Hydroxyethyl starch: A review of pharmacokinetics, pharmacodynamics, current products, and potential clinical risks, benefits, and use

Abstract

The extrapolation of data from human studies directly to small animals should be done with the knowledge that there may be species variations and different pharmacokinetics with different HES solutions. Veterinary reports indicate that bolus and continuous rate infusions of 6% hetastarch solutions at moderate doses are well tolerated in feline and canine subjects. Further research in domesticated species is necessary to better define and expand the knowledge regarding use of HES solutions in small animal medicine.

Retrospective evaluation of the effects of administration of tetrastarch (hydroxyethyl starch 130/0.4) on plasma creatinine concentration in dogs (2010–2013): 201 dogs

“…Previous guidelines for the use of HES in small animals have largely been based on human literature and authors’ personal experiences . Adopting the new recommendations for people and restricting the use of HES in critically ill veterinary patients would therefore be consistent with previous practice.…”

The effect of 3 resuscitative fluid therapies on hemostasis as measured by rotational thromboelastometry in dogs

“…In human beings, a plasma terminal half‐life of 12.1 hours has been reported for 6% tetrastarch 130/0.4 . Dogs are reported to have higher plasma concentrations of α‐amylase, the enzyme responsible for breakdown of synthetic starch products, than human beings, which may be why elimination half‐life of some hetastarch products is shorter in dogs than people . Further evaluation of the pharmacokinetics of tetrastarch products in dogs is required to establish elimination half‐life to ensure that appropriate washout periods are employed.…”

Treatment of meloxicam overdose in a dog via therapeutic plasma exchange

“…Additionally, these solutions may impact coagulation and platelet function. Dogs that receive >25% of their blood volume as HES can experience significant bleeding . In this case, the dog received 60 mL/kg of HES.…”