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.
[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
[AM2]TABLE – use Table 1 from EKF veterinary page
| Lactate is useful tool in treatment decision making |
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