Evaluation of initial plasma lactate values as a predictor of gastric necrosis and initial and subsequent plasma lactate values as a predictor of survival in dogs with gastric dilatation-volvulus: 84 dogs (2003-2007)

Tiffany I. Green, Caroline C. Tonozzi, Rebecca Kirby, Elke Rudloff

Research output: Contribution to journalArticle

Abstract

Objective - To test whether an initial plasma lactate≥6.0mmol/L is associated with the presence of macroscopic gastric wall necrosis and overall survival in dogs presenting with gastric dilatation-volvulus (GDV). Additionally, if no association was identified we sought to identify a different predictive initial plasma lactate concentration and to examine whether serial plasma lactate concentrations provide better prediction of survival. Design - Retrospective study over a 5-year period (2003-2007). Setting - Urban private referral small animal teaching hospital. Animals - Eighty-four client-owned dogs with a diagnosis of GDV and plasma lactate measurements. Interventions - None. Measurements and Main Results - There was no statistically significant relationship found between survival and the presence of macroscopic gastric wall necrosis with the initial plasma lactate≥6mmol/L. There was a significant relationship between the initial plasma lactate >2.9mmol/L for predicting necrosis and <4.1mmol/L for predicting survival to discharge. Forty dogs that had an increased initial plasma lactate (>2.5mmol/L) also had a subsequent plasma lactate measured within 12 hours of presentation, with 37/40 dogs surviving and 70% of these surviving dogs having the subsequent lactate decrease by≥50% within 12 hours. The 3/40 that died failed to decrease their plasma lactate by≥50% from the initial blood lactate. Conclusion - The results of this study indicate that an initial presenting plasma lactate concentration≥6.0mmol/L is not predictive of macroscopic gastric wall necrosis or survival in dogs presenting with GDV. A decrease in plasma lactate concentrations≥50% within 12 hours may be a good indicator for survival. Limitations to the study include its retrospective nature, the small number of patients, and the number of dogs that were euthanized rather than allowed to progress to a natural outcome.

Original languageEnglish (US)
Pages (from-to)36-44
Number of pages9
JournalJournal of Veterinary Emergency and Critical Care
Volume21
Issue number1
DOIs
StatePublished - Feb 1 2011
Externally publishedYes

Fingerprint

Gastric Dilatation
Stomach Volvulus
volvulus
lactates
Lactic Acid
Stomach
necrosis
stomach
Necrosis
Dogs
dogs
Survival
Animal Hospitals
retrospective studies
Teaching Hospitals
animals
Referral and Consultation
Retrospective Studies

Keywords

  • Canine
  • GDV
  • Prognosis
  • Surgery

ASJC Scopus subject areas

  • veterinary(all)

Cite this

@article{825a2e1ef1f145f684729633dc15b126,
title = "Evaluation of initial plasma lactate values as a predictor of gastric necrosis and initial and subsequent plasma lactate values as a predictor of survival in dogs with gastric dilatation-volvulus: 84 dogs (2003-2007)",
abstract = "Objective - To test whether an initial plasma lactate≥6.0mmol/L is associated with the presence of macroscopic gastric wall necrosis and overall survival in dogs presenting with gastric dilatation-volvulus (GDV). Additionally, if no association was identified we sought to identify a different predictive initial plasma lactate concentration and to examine whether serial plasma lactate concentrations provide better prediction of survival. Design - Retrospective study over a 5-year period (2003-2007). Setting - Urban private referral small animal teaching hospital. Animals - Eighty-four client-owned dogs with a diagnosis of GDV and plasma lactate measurements. Interventions - None. Measurements and Main Results - There was no statistically significant relationship found between survival and the presence of macroscopic gastric wall necrosis with the initial plasma lactate≥6mmol/L. There was a significant relationship between the initial plasma lactate >2.9mmol/L for predicting necrosis and <4.1mmol/L for predicting survival to discharge. Forty dogs that had an increased initial plasma lactate (>2.5mmol/L) also had a subsequent plasma lactate measured within 12 hours of presentation, with 37/40 dogs surviving and 70{\%} of these surviving dogs having the subsequent lactate decrease by≥50{\%} within 12 hours. The 3/40 that died failed to decrease their plasma lactate by≥50{\%} from the initial blood lactate. Conclusion - The results of this study indicate that an initial presenting plasma lactate concentration≥6.0mmol/L is not predictive of macroscopic gastric wall necrosis or survival in dogs presenting with GDV. A decrease in plasma lactate concentrations≥50{\%} within 12 hours may be a good indicator for survival. Limitations to the study include its retrospective nature, the small number of patients, and the number of dogs that were euthanized rather than allowed to progress to a natural outcome.",
keywords = "Canine, GDV, Prognosis, Surgery",
author = "Green, {Tiffany I.} and Tonozzi, {Caroline C.} and Rebecca Kirby and Elke Rudloff",
year = "2011",
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doi = "10.1111/j.1476-4431.2010.00599.x",
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T1 - Evaluation of initial plasma lactate values as a predictor of gastric necrosis and initial and subsequent plasma lactate values as a predictor of survival in dogs with gastric dilatation-volvulus

