Serial blood lactate concentrations in systemically ill dogs

Lactate concentration often is quantified in systemically ill dogs and interpreted based on human data. To our knowledge, there are no published clinical studies evaluating serial lactate concentrations as a prognostic indicator in ill dogs.

Our objective was to perform a prospective study, using multivariate analysis, to determine whether serial lactate concentrations were associated with outcome in ill dogs requiring intravenous fluids.

Eighty sick dogs had lactate concentrations evaluated, using an analyzer that measures lactate in the plasma fraction of heparinized whole blood, at 0 hours and 6 hours after initiation of treatment. Severity of illness and outcome (survivor, nonsurvivor) were determined by reviewing the patient's record 2 weeks after admission. Lactate concentrations, age, body weight, gender, and severity of illness were evaluated using multivariate analysis to determine their effects on outcome.

Dogs with lactate concentrations greater than the reference interval at 6 hours were 16 times (95% confidence interval = 2.32-112.71 times, P <.01) more likely not to survive compared to dogs with lactate concentrations within the reference interval. Lactate concentrations above the reference interval at 0 hours were not significantly related to outcome. However, hyperlactatemia that did not improve by > or = 50% within 6 hours was significantly associated with mortality (P = .024).

Dogs with a lactate concentration higher than the reference interval at 6 hours were more likely not to survive. These results indicate an association between lactate concentration and outcome and emphasize the importance of serial lactate concentrations in evaluating prognosis.