Association of blood lactate concentration with physical perfusion variables, blood pressure, and outcome for cats treated at an emergency service

Objective: To identify physical exam findings, clinicopathological parameters, time to surgery, empirical antimicrobial use, and culture results that could be associated with outcome in cats with septic peritonitis (SP). Design:Retrospective cohort study of cats from 2002 to 2015.Setting: Four university teaching hospitals.Animals: Eighty-three cats diagnosed with SP by cytology or culture. Interventions: NoneMeasurements and Main Results: Fifty-eight cats survived to discharge (69.9%); 1 cat was euthanized in surgery; 20 were euthanized postoperatively; 4 cats suffered cardiac arrest after surgery.The most common etiology of SP was secondary SP due to gastrointestinal perforation (49.4%), followed by primary SP (22.3%). Mean blood glucose concentration was significantly different between survivors and nonsurvivors (P = 0.006). Cats that received appropriate empirical antibiotic therapy were 4.4 times more likely to survive than cats that did not receive appropriate antibiotics (P = 0.018). Conclusions:As previously documented, SP secondary to gastrointestinal leakage was the most common etiology. In this population, cats with a higher blood glucose concentration on presentation had a worse prognosis. Cats that received appropriate empirical antimicrobial therapy were more likely to survive. K E Y W O R D Sgastrointestinal, hyperglycemia, primary peritonitis, sepsis

Section: Discussionmentioning

confidence: 41%

Prognostic indicators in cats with septic peritonitis (2002–2015): 83 cases

Scotti

Koenigshof

Sri‐Jayantha

et al. 2019

“…Presently, there are few highly powered, large‐scale studies in the veterinary literature on which to base recommendations for using [LAC] measurements in patient evaluation and management. In an effort to provide some general guidelines, a literature search of PubMed, Scopus, and CAB Abstracts performed for this review identified 35 clinical studies that investigated [LAC] as a prognostic indicator in dogs and cats . As in the human medical literature, there was marked heterogeneity in study sizes, study populations, mortality, and selected lactate cut‐off points making comparison across studies challenging.…”

Section: Lactate As a Prognostic Indicatormentioning

confidence: 99%

“…Cats with [LAC] >4.0 mmol/L and a decrease of ≥30% within 8 hours of admission had a higher survival (9/10: 90%) than those where [LAC] decreased <30% (1/6: 17%). In 111 cats presenting to an ED, 123 sick cats hospitalized for emergency care, and in 51 cats with septic peritonitis, [LAC] was not significantly different between nonsurvivors and survivors. In contrast, in 26 cats with septic peritonitis and in 600 cats admitted to an ICU, nonsurvivors had significantly higher [LAC] compared to survivors .…”

Section: Catsmentioning

confidence: 99%

Clinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia

Rosenstein

Tennent‐Brown

Hughes

2018

“…There are fewer studies evaluating the prognostic utility of lactate in cats. In contrast to many studies in people and dogs, a recent study reported that emergency room admission lactate concentration was not significantly different between cats that did or did not survive to hospital discharge …”

Section: Introductionmentioning

confidence: 99%

Retrospective evaluation of the prognostic utility of plasma lactate concentration, base deficit, pH, and anion gap in canine and feline emergency patients

Kohen

Hopper

Kass

et al. 2017

Objective -To determine the association of plasma lactate concentration, pH, base deficit (BD), and anion gap (AG) in dogs and cats on presentation to an emergency room with outcome, and to compare the prognostic significance of hyperlactatemia with a concurrent metabolic acidosis with that of hyperlactatemia and a normal metabolic acid-base balance. Design -Retrospective study. Setting -University teaching hospital. Animals -Five hundred sixty-six dogs and 185 cats that had venous blood gas analysis performed. Interventions -None. Measurements and Main Results -Medical records were reviewed for plasma lactate concentrations, electrolyte concentrations, and acid-base parameters obtained on emergency room admission, clinical diagnosis, and inhospital mortality. The primary outcome measure was all-cause mortality for the hospitalized visit. Median plasma lactate concentration and AG were higher, BD was more negative, and pH was lower, in non-survivor dogs and cats. The prevalence of hyperlactatemia was 53% in dogs and 30% in cats. Lactic acidosis was present in 42% and 80% of hyperlactatemic dogs and cats, respectively. Multivariate regression analyses revealed that plasma lactate concentration, BD, and pH, but not AG, were independent predictors of mortality in dogs, and that only plasma lactate concentration was an independent predictor of mortality in cats. Mortality was highest for animals with lactic acidosis, at 59.8% in dogs and 49% in cats. Mortality in dogs with lactic acidosis was significantly higher than dogs with hyperlactatemia and a normal acid-base status (P < 0.0001). Conclusions -The presence and magnitude of hyperlactatemia on presentation to the emergency room may help identify dogs and cats with high likelihood of in-hospital mortality, and the presence of lactic acidosis specifically may help identify dogs with yet higher risk of in-hospital mortality.