RESEARCH       TIME      DEXTROSE   COMPLEX CHO% REDUCTION
        STUDY  PERIOD  Stool Volume  Stool Volume       STOOL

Molina, et al., 1994       0 –   6 hours   22 ± 20a           16 ± 14b    27.3 %      
Molina, et al., 1994       6 – 12 hours  14 ± 19a9 ± 13b   35.7 %      
Molina, et al., 1994    12 – 24 hours  25 ± 3322 ± 20       N.S.        
Fayad, et al., 1993       0 – 24 hours     69a           53b 23.2 %      
Islam et al., 1990* 0 – 24 hours       176.7 ± 72.1101.7 ± 50.2        42.4 %      
Islam et al., 1990*      24 – 48 hours      184.7 ± 108.390.8 ± 40.2        50.8 %      
Molla, et al., 1985 0 – 24 hours           204c   155d      24.0 %      
Sabchareaon et al., 1989*    0 – 24 hours    2046.3 g stool/day    775.8 g stool/day       62.1 %     
Greenough, 1987* 0 – 24 hours            325             105        67.6 %      
Greenough, 1987*       24 – 48 hours            150       65        56.7 %      

The Complex
That Simply Works
Best
Concentrated High Energy Electrolyte Rehydration Solution
TECHNICAL TRAININGFor Use With
CALF SCOURS
21 Normandy Drive,
Lake St. Louis, MO  63367, USA
Tel: (636) 625-1884    Fax: (636) 625-1747  
Advantages:

Complex Carbohydrate, No Osmotic Penalty:

Electrolyte Salts - Sodium, Chloride, Potassium, Calcium, Magnesium & Sulfate:

A Baby Calf's Body Is Over 75% Water - Water Is Necessary To:
- Balance pH and inhibit or eliminate the onset of acidosis.
- Bring oxygen filled blood to muscles for energy production.
- Bring oxygen to brain for alertness

Metabolizable Bases/Acid Neutralizers - Citrate, Acetate & Propionate:

Ideal For Periods Of Scours To Fight Dehydration

Palatable/Digestible/Efficient

Concentrated High Energy Electrolyte Rehydration Solution
A Source of Electrolytes & Fluid for Calves

Ingredients:
Maltodextrins, Sodium Acetate, Glycine, Sodium Propionate, Salt, Calcium Acetate, Potassium Chloride,    Sodium Citrate, Potassium Phosphate, Citric Acid, Flavor Ingredients.

Mixing Directions:
U.S. – Mix 5 oz (70 g) of C.H.E.E.R.S.™ powder with warm water (110o F) to make two quarts of solution.     Enclosed scoop (4 oz. Liquid) holds approximately 2.5 oz dry C.H.E.E.R.S. powder.  Use two level scoops full of dry C.H.E.E.R.S. powder to make two quarts of solution.

Metric – Mix 148 grams (5.25 oz) of C.H.E.E.R.S.™ powder with warm water (43o C) to make two liters of   solution.   Enclosed scoop (4 oz. Liquid) holds approximately 70 grams dry C.H.E.E.R.S. powder.  Use two heaping scoops full of dry C.H.E.E.R.S. powder to make two liters of solution.

Feeding Directions:
U.S. – For Calves Requiring Electrolytes and Fluid – Feed 2 quarts (4 lb) of electrolyte solution per calf 2-3 times daily, 2 to 3 hours after feeding.

Metric – For Calves Requiring Electrolytes and Fluid – Feed 2 liters (2 kg) of electrolyte solution per calf 2-3 times daily, 2 to 3 hours after feeding.

Continue Feeding Milk or Milk Replacer
C.H.E.E.R.S. does not interfere with milk digestion.  Continue feeding milk replacer when using this    product.  Feed C.H.E.E.R.S.™ electrolyte solution through esophageal feeder, if needed.   Research shows calves fed milk, even during periods of scours, gain more weight than calves fed electrolytes only.


