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Lactate testing for veterinary applications

Applications of lactate testing in small animals


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 trauma.

 

The following table provides a brief overview of a number of such studies.

 

Troja 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 outcome [REF[SP1] ]. 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 [REF[SP2] ].

 

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 prognosis [REF[SP3] ]. 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 treatment [REF[SP4] ]. It really should be used as an indicator of an underlying problem that should be addressed rapidly.

 

 

References

 

[SP1]Sharkey & Wellman 2015 – Use of lactate in small anima clinical practice

 [SP2]What is the reference for this fact that is on the EKF website?

 [SP3]Sharkey & Wellman 2015 – Use of lactate in small anima clinical practice

 [SP4]M.Savigny & J.Berzon. Vetflio March 2019. Measuring Blood Lactate Levels

 [AM1]Refs taken from EKF website Table 1 -  Troja et al 2018; McQuown et al 2018; Castagnetti et al 2017 ; Hall et al 2014

 [AM2]TABLE – use Table 1 from EKF veterinary page

Vet-lactate-testing-in-small-animals
Lactate  is useful tool in treatment decision making

Rapid, cost effective, near patient results