Retrospective evaluation of carboxyhemoglobin and methemoglobin levels in dogs and cats with respiratory disease

Wolf, Jacob M; Hess, Rebecka S.; Hering, Caitlin T; Silverstein, Deborah C.

doi:10.1111/vec.13202

Cited by 3 publications

(2 citation statements)

References 35 publications

(110 reference statements)

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“…Failure to reach reported toxic concentrations (ie, >10%‐15%), above which clinical signs appear, is another possible explanation. Lastly, in 2 large retrospective studies of 868 critically‐ill, human patients 30 and 466 dogs with respiratory diseases, 31 COHb was not associated with death.…”

Section: Discussionmentioning

confidence: 93%

Carboxyhemoglobin as a diagnostic and prognostic biomarker of hemolytic anemias in dogs

Nivy

Sutton

Bruchim³

2022

Veterinary Internal Medicne

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Background Endogenous production of carbon monoxide during hemoglobin metabolism leads to the formation of carboxyhemoglobin. Carboxyhemoglobin concentration is abnormally high in humans with hemolytic anemia (HA). Hypothesis Measurement of carboxyhemoglobin concentration can discriminate HA from other forms of anemia. Animals Twenty‐seven dogs with HA (immune‐mediated HA, n = 22; microangiopathic HA, n = 5), 27 dogs with non‐HA (kidney disease, n = 14; immune‐mediated thrombocytopenia, [n = 6]; miscellaneous, n = 7) and 24 nonanemic control dogs. Methods Prospective cohort study. Carboxyhemoglobin quantification, a CBC and biochemistry profile were performed upon admission, and survival to hospital discharge and at 30 days were the measured outcomes. Groups were compared by the Mann‐Whitney and Kruskal‐Wallis tests. Receiver‐operator characteristic (ROC) analyses were used to examine the predictive utility of carboxyhemoglobin for the diagnosis of HA in anemic dogs. Results Carboxyhemoglobin (median [interquartile range]) differed between dogs with HA (7.7% [2.5%]) and non‐HA (3.6% [1.05]; P < .001) and dogs with HA and nonanemic dogs (3.5% [0.65%]; P < .001). No difference was detected between nonHA and nonanemic dogs. The area under the ROC curve for carboxyhemoglobin as predictor of HA in anemic dogs was 0.997 (95% CI, 0.99‐1.00). Three optimal cut‐off points were identified, including 5.05%, 4.55% and 4.85%, with corresponding sensitivity/specificity of 92.6%/100%, 100%/92.6% and 96.3%/96.3%, respectively. Neither carboxyhemoglobin nor any of the CBC or chemistry analytes were associated with survival. Conclusions and Clinical Importance Carboxyhemoglobin proved an excellent predictor of HA in dogs and might constitute a useful, ancillary tool for diagnosing and monitoring hemolytic anemias.

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Section: Discussionmentioning

confidence: 93%

Carboxyhemoglobin as a diagnostic and prognostic biomarker of hemolytic anemias in dogs

Nivy

Sutton

Bruchim³

2022

Veterinary Internal Medicne

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“…Indeed, the physiological percentage of COHb is usually lower than 3% (16,17), and its significant increase has been reported in animals surviving fires and in CO poisoning (19,20,35). Moreover, only mild increases in COHb% have been reported due to exposure to cigarettes smoke or environmental pollution and in animals with specific pathological conditions such as sepsis or respiratory diseases (38)(39)(40). Surprisingly, the comparison of the COHb levels in cadavers exposed post-mortem to fire (Group C) before and after the heat treatment showed an increase in COHb% ranging between 3.1 and 18.7% (mean value 12.57 ± 6.65 SD), suggesting a post-mortem action of the heat and smoke on animal's blood gas composition.…”

Section: Toxicological Findingsmentioning

confidence: 99%

Pathological alterations and COHb evaluations as tools for investigating fire-related deaths in veterinary forensic pathology

Piegari,

d’Aquino,

Salanti

et al. 2024

Front. Vet. Sci.

