Physical Signs

SKIN TURGOR: DO WE UNDERSTAND THE CLINICAL SIGN?

Endurance racing is one long-distance event among the equine sporting activities associated with severe injuries and metabolic derangements that impede the health status of horses participating in the event. Therefore, this study evaluated the physical parameters and risk factors associated with the elimination of Arabian and crossed Arabian endurance horses during a 120-km race. Fifty-three Arabian and crossed Arabian endurance horses aged 6 to 15 years old participated in an endurance race of 120 km. All the horses were examined and found fit according to Fédération Équestre Internationale (FEI) regulations. After the endurance race 14 Arabian endurance horses completed the race successfully while 31 Arabian and crossed Arabian were eliminated. Their speed and heart rates were significantly higher (P < .0001). There were significant differences in skin recoil (P < .0395), color of mucous membrane (P < .0189), intestinal motility (P < .0124), and capillary refill time (P < .0082). There also were significant differences in age (P < .0018), breed (P < .0119), and equine establishments (P < .0205) among the eliminated horses and the Arabian and crossed Arabian endurance horses that successfully completed the race. In conclusion, the physical parameters and risk factors were significantly associated with the elimination of Arabian and crossed Arabian endurance horses. Therefore, close monitoring of the physical parameters and risk factors are essential in order to improve the performance of Arabian and crossed Arabian horses, and further studies are required on other associated parameters.

Although often used interchangeably, dehydration and volume depletion are not synonyms. Dehydration refers to loss of total-body water, producing hypertonicity, which now is the preferred term in lieu of dehydration, whereas volume depletion refers to a deficit in extracellular fluid volume. In particular, hypertonicity implies intracellular volume contraction, whereas volume depletion implies blood volume contraction. Using a case of hyperglycemic hypertonic nonketosis as an example, we examine the changing composition of body fluid spaces to explore the distinction between dehydration and hypertonicity from volume depletion.

102 children with acute gastroenteritis were thought by the admitting junior doctors to be 5% or more dehydrated. As judged by subsequent weight recovery in hospital, the main indicators of mild to moderate dehydration were decreased peripheral perfusion, deep breathing, decreased skin turgor, high urea, low pH, and a large base deficit; a history of increased thirst was just short of statistical significance. Dehydration was not indicated by a history of oliguria, by the presence of restlessness or lethargy, sunken eyes, dry mouth, or a sunken fontanelle or by the absence of tears. Clinical signs of dehydration became apparent at 3-4% rather than 5% dehydration. The degree of dehydration was overestimated by a mean of 3·2%; this caused unnecessary hospital admissions and overtreatment with intravenous fluid.