Product Code:  9898 4B    Net Weight: 25 lb (11.34 kg) heat-sealed, poly-lined paper bag

Product Code:  9898 34    Net Weight: 10 lb (4.54 kg) Plastic rectangular pail with E-Z open lid and carrying handle

Product Code:  9898 L7    Net Weight: 3.5 lb (1.59 kg) Plastic square pail with E-Z open lid

Product Code:  9898 ER    Net Weight: 6 kg (13.23 lb) Plastic pail with lid
Overview of Scours
Defining Scours
In a normal gut, as needed, water flows to the lumen of the intestine for the purpose of aiding digestion and back to the blood for the purpose of absorbing nutrients, maintaining blood pH and distributing oxygen throughout the body.

Scours is a general term for a disease process which results from a disturbance in flow of water, back and forth, between the small intestine and the blood.

Scours may progress through four stages, if left unchecked (Dr. Vermeire’s “Four D’s of Scours“):

1) Diarrhea
2) Dehydration
3) Depression
4) Death from acidosis

Causes Of Scours
The causes of scours are varied and include exposure to viruses, bacteria, protozoa or various nutritional and digestive problems.  These microbial or nutritional causes of scours can often interrupt and damage (usually temporary if corrected quickly) the internal system at the villi and crypt cell level that regulate continuous back and forth flow of water between the intestinal lumen and the body (via the blood).

The normal calf transports about 100 liters (about 26.4 gallons) of water across the gut wall into the intestine and reabsorbs this 100 liters back into the body via the blood, throughout the day.

Diarrhea
When water gets "stuck" in the lumen and cannot get back into the body, this excess water becomes part of the stool and appears as diarrhea.  The loss of body fluids via stool leads to dehydration.

Recognizing Symptoms Of Scours
Dehydration 0-5% of body weight:

Dehydration 6-8% of body weight:

Dehydration 9-11% of body weight:
- Losing ability to suck and blink
- Lack of tactile response-skin twitching and head movement
- Lack of response to quick hand movements near eyes

Dehydration 12-15% of body weight:
Understanding Digestion & Absorption

DIGESTION
Nutrients must be separated out from food and made water soluble before they can be absorbed.  By digestion we mean first reducing food to its constituent parts, into a form suitable for absorption by the body fluids: the insoluble or barely soluble macromolecular organic nutrients such as proteins and complex        carbohydrates are transformed into water soluble compounds of low molecular weight by enzymes in the    digestive juices.

Enzymes are synthesized in glands in the mouth, stomach, intestine and pancreas.  Each digestive enzyme is responsible for the chemical splitting of a particular type of nutrient. 

ABSORPTION
Almost all the nutrients in food, including minerals and vitamins as well as the end products of digestion, are absorbed in the small intestine.  When digestion is complete, the proteins, fats and complex carbohydrates are changed into amino acids, shorter chain fatty acids (up to C10) and monosaccharides which can pass through the mucous membrane villi cells along the "brush border" of the small intestine and into the blood vessels.  This process is called absorption.  Only when nutrients are absorbed are they considered to be  nutritionally "in the body".

A Close Look At The Small Intestine: Site Of Absorption
VILLI, projections formed by folds in the lining of the small intestine, contain cells that absorb water and nutrients from the intestinal lumen, or cavity.  These villus cells send the nutrients to the blood or lymph.  Other projections (microvilli) on the cells (details at right) increase the absorptive area.  At the base of the villi are crypt cells, which also participate in digestion.
The Sodium-Water Absorption Systems

Absorption of water occurs at the gut wall via sodium or solute-sodium systems of transport:

1. The Sodium Transport System
Water can be absorbed via a primary channel whereby water ions follow sodium and other electrolyte salts across the semi-permeable gut wall. 

2. The Glucose or Amino Acid-Induced Sodium Transport System
An alternative, highly effective, auxiliary transport channel exists for sodium and water, when glucose is present.  This auxiliary co-transport channels remain in operation even when the primary sodium-water channel is disabled from disease or stress.

