A new open-access study has provided reassuring evidence that intracecal fluid therapy can be a safe and effective alternative for rehydrating horses when conventional routes are not suitable.
Published in Frontiers in Veterinary Science, the research, led by Brenda Ventura Lopes Carvalho and a large international team of collaborators, evaluated the clinical and laboratory effects of administering enteral electrolyte solutions directly into the caecum at two different infusion rates.
Why intracecal fluid therapy matters
Intravenous and nasogastric fluid administration are the most commonly used methods to correct fluid, electrolyte and acid–base imbalances in horses. However, there are clinical situations, particularly involving compromised foregut function, where these routes may be impractical or contraindicated.
Intracecal fluid therapy offers an alternative approach, allowing enteral electrolyte solutions to be delivered directly into the hindgut, bypassing the stomach and small intestine. Until now, limited data have been available on the safety and physiological effects of this technique at different infusion rates.
How the study was carried out
The researchers used a crossover study design involving six horses that were experimentally dehydrated through a 24-hour period of food and water deprivation.
Each horse received the same neutral, hypotonic electrolyte solution on two separate occasions, administered intracecally over 12 hours at different rates:
- Treat10 – 10 mL/kg/hour
- Treat15 – 15 mL/kg/hour
To deliver the fluids, the horses underwent caecal cannulation using video laparoscopy and a modified Hasson technique, with a Foley catheter placed for controlled administration.
Blood and urine samples were collected at multiple time points before, during and after fluid therapy. These were analysed for a wide range of parameters, including blood gases, serum electrolytes, osmolarity, kidney markers, total protein, lactate and glucose.
Key findings
Across both treatment groups, the researchers observed:
- A progressive decrease in serum urea and potassium concentrations during fluid therapy
- Reduced urinary specific gravity, urea and creatinine levels, consistent with improved hydration
- No clinically significant disturbances in electrolyte balance or acid–base status
Importantly, both infusion rates were well tolerated, with no evidence that the higher rate compromised safety or physiological stability.
What this means for equine practice
The authors conclude that intracecal administration of electrolyte solutions at both 10 mL/kg/hour and 15 mL/kg/hour over a 12-hour period is effective and safe in dehydrated horses. The neutral hypotonic solution used in the study did not induce harmful biochemical changes, suggesting its formulation is appropriate for clinical use.
These findings support intracecal fluid therapy as a viable option in cases where intravenous or nasogastric routes cannot be used, expanding the toolbox available to equine veterinarians managing dehydration and electrolyte disturbances.
A growing evidence base
With no conflicts of interest declared and a robust laboratory monitoring protocol, the study adds valuable data to a relatively under-researched area of equine medicine. While further work in clinical patients is needed, this research provides a strong foundation for the considered use of intracecal fluid therapy in selected cases.
For practitioners facing complex gastrointestinal or hydration challenges, the results offer confidence that this alternative route can be both safe and physiologically appropriate when applied correctly.
