at least 101 F BEFORE you tube colostrum. But for severely hypothermic kids (and older aged animals, too), headded an option. Since they are so cold, they have depleted all their reserve energy (fat and clucose) and that in itself can kill the kid before it's warm enough to tube colostrum, plus that tubed colostrum has to be digested and with (almost) zero energy in the little body, digestion can't work. So whenever the temp is <95 F, he gives a dextrose injection IP (IntraPeritoneal) meaning into the abdomen, close to the navel. Here's the description of the process (he showed it to us on a lamb):

1. Using a sterile 60cc syringe fitted with a 1", 18 gauge needle; draw up 30cc of sterile 50% dextrose (these are the 500ml IV bottles you can buy at Jeffers, etc).
2. Boil water (microwave is fast) and then draw up an equal volume (30cc) of the boiling water into the syringe (you now have very warm water in that syringe, about 120 F, warm enough to have the added effect of instantly warming the kid up, not hot enough to do damage)
3. Dosage for this mixture is approximately 5cc/lb of bodyweight, but overdosing by up to 50% (so 7.5cc/lbs) is not a problem)
4. Hold the baby upside down by the rear legs (this allows organs to shift away from injection site, even though the relative risk of organ damage is extremely low using this method). Both comatose and conscious babies can be injected in this manner.
5. Inject into the abdomen approximately 1 inch below and to the side of the navel at a 45 degree angle (that's a little less steep than this /).
6. go through your regular system of heating up the kid (warming box works well) and when the kid's body temp reaches 101 F you can feed colostrum by stomach tube. 
7. Take temperature again after colostrum tubing: if the kid's above 101 you can return it to the mom or kid pen (keep an eye on it though), if it dropped back below 101, then put it back in the warming box for awhile.

Marion


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## Cannon_farms (Nov 17, 2009)

Makes perfect sense just never had thought about it, thank you for sharing maybe this should be in the stickies.


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## dragonlair (Mar 24, 2009)

Some vets will give heated glucose IV so it warms the entire body as the fluid circulates with the blood.

Great lesson! I think I will put it on my barn, since my kids will be coming within 2 weeks.


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## fmg (Jul 4, 2011)

Thank you Marion. I took a sheep production class in college, and the sheep farm manager did use this method, and I could never remember the exact amounts of Dextrose solution to mix it right. So appreciate your post! Hope I never need it!


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## doublebowgoats (Mar 6, 2008)

Just the thought of doing that scares me. How far do you go in? How do you know you are in the peritoneum and not hitting some vital organ?


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## MF-Alpines (Mar 29, 2010)

doublebowgoats said:


> Just the thought of doing that scares me. How far do you go in? How do you know you are in the peritoneum and not hitting some vital organ?


 :yeahthat

On the other hand, if you don't intervene and the temp is real low, you'll lose the kid anyway.

I'm guessing it was put on by Dr. Richard Earhardt? I like him, but the goat guy side-kick he usually has with him, well, I'm not impressed.


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## Trysta (Apr 5, 2011)

doublebowgoats said:


> Just the thought of doing that scares me. How far do you go in? How do you know you are in the peritoneum and not hitting some vital organ?


Like Cindy says above: you will lose this goatling if you don't do this, since with that temp it has already depleted all it's reserves (which is very little to begin with in a very young kid) and even if you could get it warm, it would not have the basic energy to digest the colostrum you'll tube and therefore it will starve. Also, as mentioned in the directions: you are using a 1" needle so you go in the length of that needle, but at an 45 degree angle, so the actual depth you go in is only 1/2". It's an 18 gauge needle, that's pretty small and the way he explained it is that since you keep the kid upside down intestines will shift and most likely be out of the way, and even if not, the intestines are very well supplied with blood and a hole as tiny as made by that needle will close and heal almost immediately so it would have no ill effect.

Cindy, indeed Dr, Richard Ehrhardt did the clinic. The input of the goat man was minimal. The valuable stuff I learned all came from Dr. Ehrhardt, who seemed very knowledgeable to me. I really liked his sheep set up and how he organized it all, too. Nice sheep with the best sheep udders I have ever seen!


