Effects of Prednisone on Blood Lactate Concentrations in Healthy Dogs

Abstract

Background: Glucocorticoids affect carbohydrate and lactate metabolism. Hypothesis: Administration of prednisone to healthy dogs will result in clinically relevant hyperlactatemia. Animals: Twelve healthy adult Beagle dogs. Methods: Prospective, controlled experimental study. Twelve healthy adult Beagles were divided into 2 groups (3 of each sex per group). One group served as control. The other group received 2 treatments: low, 1 mg/kg prednisone PO q24h for 2 weeks; high, 4 mg/kg prednisone PO q24h for 2 weeks. A washout period of 6 weeks separated the treatments. Blood samples were drawn for whole blood lactate measurement on day (D) 0, D4, and D14 and measured in duplicate.Results: Compared with the control group, low and high groups had significantly higher blood lactate concentrations at D4 and D14. There was no difference at D0. There was no effect of time within the control group. In the low and high groups, blood lactate concentration was increased at D4 and D14 versus D0. Blood lactate concentration was greater in the high group than the low group at D14 only.Conclusions and Clinical Importance: Dogs treated with prednisone experience statistically significant increases in blood lactate concentrations, which can result in type B hyperlactatemia. In such cases, improving tissue perfusion, treatment for the commonest form of hyperlactatemia (type A) would be unnecessary.

Effect of Dexamethasone on Resting Blood Lactate Concentrations in Horses

“…In healthy dogs, daily administration of a low (1 mg/kg) or high (4 mg/kg) dosage of prednisone led to a statistically significant increase in blood lactate concentrations up to 4.3 mmol/L for the high prednisone dosage, well above what would be considered normal. 17 These results were similar to an earlier study, also showing an increase in blood lactate concentrations in healthy dogs after administration of methylprednisolone. 20 This phenomenon also is observed in human medicine, where cardiac surgery patients receiving a single perioperative high dose of dexamethasone had increased blood lactate (2.1 mmol/L versus 0.7 mmol/L) and blood glucose concentrations (10.0 mmol/L versus 8.0 mmol/L) after surgery compared to the placebo group.…”

“…Despite the potential important clinical implications of glucocorticosteroid‐induced type B hyperlactatemia, only a few studies have documented this phenomenon. In healthy dogs, daily administration of a low (1 mg/kg) or high (4 mg/kg) dosage of prednisone led to a statistically significant increase in blood lactate concentrations up to 4.3 mmol/L for the high prednisone dosage, well above what would be considered normal . These results were similar to an earlier study, also showing an increase in blood lactate concentrations in healthy dogs after administration of methylprednisolone .…”

“…Dexamethasone is a corticosteroid often used in equine practice to treat a variety of diseases such as recurrent airway obstruction, inflammatory airway disease, or hemolytic anemia, with suggested dosages ranging from 0.05 to 0.1 mg/kg q24h . A previous study in dogs showed that administration of prednisone caused a statistically significant increase in lactate concentrations, a phenomenon also reported in humans . The mechanism behind this effect is not fully understood, but may be related to the effect of corticosteroids on carbohydrate metabolism, whereby increased rates of glucose production and utilization lead to increased production of pyruvate and lactate …”

Clinical use of plasma lactate concentration. Part 1: Physiology, pathophysiology, and measurement

“…Glucocorticoids elicit hyperlactatemia by promoting amino acid conversion to pyruvate, inhibiting PDH, potentiating the hyperlactatemic effect of catecholamines and altering carbohydrate metabolism. 197,[261][262][263][264][265][266][267] Both anti-inflammatory (1 mg/kg/day) and immunosuppressive (4 mg/kg/day) doses of prednisone resulted in statistically significant and clinically relevant increases in lactate concentrations in healthy Beagles. 266 In dogs receiving 4 mg/kg/day of methyl prednisolone injected intramuscularly for 7 days, plasma lactate concentrations increased 8-fold.…”

Avaliação de parâmetros perfusionais nas diferentes classes de insuficiência cardíaca em cães

“…Assim sendo, os tecidos periféricos estarão submetidos a uma situação de hipóxia no indivíduo que apresenta pressão arterial sistêmica, nível de consciência e temperatura central inalterados, situação denominada hipoperfusão oculta (Hu et al, 2012 dias, sepse, anemia, neoplasias e epilepsia (2) fêmeas gestantes ou no cio, de acordo com o relato do proprietário; (3) uso de terapia com corticosteróides no momento da avaliação; (4) ausência de termo de consentimento assinado pelo proprietário. Todos os critérios de exclusão utilizados foram baseados no objetivo de evitar qualquer outra causa de ativação simpática compensatória ou hiperlactatemia que não fossem geradas pela doença cardíaca em curso (Boysen et al, 2009;Lima et al, 2010;Rabelo, 2010;Strehlow, 2010;van Hall, 2010;AdevaAndany et al, 2014 (Kienle, 1998). Para a obtenção das imagens nas diferentes modalidades ecocardiográficas utilizou-se um ecocardiógrafo (DC3-Vet, Mindray, Shenzhen, China) com um transdutor setorial.…”