Association between outcome and changes in plasma lactate concentration during presurgical treatment in dogs with gastric dilatation-volvulus: 64 cases (2002–2008)

Abstract

Calculating changes in plasma lactate concentration following initial treatment in dogs with GDV may assist in determining prognosis and identifying patients that require more aggressive treatment.

Total antioxidant capacity in dogs with gastric dilatation and volvulus

“…Lactate concentration and kinetics have been described as a prognostic indicator as well as a marker of gastric necrosis in patients with GDV (de Papp et al 1999;Zacher et al 2010). A poor outcome was observed when lactate concentrations at admission were higher than 6 mmol/l (de Papp et al 1999), while Zacher et al (2010) proposed an initial cut-off value of 9 mmol/l. Two dogs that died in our study had lactate levels of 8.4 mmol/l and 5.66 mmol/l.…”

Cardiovascular and Systemic Effects of Gastric Dilatation and Volvulus in Dogs

“…Its origin is likely multifactorial, stemming from both global and local (gastric) hypoperfusion. Although multiple studies report the use of lactate as a prognostic biomarker in dogs with GDV, [16][17][18][19] the true prevalence of hyperlactatemia at presentation is not always reported. One recent study documented that 58.5% of dogs (38/66) with GDV were hyperlactatemic at presentation, 20 whereas another reported that 30% of dogs (30/101) had an admitting lactate level 4 6 mmol/L.…”

Postoperative Management of Dogs With Gastric Dilatation and Volvulus

“…8 As blood lactate concentration on presentation and changes in lactate during hospitalization have repeatedly shown to accurately predict complications and outcome in GDV, dogs with a high presenting lactate level (4 6 mmol/L) should be closely monitored, and serial lactate measurements are recommended in these patients. 6,9,10 Lactate concentrations that remain high postoperatively should raise suspicion for gastric necrosis. 9…”

“…3,7 Despite appropriate medical and surgical treatment, the reported mortality rate in dogs with GDV is high (10%-28%). [4][5][6]8,9 Prognostic Indicators Gastric necrosis and high serum lactate concentrations have been identified as strong predictors of postoperative complications and mortality in numerous studies of dogs with GDV, indicating the important role of ischemic hypoperfusion in the progression of this disease. [4][5][6]8,10 Other reported risk factors for morbidity and mortality include time lag (4 5 hours) from onset of clinical signs to admission, body temperature o381C (o100.4 F) on admission, hypotension at any time during hospitalization, sepsis, peritonitis, and the need for splenectomy or partial gastrectomy or both during surgery.…”