Numerous studies have highlighted the use of lactate testing for the diagnosis, monitoring and prognosis assessment in a number of clinical conditions in small animals, including gastric dilation volvulus, lymphoma, post partum distress and trauma1.
The following table provides a brief overview of a number of such studies.
|
Troia et al 2018 |
Gastric dialtion volvulus |
Correlation between lactate concentration and dogs with confirmed GDV |
|
Aona et al 2017 |
Gastric dilatation volvulus |
Increased lactate levels associated with GDV and changes in ventricular diameter |
|
McQuown et al 2018 |
Lymphoma |
Increased lactate in dogs with confirmed lymphoma compared with controls |
|
Robbins et al 2017 |
Fatigue |
Increased lactate correlates with other parameters of fatigue in working dogs |
|
Keyserling et al 2017 |
Abnormal thoracic radiographs |
In dogs with abnormal thoracic Xrays not associated with cardio/pulmonary diagnosis, increased lactate was associated with increased morbidity |
| Castagnetti et al 2017 | Post partum distress | Increased lactate levels and inability to normalize lactate within 24 of birth were associated increased morbidity in puppies |
| Groppetti et al 2015 | Post partum distress | Stillborn puppies have elevated amniotic fluid lactate levels compared with live births and lactate could be a predictor of postpartum outcomes |
| Fahey et al 2017 | Cardiac effusion | Elevated lactate levels above 5 mmol L-1 were associated with dogs with cardiac effusion |
| Bush et al 2016 | Septic peritonitis | Increased lactate levels were associated with secondary septic peritonitis |
| Cortellini et al 2015 | Septic peritonitis | Lactate concentration and lactate clearance were good prognostic indicators in dogs with septic peritonitis |
| Gillespie at al 2017 | NA | Normal lactate value is a better predictor of survival than a high lactate value is of death |
| Eichenberger et al 2016 | Babesiosis | Increased levels of lactate are associated with increased chance of non-survival in confirmed cases of babesia infection |
| Bruchim et al 2016 | Heat shock | Lactate is significantly elevated at 12 hours post-presentation in non-surviving with heatstroke |
| Sharma & Holowaychuk 2015 | Head trauma | Elevated lactate levels post-head trauma is a risk factor for non-survival |
| Proot et al 2015 | Septic arthritis | Synovial fluid lactate concentration is significantly increased in septic arthritis and could help rule out this condition in a quick and cost-effective way |
| Ateca et al 2015 | Hypotension | Blood lactate is negatively associated with systolic blood pressure and survival probability and may represent a useful prognosis in hypotensive dogs |
| Hall et al 2014 | Trauma | Low lactate levels at admission were predictive of survival to discharge |
| Malek et al 2013 | Post-cholecystectomy recovery | Elevated lactate post gall bladder removal is associated with poor clinical outcomes |
| Volpato et al 2013 | Pyometra | Lactate levels are increased in bitches with pyometra |
Table 1
The measurement of lactate concentration in small animals can be used to establish the severity of an underlying disorder, monitor response to therapy, and predict outcome2. Interestingly, a normal lactate value (typically under. 2.0 mmol l-1) in dogs is a far better predictor of survival than a high lactate value is of morbidity or death.
As previously discussed, serial standardised lactate measurements generally provide a better indication of outcome than a single value. Decreasing lactate levels suggest improvement with treatment, whereas a prolonged increase in concentrations would suggest deterioration and poor prognosis2. Ultimately, a single high initial lactate measure should not be taken as a reason for euthanasia. Many animals having had an initial high lactate value can respond favourably to treatment3. It really should be used as an indicator of an underlying problem that should be addressed rapidly.
| Lactate is useful tool in treatment decision making |
Find out more about the different methods for testing, the symptoms and the associated conditions, and understand how POCT can help vets provide a specialised service to their clients.
Cell-Free DNA, High-Mobility Group Box-1, and Procalcitonin Concentrations in Dogs With Gastric Dilatation-Volvulus Syndrome.
Front Vet Sci. 2018 Apr 9;5:67
Evaluation of the association between strong ion acid-base disturbances and mortality in dogs: a retrospective study.
Vet Med Sci. 2018 Apr 10
Clinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia.
J Vet Emerg Crit Care (San Antonio). 2018 28(2):106-121
Validation of a portable monitor for assessment of cerebrospinal fluid lactate in dogs.
Vet Clin Pathol. 2018;47(1):108-114
Time-dependent changes and prognostic value of lactatemia during the first 24 h of life in brachycephalic newborn dogs.
Theriogenology. 2017;94:100-104
Update: Clinical Use of Plasma Lactate.
Vet Clin North Am Small Anim Pract. 2017; 47(2):325-342
Preliminary investigation of blood concentrations of insulin-like growth factor, insulin, lactate and β-hydroxybutyrate in dogs with lymphoma as compared with matched controls.
Vet Comp Oncol.2018 ;16(2):262-267
Prognostic Markers in Acute Babesia canis Infections.
J Vet Intern Med. 2016;30(1):174-182
Prognostic potential of amniotic fluid analysis at birth on canine neonatal outcomes.
Vet J. 2015 ;206(3):423-5
Hospitalized dogs recovery from naturally occurring heatstroke; does serum heat shock protein 72 can provide prognostic biomarker?
Cell Stress Chaperones. 2016;21(1):123-130
Use of Lactate in Small Animal Clinical Practice.
Clin Lab Med. 2015;35(3):567-77
Retrospective evaluation of prognostic indicators in dogs with head trauma: 72 cases (January-March 2011)
J Vet Emerg Crit Care (San Antonio). 2015;25(5):631-639
Analysis of lactate concentrations in canine synovial fluid.
Vet Comp Orthop Traumatol. 2015;28(5):301-5
Survival analysis of critically ill dogs with hypotension with or without hyperlactatemia: 67 cases (2006-2011)
J Am Vet Med Assoc. 2015;1;246(1):100-4
Plasma lactate concentrations in septic peritonitis: A retrospective study of 83 dogs (2007-2012)
J Vet Emerg Crit Care (San Antonio). 2015;25(3):388-395
Multicenter prospective evaluation of dogs with trauma.
J Am Vet Med Assoc. 2014; 244(3):300-8
Clinical findings and prognostic factors for dogs undergoing cholecystectomy for gall bladder mucocele.
Vet Surg. 2013;42(4):418-426
Lactate in bitches with pyometra.
Reprod Domest Anim. 2012;47 Suppl 6:335-336
Comparison of two portable lactate meters in dogs.
J Am Anim Hosp Assoc. 2013;49(1):8-15
Sharkey & Wellman 2015 – Use of lactate in small anima clinical practice
M.Savigny & J.Berzon. Vetflio March 2019. Measuring Blood Lactate Levels
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