Hydroxyethyl Starch (HES)
Also known as: Hespan, Hextend, Voluven
**Information for Pet Owners:** * **Emergency ICU Use:** Hydroxyethyl starch (HES) is an intravenous fluid used exclusively in a hospital setting, typically in the Intensive Care Unit (ICU). * **Why it is used:** It is a "colloid" fluid, meaning it contains large molecules that stay in the blood vessels longer than standard IV fluids. It is used to rapidly treat shock, dangerously low blood pressure, or severe protein loss. * **Monitoring:** Because it is a potent fluid, your pet will be closely monitored for signs of fluid overload (which can affect breathing) and changes in blood clotting. * **Cost:** Colloid therapies and the intensive monitoring they require can add significantly to the cost of emergency care. Your veterinarian will discuss the specific reasons this therapy is necessary for your pet's stabilization.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- Shock bolus (resuscitation)
- Infusion
- Emergent situations / Colloid oncotic pressure support
- Shock resuscitation
- Adult horses - volume support
- Foals - rapid volume support
- Hypo-oncotic, well hydrated horses
- Volume replacement
- Fluid resuscitation and management of hypoproteinemia
- Volume replacement
- Small volume replacement/CPCR resuscitation
- Volume replacement
- Camelids - Volume expansion
How it is given
Possible side effects
- Coagulopathies (prolonged PT/PTT, altered Factor VIII and von Willebrand Factor)
- Nausea and vomiting (especially in cats if administered too rapidly)
- Volume overload leading to pulmonary edema
- Hypersensitivity/anaphylactic reactions (rare)
- Falsely elevated serum amylase levels
- Transient increases in indirect serum bilirubin
- Potential risk for acute kidney injury (extrapolated from human data)
Cautions & contraindications
- Severe heart failure
- Severe bleeding disorders
- Oliguric or anuric renal failure
- **Important Warnings & Precautions:** * **Coagulation:** HES can precipitate Factor VIII and interfere with von Willebrand Factor. Use with extreme caution in patients with pre-existing coagulopathies (e.g., von Willebrand's disease), thrombocytopenia, or those undergoing CNS surgery. * **Renal Risk:** Human data suggests a risk of acute kidney injury (AKI), particularly in septic patients. Use cautiously in veterinary patients with pre-existing renal dysfunction or sepsis. * **Volume Overload:** Can cause severe circulatory overload. Use with caution in patients with congestive heart failure (CHF), oliguric renal failure, or pulmonary edema. * **Capillary Leak:** In severe sepsis, SIRS, or trauma, HES may extravasate into the pulmonary interstitium, potentially causing or worsening pulmonary edema. * **Administration in Cats:** Rapid IV boluses in cats frequently cause nausea and vomiting; administer slowly (over 15-30 minutes). * **Not a Blood Substitute:** HES has no oxygen-carrying capacity and does not replace the need for RBCs in anemic patients.
Drug interactions
- Whole Blood / Red Blood Cells: Do not administer Hextend simultaneously with blood through the same administration set due to a risk of coagulation.
Frequently asked questions
What is Hydroxyethyl Starch (HES) used for in pets?
**Information for Pet Owners:** * **Emergency ICU Use:** Hydroxyethyl starch (HES) is an intravenous fluid used exclusively in a hospital setting, typically in the Intensive Care Unit (ICU). * **Why it is used:** It is a "colloid" fluid, meaning it contains large molecules that stay in the blood vessels longer than standard IV fluids. It is used to rapidly treat shock, dangerously low blood pressure, or severe protein loss. * **Monitoring:** Because it is a potent fluid, your pet will be closely monitored for signs of fluid overload (which can affect breathing) and changes in blood clotting. * **Cost:** Colloid therapies and the intensive monitoring they require can add significantly to the cost of emergency care. Your veterinarian will discuss the specific reasons this therapy is necessary for your pet's stabilization.
Is Hydroxyethyl Starch (HES) safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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