T2 - 84 dogs (2003-2007)

AU - Green, Tiffany I.

AU - Tonozzi, Caroline C.

AU - Kirby, Rebecca

AU - Rudloff, Elke

PY - 2011/2/1

Y1 - 2011/2/1

N2 - Objective - To test whether an initial plasma lactate≥6.0mmol/L is associated with the presence of macroscopic gastric wall necrosis and overall survival in dogs presenting with gastric dilatation-volvulus (GDV). Additionally, if no association was identified we sought to identify a different predictive initial plasma lactate concentration and to examine whether serial plasma lactate concentrations provide better prediction of survival. Design - Retrospective study over a 5-year period (2003-2007). Setting - Urban private referral small animal teaching hospital. Animals - Eighty-four client-owned dogs with a diagnosis of GDV and plasma lactate measurements. Interventions - None. Measurements and Main Results - There was no statistically significant relationship found between survival and the presence of macroscopic gastric wall necrosis with the initial plasma lactate≥6mmol/L. There was a significant relationship between the initial plasma lactate >2.9mmol/L for predicting necrosis and <4.1mmol/L for predicting survival to discharge. Forty dogs that had an increased initial plasma lactate (>2.5mmol/L) also had a subsequent plasma lactate measured within 12 hours of presentation, with 37/40 dogs surviving and 70% of these surviving dogs having the subsequent lactate decrease by≥50% within 12 hours. The 3/40 that died failed to decrease their plasma lactate by≥50% from the initial blood lactate. Conclusion - The results of this study indicate that an initial presenting plasma lactate concentration≥6.0mmol/L is not predictive of macroscopic gastric wall necrosis or survival in dogs presenting with GDV. A decrease in plasma lactate concentrations≥50% within 12 hours may be a good indicator for survival. Limitations to the study include its retrospective nature, the small number of patients, and the number of dogs that were euthanized rather than allowed to progress to a natural outcome.

AB - Objective - To test whether an initial plasma lactate≥6.0mmol/L is associated with the presence of macroscopic gastric wall necrosis and overall survival in dogs presenting with gastric dilatation-volvulus (GDV). Additionally, if no association was identified we sought to identify a different predictive initial plasma lactate concentration and to examine whether serial plasma lactate concentrations provide better prediction of survival. Design - Retrospective study over a 5-year period (2003-2007). Setting - Urban private referral small animal teaching hospital. Animals - Eighty-four client-owned dogs with a diagnosis of GDV and plasma lactate measurements. Interventions - None. Measurements and Main Results - There was no statistically significant relationship found between survival and the presence of macroscopic gastric wall necrosis with the initial plasma lactate≥6mmol/L. There was a significant relationship between the initial plasma lactate >2.9mmol/L for predicting necrosis and <4.1mmol/L for predicting survival to discharge. Forty dogs that had an increased initial plasma lactate (>2.5mmol/L) also had a subsequent plasma lactate measured within 12 hours of presentation, with 37/40 dogs surviving and 70% of these surviving dogs having the subsequent lactate decrease by≥50% within 12 hours. The 3/40 that died failed to decrease their plasma lactate by≥50% from the initial blood lactate. Conclusion - The results of this study indicate that an initial presenting plasma lactate concentration≥6.0mmol/L is not predictive of macroscopic gastric wall necrosis or survival in dogs presenting with GDV. A decrease in plasma lactate concentrations≥50% within 12 hours may be a good indicator for survival. Limitations to the study include its retrospective nature, the small number of patients, and the number of dogs that were euthanized rather than allowed to progress to a natural outcome.

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KW - Prognosis

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