Septic Shock and Prognosis in Dogs and Cats With Sepsis-Consensus Definition and Clinical Criteria

Death from sepsis results from progressive organ dysfunction. Early recognition of increased illness severity or deterioration in clinical status enables timely interventions that can improve outcomes. We aimed to define septic shock by consensus and to use the existing literature to identify associated clinical and clinicopathologic abnormalities that would aid rapid identification of the most severely affected patients. We systematically reviewed the available data on sepsis in dogs and cats to identify factors that were predictive of multiple organ dysfunction or mortality. Septic shock was defined as a subset of sepsis with increased mortality, associated with cardiovascular instability and metabolic abnormalities indicative of impaired tissue perfusion despite adequate fluid resuscitation. Clinically, septic shock can manifest as hyperlactatemia, persistent hypotension, and progressive organ dysfunction. For the assessment of prognosis in dogs, we suggest scoring organ dysfunction and illness severity using validated instruments, and measuring objective physiologic parameters, lactate, and ionized calcium, and performing CBCs and serum biochemistry profiles. Where available, serial measurements of protein C and antithrombin activity, and quantitation of acute phase proteins and cytokine concentrations, should be considered. Fewer data were available for cats, and although many similar conclusions were reached as for dogs, only limited recommendations could be made.