Throughout human history there has existed the myth of the ultimate panacea, a 'cure-all' medicine, sometimes called the elixir of life. The word 'panacea' is derived from the name of the Greek goddess of healing, Panakeia. In ancient Greek, pan means 'all' and akeia means 'remedy'. Western mythology has the philosopher's stone, which Christian tradition says was taken out of the Garden of Eden by Eve. It has the power to turn base metals into gold and to bestow immortality and was sought by alchemists throughout the Middle Ages as the ultimate panacea. China has its own version of the myth. It is said that Qin Shi Huang, the first emperor to unify China, sent a contingent of several hundred young men and women in search of the fabled Mount Penglai to find a 1,000-year-old magician living there who knew the secret of the elixir of life. The search was in vain and, fearing death for their failure to find the elixir of life, the men and women never returned and were thought to have colonised Japan. Ironically, the emperor died from mercury poisoning. For some strange reason, people from antiquity to the Renaissance had a morbid fascination with mercury and consistently failed to recognise its fatal characteristics. Maybe it was because they all went mad and died before they could record their findings. It is theoretically possible for science to overcome our failing bodies and the inevitability of death. It has already prolonged life, with life expectancy rising year after year despite our polluted planet's ills. But I find it difficult to imagine we will ever find out what makes life tick, what makes an inanimate substance come to life, what gives it a soul, so to speak. The closest thing medicine has to a panacea is water. Fluid therapy is useful in many diseases and conditions. My lecturer in anaesthesiology said: 'If in doubt, fluids are always the correct choice.' Water is essential for life to exist, it is the medium in which our cells live, it is what our cells are primarily made of, it is the substance that surrounds our DNA, intracellular proteins and enzymes, and it is essential for many of the chemical reactions that occur in our cells. The traditional medical practices of many cultures often use substances that resemble an organ to stimulate that organ and help fix its ills. For example, in Chinese medicine it is thought the humble walnut has medicinal properties that aid the brain. Because the contours of the walnut have a remarkable resemblance to the cerebral contours of the brain, traditional practitioners linked the two. I don't have much faith in such ideas, but water is the exception. Water is essential and useful in our water-filled bodies. Through fluid therapy we not only fix dehydration, we improve circulation, increase metabolism and promote the immune system. Rather than an apple a day, the saying should be: 'Three glasses of water a day keep the doctor away.' The amount of fluid we give depends on the weight of the patient and the degree of dehydration. A typical small dog needs one to two cups of water a day; a dehydrated one may need three cups a day. If the animal is in shock, it may need two cups in the first hour alone. When a dog or cat is ill it is usually not practical to force it to drink water. We usually have to give it by needle. In cats with a lot of folds of skin, it is possible to give fluids under the skin, which is called subcutaneous fluid therapy. But in most cases the fluid is provided continuously via a plastic tube inserted into a vein. We don't use plain water because it would cause massive cellular damage. Cells are not surrounded by plain water; it's really a soup of water, proteins and salts - not table salt, but a combination of various sugars and electrolytes. So the water we give contains such ingredients. Many conditions cause water loss, such as through vomiting and diarrhoea, and diabetes causes water loss through excessive urination. By using fluid therapy we can reverse an animal's dehydration. And amazingly, even if the animal is not dehydrated, giving fluids can result in a dramatic improvement in the animal's condition. I most commonly use fluid therapy during anaesthesia, which causes a slight drop in blood pressure. By giving fluids intravenously, we compensate for this drop in blood pressure. This is particularly useful in older animals, which may be in the early but virtually undetectable stages of renal failure. The fluids will maintain good blood circulation in the kidneys during the anaesthetic and prevent exacerbation of the pre-existing kidney problem. And when an animal does have kidney failure, we again turn to fluid therapy. Water is the most important factor in treating animals with kidney failure. It is truly a panacea.
