The TPN solution is a perfect culture media for bacteria, so it is necessary to take extra precautions not to contaminate the set-up. The administration sets were changed every 24 hours and the pre-mixed TPN solution was kept refrigerated until three hours before its use. The mare was cross-tied during TPN administration to assist in preservation of the catheter. Over the five-day course of therapy, hydration, blood electrolytes, and acid base status were monitored daily and adjustments in the fluid therapy were made accordingly. All blood parameters stayed within normal limits.
Careful monitoring is critical.
In order to minimize risk to the patient, it is necessary to be aware of these complications early in order to appropriately adjust the TPN therapy. She was less depressed and became much more active in the stall as therapy continued. It also was noticed that she had an increased interest in food. When offered food on Day 13, a strong appetite was demonstrated. The TPN calories were slightly below maintenance for her body weight, and the added bulk of the recently consumed food could account for most of this weight gain.