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## fmg (Jul 4, 2011)

You also want to aspirate (pull back on plunger), like you would for any injection when checking for blood, and if you get anything, probably you don't want to inject there. I have done IP injections on several different animal species...as bad as it sounds, as long as you are as clean as you can be, it is a pretty safe procedure. The reason for doing IP rather than SQ, in case anybody is wondering, is that 1. IP is absorbed faster, almost as fast as IV, and 2. you aren't suppose to use dextrose SQ. There is a long explanation as to why, but the short of it is that it is painful and can cause tissue necrosis given that way.

Well, crud, I just read something that said not to use it IP either, but it didn't explain why...I dunno what to believe...and I know a vet that uses it SQ sometimes, but I think it's pretty dilute. Hmm.


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## NubianSoaps.com (Oct 26, 2007)

It's what you do with chilled pups also....everyone is likely to lose a kid this year during kidding season or have one to put down. It's a great way of learning gross anatomy to know where the belly is. Learning how to set and IV is better, and bottles of glucose are cheap. As you move to doing more of your vetting, you have to learn this stuff...we have very little hypothermia down here, but we do get hypoglycemia in hot kids and pups, stressed kids and pups. Vicki


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## MF-Alpines (Mar 29, 2010)

Oh, good idea to practice on a kid that you'd have to put down.


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## NubianSoaps.com (Oct 26, 2007)

Maybe IV's, but you would want to practice most of this after you have put the kid down. And most is above pay grades of some on the forum, it at some point is vet time for everyone. Vicki


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## Qadosh Adamah Lamanchas (Nov 2, 2012)

Is it essential to do this in the abdomen? Do you go directly into the stomach or does it end up being something else you're injecting into?


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## Trysta (Apr 5, 2011)

I wish I could get a picture on here, but maybe I can show you guys with some well placed dots. Remember, you are holding the kid UPSIDE DOWN by it's hind legs. Make sure it doesn't wiggle by having a helper, or using your body and a wall to make sure its still and straight down. Now, the instructions say 1 inch below and to the side of the navel. Please realize that with this kid hanging upside down, you are actually injecting in a spot located above the navel!! (Makes sense, right?). Okay so here's a "drawing"
Left hind Right hind (so the stomach is pointing forward here, to you)
leg leg 

:yeahthat :yeahthat





/ Needle, 45 degree angle
 injection site



:biggrin navel


Okay, weird drawing, but hopefully this helps. I will try to make a pic the first time I need this myself, if I have someone with me. Usually I am a one man show... I almost needed it this morning, but the little doeling warmed up fast enough in the house to go with just a nice warm colostrum feeding. I realize this process may not be for everyone, but a lot of us doe a lot of vet-work for our animals already, so for those of you that can and want to, here's your chance to save that extra kid. Good luck and happy kidding, y'all!


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## Trysta (Apr 5, 2011)

Okay, now that it posted, it's a little off. The right hind leg needs to move a bit to the right, the navel is in the middle of course :lol


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## Qadosh Adamah Lamanchas (Nov 2, 2012)

That was great, Marion :lol


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## fmg (Jul 4, 2011)

You are injecting into the peritoneal cavity (the abdomen space that holds the organs), not within any of the organs themselves.


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## dragonlair (Mar 24, 2009)

What a great way to illustrate without using a picture! Clear as ice with your diagram! Thanks!


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## NubianSoaps.com (Oct 26, 2007)

http://www.google.com/imgres?hl=en&...tbnh=192&tbnw=161&start=0&ndsp=21&tx=78&ty=68


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## NubianSoaps.com (Oct 26, 2007)

Just click on it like it's a link, it will take you to a google.com image.


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## Trysta (Apr 5, 2011)

What now Vicki, you didn't like my smiley faces? :rofl Okay, fine I admit it: yours looks better. Still: that lamb in that picture is not going to live, no matter what they inject in it......
Marion


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## NubianSoaps.com (Oct 26, 2007)

That is what my grandson said! Granny it's dead....no Jace it is fake  Vicki


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## H Diamond Farms (Jun 3, 2011)

So, just like the picture, except you have the goat upside down? Upside down to minimize hitting an organ?


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## Trysta (Apr 5, 2011)

Yes, that is what the small ruminant specialist said and demonstrated, and that makes sense to me.


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