This paper examines the possibility that treatment of diarrhoea with conventional oral rehydration solutions (ORSs) may be detrimental to villus structure by imposing nutrient deprivation and that such detrimental effects may be reduced or avoided by using a nutrient ORS. A conventional WHO-type ORS (W) was compared with two nutrient solutions (N and G) both containing high glucose concentrations and the latter containing glutamine; their effects on enteric structure were assessed by morphometric analysis of samples obtained from diarrhoeic calves after 96 h treatment. Comparisons were also made with samples from controls and diarrhoeic calves at the stage where oral rehydration would have begun in the treated groups. As in our previous ORS studies, diarrhoea was induced with enterotoxigenic Escherichia coli (09:K30:K99). We measured villus length and width, crypt depth and width and calculated villus surface area in proximal, mid and distal small intestine (PSI, MSI, DSI), using standard morphometric techniques. Proximal and distal spiral colon samples (PC, DC) were examined for crypt depth and width; mitoses per crypt were counted in samples from all regions. Non-diarrhoeic calves showed the expected gradient of villus length through PSI, MSI and DSI, hence data for each region are normalized as a percentage of the control value for that region. PSI showed the greatest loss of villus length and surface area (50%) with diarrhoea. In MSI and DSI the villus loss was greater with solution W and N or G, as were increased mitoses and crypt depth. Crypt depth and mitoses also increased in the colon with solution W. Colonic crypt width increased with diarrhoea and conventional oral rehydration but less so with G; there is reason to believe that such changes have functional significance. Crypt changes in colon, MSI and DSI were least with solution G. The changes developing in diarrhoeic calves prior to treatment were thus less apparent in those treated with a nutritional ORS, particularly if it contained glutamine.

Changes in plasma urea, creatinine and glomerular filtration rate (GFR) were measured in calves before and after development of diarrhoea and during treatment with a conventional (WHO-type) or a nutritional oral rehydration solution (ORS). Changes in urea and creatinine failed to represent the extent of pre-renal failure. The two ORSs differed in their impact on GFR with the nutritional ORS improving GFR whereas with the WHO-type solution it deteriorated further.

The essential constituents of a conventional oral rehydration solution (ORS) are sodium, glucose and a bicarbonate precursor. The glucose promotes sodium uptake but because these solutions are isotonic, it is insufficient to sustain calorie requirements. This paper examines the performance of a novel ORS with over three times the conventional glucose concentration, by comparing it with two leading commercial ORSs in calves with induced Escherichia coli diarrhoea. This solution showed greater ability than the current market-leading ORS to repair extracellular fluid and plasma volume and to correct both hyponatraemia and metabolic acidosis, especially in more severely affected calves. In acidotic calves it was more effective in correcting hyperkalaemia, probably by supplying glucose to promote cellular potassium uptake as well as by correcting the acidosis. It therefore appears possible to depart from the traditional isotonic formulations for calf ORSs and gain significant nutritional support while retaining effective rehydration and correction of acid-base and electrolyte disturbances. This seems especially important in young animals where energy deprivation imposes a particular penalty; the use of hypertonic ORSs should not, however, be extended to other species without further research.

It is often said that the success of oral rehydration in humans depends on the adequacy of the improvement in the composition and volume of extracellular fluid, not reduction of faecal output. Indeed, the latter may increase initially. Such increases do not prevent the treatment from being effective but they may, falsely, undermine its acceptability to patients or those caring for them. This paper provides data to show that standard oral rehydration solutions used to treat experimentally induced calf diarrhoea procure identical improvements in plasma volume during the first 48 h, whether faeces improve or not, and those calves whose faecal consistency improved actually showed greater deterioration of extracellular fluid volume. While it is important for this to be appreciated by clinicians and explained to owners, it is absolutely imperative that those responsible for the approval of new therapeutic products for registration understand and accept that faecal consistency offers no reliable insight into the effectiveness of oral rehydration therapy for calf diarrhoea. It was, however, interesting that there was some relationship with correction of acidosis-perhaps because some of the contributing factors arise from colonic dysfunction.

Three commercial oral rehydration solutions (Effydral (‘E’), Lectade (‘L’) and Lectade Plus (‘LP’)) were evaluated in young calves with diarrhoea following the administration of E. coli. Twenty calves with non-fatal diarrhoea were included in each group and examined for electrolytes, acidosis (pH, PCO2and TCO2), PCV and selected biochemical parameters. Faecal consistency and clinical state were also assessed. Eight calves were examined for plasma and ECF volume. Calves were treated with the appropriate ORS only for 2 days and with ORS plus milk substitute for a further 2 days. No other treatments were given. Solutions E, L and LP were chosen specifically to test the hypothesis that their ability to repair extracellular volume would depend on their sodium content (E>L>LP) and their ability to correct metabolic acidosis would reflect their content of bicarbonate precursor (E>LP>L). Both hypotheses were confirmed as was the fact that the higher sodium content of E helps it to repair ECF volume without predisposing to hypernatraemia. The importance of correcting hyponatraemia as well as ECF volume is emphasized. Direct measurement of such changes proved much more sensitive than traditional clinical parameters such as weight loss, skin elasticity, etc. Although this study was not designed to examine mortality, it is noted that nine treated calves died, none in the E-treated group.

This report is limited to papillary cystadenoma of the palate. These tumors have appeared under various names. A review of the literature is presented. There have been four cases previously reported. Two new cases are added. Data are given to support the idea that papillary cystadenoma of the palate is a low-grade malignant tumor.