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Fire-related deaths are usually a consequence of carbon monoxide (CO) poisoning or shock from thermal injuries. In humans, high levels of carboxyhemoglobin (COHb) concentrations in the blood can support a diagnosis of CO poisoning. In veterinary medicine, few studies investigated the pathological changes and blood COHb% in fire victims, and no data are available on post-mortem changes in blood gas composition due to fire. This study aims to investigate the pathological changes and COHb levels in both animal victims of fire and cadavers experimentally exposed to fire. For this purpose, dogs were selected and subdivided into three groups. Group A comprised 9 adult dogs, and Group B comprised 7 puppies that died under fire-related conditions. Group C was represented by 4 dog cadavers experimentally exposed to heat and smoke. A complete macroscopic, histological, and COHb evaluation were performed on each animal. Animals in Groups A and B showed cherry-red discoloration, thermal-injuries and soot deposits along the respiratory tract. Animals in Group C showed thermal injuries and soot deposits limited to the upper respiratory tract. The mean COHb% values in cadavers in Group C were lower than those observed in the other groups but higher compared to the values detected before the heat and smoke treatment. These findings suggest that both pathological changes and COHb analysis are valid tools for investigating fire-related deaths in dogs. However, the increase of COHb levels in cadavers exposed post-mortem to heat and smoke highlights how the COHb analysis should always be evaluated together with macroscopical and microscopical findings to avoid significant misjudgments in investigating fire-related fatalities in veterinary forensic practice.

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Validation of Noninvasive Methemoglobin and Carboxyhemoglobin Measurements Using Pulse Co-Oximeter in Healthy Dogs

Her,

Roh,

Keys

2024

VMRR

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Purpose To assess the agreement between pulse co-oximeter and blood co-oximeter in measuring methemoglobin (MetHb) and carboxyhemoglobin (COHb) in healthy, awake dogs. Patients and Methods Forty-five healthy dogs were enrolled in the study. Pulse co-oximetry was performed using the Masimo Radical 7 Pulse Co-Oximeter with a Rainbow ® adhesive sensor. Simultaneously, venous blood samples were collected, and MetHb and COHb were immediately measured using a Stat Profile Prime Plus VET Critical Care Analyzer. Paired measurements of MetHb and COHb were evaluated via Spearman correlation, intra-class correlation (ICC), and Bland-Altman plots to evaluate the degree of agreement between the pulse co-oximeter and the blood co-oximeter. Results A total of 45 paired MetHb and COHb measurements were collected. There was a weak correlation between the pulse co-oximeter and the blood co-oximeter readings. The correlation coefficients for MetHb and COHb were 0.0 (95% CI, −0.3 to 0.3) and 0.03 (95% CI, −0.27 to 0.32), respectively. The ICC indicated poor agreement between the pulse and blood co-oximeter for MetHb (ICC = 0.00, 95% CI: −0.12 to 0.15) and COHb (ICC = 0.03, 95% CI: −0.27 to 0.33). Bland-Altman plots revealed low mean bias but wide limits of agreement, indicating that the pulse co-oximeter overestimated MetHb by on average of 0.7% (P < 0.0001) (95% LoA: −0.5 to 2.0) and COHb by on average 0.2% (P = 0.59) (95% LoA: −4.6 to 5.0). Conclusion Obtaining MetHb and COHb measurements with the Masimo Radical 7 Pulse Co-Oximeter is straightforward in healthy, awake dogs. However, the device does not provide accurate measurements compared to the blood co-oximeter, specifically in the range of MetHb and COHb in healthy dogs, based on the wide LoA.

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Retrospective evaluation of carboxyhemoglobin and methemoglobin levels in dogs and cats with respiratory disease

Cited by 3 publications

References 35 publications

Carboxyhemoglobin as a diagnostic and prognostic biomarker of hemolytic anemias in dogs

Carboxyhemoglobin as a diagnostic and prognostic biomarker of hemolytic anemias in dogs

Pathological alterations and COHb evaluations as tools for investigating fire-related deaths in veterinary forensic pathology

Validation of Noninvasive Methemoglobin and Carboxyhemoglobin Measurements Using Pulse Co-Oximeter in Healthy Dogs

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