title: Association between outcome and changes in plasma lactate concentration during presurgical treatment in dogs with gastric dilatation-volvulus: 64 cases (2002-2008).
abstract: OBJECTIVE
  To determine whether changes in presurgical plasma lactate concentration (before and after initial fluid resuscitation and gastric decompression) were associated with short-term outcome for dogs with gastric dilatation-volvulus (GDV).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  64 dogs.
  
  
  METHODS
  Medical records were reviewed, and signalment, history, resuscitative treatments, serial presurgical lactate concentrations, surgical findings, and short-term outcome were obtained for dogs with confirmed GDV.
  
  
  RESULTS
  36 of 40 (90%) dogs with an initial lactate concentration <or= 9.0 mmol/L survived, compared with only 13 of 24 (54%) dogs with a high initial lactate (HIL) concentration (> 9.0 mmol/L). Within HIL dogs, there was no difference in mean +/- SD initial lactate concentration between survivors and nonsurvivors (10.6 +/- 2.3 mmol/L vs 11.2 +/- 2.3 mmol/L, respectively); however, there were significant differences in post-treatment lactate concentration, absolute change in lactate concentration, and percentage change in lactate concentration following resuscitative treatment. By use of optimal cutoff values within HIL dogs, survival rates for dogs with final lactate concentration > 6.4 mmol/L (23%), absolute change in lactate concentration <or= 4 mmol/L (10%), or percentage change in lactate concentration <or= 42.5% (15%) were significantly lower than survival rates for dogs with a final lactate concentration <or= 6.4 mmol/L (91%), absolute change in lactate concentration > 4 mmol/L (86%), or percentage change in lactate concentration > 42.5% (100%).
  
  
  CONCLUSIONS
  Calculating changes in plasma lactate concentration following initial treatment in dogs with GDV may assist in determining prognosis and identifying patients that require more aggressive treatment.
authors.affiliation: Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536, USA. laurie.zacher@ctvsh.com
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Zacher
authors.forename: John
authors.initials: J
authors.lastname: Berg
authors.forename: Scott P
authors.initials: SP
authors.lastname: Shaw
authors.forename: Raymond K
authors.initials: RK
authors.lastname: Kudej
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D004283:Dog Diseases / Q000097:blood*; D004285:Dogs; D005260:Female; D013271:Gastric Dilatation / Q000097:blood / Q000662:veterinary*; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019344:Lactic Acid