The authors declare no conflict of interest.
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)
Article first published online: 28 JAN 2011
© Veterinary Emergency and Critical Care Society 2011
Journal of Veterinary Emergency and Critical Care
Volume 21, Issue 1, pages 36–44, February 2011
How to Cite
Green, T. I., Tonozzi, C. C., Kirby, R. and Rudloff, E. (2011), 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). Journal of Veterinary Emergency and Critical Care, 21: 36–44. doi: 10.1111/j.1476-4431.2010.00599.x
- Issue published online: 2 FEB 2011
- Article first published online: 28 JAN 2011
- Submitted October 30, 2009; Accepted November 7, 2010.
Objective – To test whether an initial plasma lactate≥6.0 mmol/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≥6 mmol/L. There was a significant relationship between the initial plasma lactate >2.9 mmol/L for predicting necrosis and <4.1 mmol/L for predicting survival to discharge. Forty dogs that had an increased initial plasma lactate (>2.5 mmol/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≥6.0 mmol/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.