The availability of this alternate channel for sodium and water was first recognized by modern science in the 1960's, in human studies.  This discovery lead to the emergence of dehydration fighting, oral,       dextrose (glucose) electrolyte products.  However, because of osmotic pressure created by each glucose molecule, no more glucose than the proportionate amount of this solute found in normal blood can be   included in the formulation...until now, with the introduction of C.H.E.E.R.S. and its special complex carbohydrate polymer bond advantage.

Crypt Cell Activity
At the base of the villi are specialized cells called "crypt" cells.  The crypt cells work in cooperation with the villus cells during   digestion to cycle fluid from the blood to the intestinal lumen and back again to the blood.

Crypt cells extrude chloride ions (Cl-) into the lumen (1) triggering a parallel flow of sodium (Na+) and then water and other ions from the blood into the lumen (2). 

Villus Cell Activity
Later, villus cells pump sodium into the spaces between villus cells (3), thereby generating a compensatory movement of       sodium into the cells from the lumen
(4, 5) and because, as a rule, water follows sodium, the direction of the water flow is       reversed now towards
the blood (6)

Electrolytes such as sodium and chloride make use of the villus cells primary sodium-absorbing channel (a).

Additionally, sodium and water can be transported into
the body, in the presence of particular solutes, such as glucose, through an     alternate transport system (b).  Recent research has also shown that certain amino acids can further enhance transport of sodium and  water via
co-transport channels in the presence of glucose,  even when the primary sodium and water system is not able
to function, as during periods of scours, stress or nutritional upsets.
The Limitations Of Dextrose-Based Solutions

Osmosis, Osmotic Pressure & Osmotic Penalty
When two solutions are separated by a water-permeable membrane, such as the gut wall, the solution with a higher concentration will attract water from the less concentrated solution, in order to balance the amount of solutes on both sides of the  membrane, to create equilibrium. 

The higher concentration of solute on one side of a water-permeable membrane creates "osmotic          pressure".  The process by which water flows to balance the concentrations is called "osmosis".  When  water flows in an undesirable direction, this is called "osmotic penalty".


Limitations of Standard Dextrose Electrolyte Solutions:


Dextrose-based oral rehydration treatments (ORTs) must only contain up to as much glucose concentration as is found in normal blood or risk high osmotic pressure.  When glucose is provided at the level of concentration of normal blood, the co-transport system for glucose and sodium is activated and induces an osmotic flow of water towards the dehydrated blood which drags along additional ions.      Dextrose-based solutions can only exactly replace water, sodium and other ions lost from dehydrated blood.       However, they cannot generate extra fluid absorption, to reduce the extent or duration of diarrhea.

Why Extra Glucose Cannot Be Added: Osmotic Penalty
Increasing the amount of glucose in standard dextrose-based electrolyte formulas might at first seem a      reasonable way to speed fluid and electrolyte absorption.  Yet, introducing extra glucose would, in fact, be dangerous. 
An increase in concentration of glucose on the lumen side, greater than that of normal blood, would make the solution hypertonic and osmotic pressure or tendency to gain water on the lumen side would increase, in an effort
by the system to dilute the solute and create
equilibrium.  The semi-permeable gut wall would
allow water to flow undesirably from the blood into
the intestine, exacerbating any dehydration.

Tangible evidence of this process is seen when a            dehydrated, perspiring athlete, on a very hot day drinks several hypertonic, sugar-based beverages in rapid       succession.  Initially, the athlete  becomes faint as the  concentrated sucrose draws fluid into the gut lumen        before it is subsequently reabsorbed, over time. 

The Complex Carbohydrate Advantage
C.H.E.E.R.S.:  Low Osmotic Pressure - Complex Carbohydrate  Base
The Complex Carbohydrate used in C.H.E.E.R.S., is a polymer chain of linked glucose molecules.  In solution, only the unbound ends of molecules contribute to osmotic pressure while the molecules within are neutralized by the chemical links.  That explains why each molecule, whether it is one glucose unit or a chain of glucose units, adds the same amount of osmotic pressure.  C.H.E.E.R.S. reduces osmotic pressure     compared to dextrose solutions because the glucose units are bound together within our Complex             Carbohydrate molecule.  By formulating with a Complex Carbohydrate instead of simple sugar dextrose (glucose) we can deliver more glucose to the lumen for sustained sodium and water transport, without high osmotic pressure and risking osmotic penalty.

