Clinical signs, profound acidemia, hypoglycemia, and hypernatremia are predictive of mortality in 1,400 critically ill neonatal calves with diarrhea

Abstract

Profound acidemia impairs cellular and organ function and consequently should be associated with an increased risk of mortality in critically ill humans and animals. Neonatal diarrhea in calves can result in potentially serious metabolic derangements including profound acidemia due to strong ion (metabolic) acidosis, hyper-D-lactatemia, hyper-L-lactatemia, azotemia, hypoglycemia, hyperkalemia and hyponatremia. The aim of this retrospective study was to assess the prognostic relevance of clinical and laboratory findings in 1,400 critically ill neonatal calves with diarrhea admitted to a veterinary teaching hospital. The mortality rate was 22%. Classification tree analysis indicated that mortality was associated with clinical signs of neurologic disease, abdominal emergencies, cachexia, orthopedic problems such as septic arthritis, and profound acidemia (jugular venous blood pH < 6.85). When exclusively considering laboratory parameters, classification tree analysis identified plasma glucose concentrations < 3.2 mmol/L, plasma sodium concentrations ≥ 151 mmol/L, serum GGT activity < 31 U/L and a thrombocyte count < 535 G/L as predictors of mortality. However, multivariable logistic regression models based on these laboratory parameters did not have a sufficiently high enough sensitivity (59%) and specificity (79%) to reliably predict treatment outcome. The sensitivity and specificity of jugular venous blood pH < 6.85 were 11% and 97%, respectively, for predicting non-survival in this study population. We conclude that laboratory values (except jugular venous blood pH < 6.85) are of limited value for predicting outcome in critically ill neonatal calves with diarrhea. In contrast, the presence of specific clinical abnormalities provides valuable prognostic information.

Hematological and biochemical parameters of dairy calves submitted to pegbovigrastim administration

“…Nevertheless, this effect was not evidenced in the IMR + LPS group. Although higher GGT levels in the IMR + LPS group were observed, which could indicate a metabolic challenge, the values of GGT for all groups were maintained among the reference values for this category (Trefz et al, 2017). Nonetheless, the GGT activity could have been influenced by colostrum ingestion until approximately 40 d of age (Knowles et al, 2000).…”

Role of electrolyte abnormalities and unmeasured anions in the metabolic acid‐base abnormalities in dogs with parvoviral enteritis

“…26 However, assuming the veracity of the SIM paradigm we demonstrated a clear advantage of the SIM over HH in explaining complex mixed metabolic acid-base perturbations in PE. We specifically chose PE as a disease model, due the diversity of expected perturbations to acid-base homeostasis, which we suspected would have concomitant acidifying and alkalinizing effects, given the fact that diarrhea is often associated with acidemia, 10,28 and vomiting with alkalemia. 29,30 Based on previous work 5 we anticipated changes in SID and A tot would be present, but we did not anticipate the presence of UA in severe acidemia as was documented in this study.…”

Diagnosis and Treatment of Infectious Enteritis in Neonatal and Juvenile Ruminants

“…Laboratory diagnostic tests are important for guiding therapy, but they are poor predictors of prognosis in calves with diarrhea. 15 Physical examination findings are more sensitive predictors of outcome and should be the primary consideration when making clinical decisions. 15…”

“…15 Physical examination findings are more sensitive predictors of outcome and should be the primary consideration when making clinical decisions. 15…”