MDose · Veterinary drug reference
TIER2 TOPIC: EMERGENCY FLUIDS/ELECTROLYTES (NAHCO₃ / DEXTROSE / MAGNESIUM / IV LIPID EMULSION)
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Pending clinical review (PROPOSED)Rule-based (RULE_BASED)— applies to the facts and dose entries in this species selection; individual source records retain their own status.
Indications8
NaHCO₃: metabolic acidosis, urine alkalinization, hyperkalemia/hypercalcemia adjunct
DogCatNot applicable (NOT_APPLICABLE)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: NaHCO₃: metabolic acidosis, urine alkalinization, hyperkalemia/hypercalcemia adjunct — Standard hospital therapy
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: NaHCO₃: metabolic acidosis, urine alkalinization, hyperkalemia/hypercalcemia adjunct — Standard hospital therapy
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Dextrose: hypoglycemia (insulin overdose, insulinoma, neonates, toy-breed)
DogCatNot applicable (NOT_APPLICABLE)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Dextrose: hypoglycemia (insulin overdose, insulinoma, neonates, toy-breed) — Standard
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Dextrose: hypoglycemia (insulin overdose, insulinoma, neonates, toy-breed) — Standard
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Magnesium (IV): hypomagnesemia (refractory hypokalemia companion), refractory ventricular arrhythmias, anticonvulsant, MH adjunct (swine)
DogCatNot applicable (NOT_APPLICABLE)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Magnesium (IV): hypomagnesemia (refractory hypokalemia companion), refractory ventricular arrhythmias, anticonvulsant, MH adjunct (swine) — Standard
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: Magnesium (IV): hypomagnesemia (refractory hypokalemia companion), refractory ventricular arrhythmias, anticonvulsant, MH adjunct (swine) — Standard
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
IV lipid emulsion (ILE): lipophilic-drug intoxication RESCUE — local anesthetics, macrocyclic lactones (ivermectin/moxidectin — incl. MDR1 dogs), CCBs, beta-blockers, others
DogCatExtra-label (EXTRA_LABEL)2 source records · View provenance
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: IV lipid emulsion (ILE): lipophilic-drug intoxication RESCUE — local anesthetics, macrocyclic lactones (ivermectin/moxidectin — incl. MDR1 dogs), CCBs, beta-blockers, others — Extra-label antidote
- Cat · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Original excerpt: IV lipid emulsion (ILE): lipophilic-drug intoxication RESCUE — local anesthetics, macrocyclic lactones (ivermectin/moxidectin — incl. MDR1 dogs), CCBs, beta-blockers, others — Extra-label antidote
- Dog · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Indications table · Not applicable · Extra-label (EXTRA_LABEL) · Pending clinical review (PROPOSED) · Rule-based
Dose regimens0
No dose regimens recorded for this species selection.
Adverse effects0
No adverse effects or event reports recorded for this species selection.
Monitoring1
Blood gases (2–4 h post-NaHCO₃), glucose q15–60 min in crises, magnesium levels + ECG (QT), ILE: neuro/cardiac recovery signs + lipemia clearance
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Monitoring Parameters · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Contraindications1
Metabolic/respiratory alkalosis, chloride-loss states, hypocalcemia (alkalosis tetany), poor ventilation
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Precautions6
Hypermagnesemia → IV calcium 10–50 mg/kg (Macintire) — the mirror-image rescue
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Don't run other drugs through the lipid line
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Contraindications & Warnings table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
NaHCO₃ trinity: calculate don't blast (⅓ of deficit), ventilate before you medicate (CO₂ problem), and watch potassium/calcium swing together.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Hypoglycemia two-step: D50 bump → D5 drip bridge (especially long-acting insulin/insulinoma) — the rebound is the trap.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
The hypokalemia-that-won't-fix is often hypomagnesemia — Mg 0.5–1 mEq/kg/day CRI unlocks refractory K repletion.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Clinical pearl · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pharmacokinetics5
NaHCO₃ — Buffers H+ → CO₂ + H₂O — CO₂ crosses into CSF faster than bicarbonate → paradoxical CNS acidosis if rapid/under-ventilated
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
NaHCO₃ monitoring lag — Intracellular buffering equilibrates 2–4 h — early gas overestimates effect
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Dextrose — D50 hypertonic (2,500 mOsm) — vein damage if undiluted; hyperglycemia rebound
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Magnesium — Cofactor machinery; renal excretion → overload in renal failure
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
ILE ("lipid sink") — Lipid phase sequesters lipophilic drugs → drops free-drug levels at receptors
Other speciesNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Other species · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Pharmacokinetics table · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Pregnancy / lactation considerations1
Emergency-context use; treat the mother.
Species not recordedNot applicable (NOT_APPLICABLE)1 source record · View provenance
- Species not recorded · Plumb's Veterinary Drug Handbook, 7th ed., p. 1062–1064 (NaHCO₃), p. 749–750 (magnesium), p. 504–505 (IVFE), p. 647–648 insulin monograph (dextrose hypoglycemia guidance) — Pregnancy & Lactation · Not applicable · Not applicable (NOT_APPLICABLE) · Pending clinical review (PROPOSED) · Rule-based
Sources: Plumb DC. Plumb's Veterinary Drug Handbook. 7th ed. PharmaVet Inc; 2011.