Why C.H.E.E.R.S. Works Better
The rates of hydrolysis (splitting of bonds) of Complex Carbohydrate bonds by pancreatic amylase and brush-border hydrolases are approximately equal to the rate at which the end product (glucose) is absorbed.        Instant absorption of high levels of individual glucose molecules, which are released only at the intestinal wall, virtually eliminates time for the system to experience osmotic penalty.  Therefore, it is now possible, without any increase in osmolarity of luminal contents, and allows us to deliver a relatively higher                           concentration of glucose, markedly broaden the activity of glucose-induced sodium transport channel and draw extra water and electrolytes into the blood than with dextrose-based solutions.  This extra fluid            absorption is drawn from the bowel, to reduce the volume of watery stool and possibly also the duration of  diarrhea.
C.H.E.E.R.S.ControlComments
Dehydration Score
Day 1 1.61.0C.H.E.E.R.S. Calves started out slightly      worse than control calves
Dehydration Score
Day 50.0 0.0No difference

Depression/Acidosis Score
Day 12.21.0 C.H.E.E.R.S. Calves started out slightly worse than control calves
Depression/Acidosis Score
Day 50.21.5 C.H.E.E.R.S. calves BETTER than control calves
Fecal Consistency Score
Day 12.82.6 No difference

Fecal Consistency Score
Day 51.82.5 C.H.E.E.R.S. calves BETTER than control calves

Number of calves5  5   Same number of calves
Day 1

Number of calves5    2  C.H.E.E.R.S. calves BETTER than
Day 5control calves

Death Loss 0      3/5 = 60% C.H.E.E.R.S. calves BETTER than control calves

What the scores mean:
Dehydration score = Skin tenting score (0-2 with 2 worse) + Eyeball recession score (0-2 with 2 worse)
Depression score = Suck reflex score (0-2 with 2 worse) + Menace reflex score (0-2 with 2 worse) +
Tactile response score (0-2 with 2 worse) + Ability to stand score (0-2 with 2 worse)
Fecal consistency score (1-4 with 4 worse)

For all scoring measures, the lower number is better than higher numbers.
Did You Know C.H.E.E.R.S. …

Contains Organic Salts to Correct Acidosis Without Interfering With Digestion
C.H.E.E.R.S. was developed utilizing the most recent research from around the world.  C.H.E.E.R.S.     effectively corrects metabolic acidosis by using organic salts (Sodium Acetate, Sodium Propionate, Calcium Acetate, Sodium Citrate) rather than using sodium bicarbonate.  Unlike sodium bicarbonate, organic salts do not interfere with milk digestion.  This superior system allows the continuous feeding of milk or milk replacer while using C.H.E.E.R.S. for rehydration of scoured calves.

Carbohydrate Technology is Based On Human Research Studies
Superior human electrolyte solutions have included carbohydrate formulas for almost 20 years, yet only unique C.H.E.E.R.S. Electrolyte Nutrient Product applies the osmotic benefits of Complex Carbohydrates to use with calves  and other animals.  Yes, Complex Carbohydrate costs a little more and, yes, it takes just a bit longer to mix but the performance results will be well worth the small additional investment.

Below are several key human studies demonstrating the highly effective results of using Complex              Carbohydrates to reduce the volume of diarrhea compared to dextrose-based electrolyte solutions.
Stool volume Compairson: Dextrose vs. Complex Carbohydrte Electrolyte Solutions in Humans
a, b Treatments with unlike superscripts are different (P<.05)
c, d Treatments with unlike superscripts are different (P<.01)
* Significance levels not reported
Key Findings:  In all cases, stool volume was lower when complex carbohydrate was used than when dextrose was used.  Complex carbohydrate was superior to dextrose in every case.
C.H.E.E.R.S. References

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