title: Evaluation of initial plasma lactate values as a predictor of gastric necrosis and initial and subsequent plasma lactate values as a predictor of survival in dogs with gastric dilatation-volvulus: 84 dogs (2003-2007).
abstract: OBJECTIVE
  To test whether an initial plasma lactate ≥ 6.0 mmol/L is associated with the presence of macroscopic gastric wall necrosis and overall survival in dogs presenting with gastric dilatation-volvulus (GDV). Additionally, if no association was identified we sought to identify a different predictive initial plasma lactate concentration and to examine whether serial plasma lactate concentrations provide better prediction of survival.
  
  
  METHODS
  Retrospective study over a 5-year period (2003-2007).
  
  
  METHODS
  Urban private referral small animal teaching hospital.
  
  
  METHODS
  Eighty-four client-owned dogs with a diagnosis of GDV and plasma lactate measurements.
  
  
  METHODS
  None.
  
  
  RESULTS
  There was no statistically significant relationship found between survival and the presence of macroscopic gastric wall necrosis with the initial plasma lactate ≥ 6 mmol/L. There was a significant relationship between the initial plasma lactate >2.9 mmol/L for predicting necrosis and <4.1 mmol/L for predicting survival to discharge. Forty dogs that had an increased initial plasma lactate (>2.5 mmol/L) also had a subsequent plasma lactate measured within 12 hours of presentation, with 37/40 dogs surviving and 70% of these surviving dogs having the subsequent lactate decrease by ≥ 50% within 12 hours. The 3/40 that died failed to decrease their plasma lactate by ≥ 50% from the initial blood lactate.
  
  
  CONCLUSIONS
  The results of this study indicate that an initial presenting plasma lactate concentration ≥ 6.0 mmol/L is not predictive of macroscopic gastric wall necrosis or survival in dogs presenting with GDV. A decrease in plasma lactate concentrations ≥ 50% within 12 hours may be a good indicator for survival. Limitations to the study include its retrospective nature, the small number of patients, and the number of dogs that were euthanized rather than allowed to progress to a natural outcome.
authors.affiliation: Animal Emergency Center & Specialty Services, Glendale, WI 53209, USA. tiffany.green@hotmail.com
authors.forename: Tiffany I
authors.initials: TI
authors.lastname: Green
authors.forename: Caroline C
authors.initials: CC
authors.lastname: Tonozzi
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kirby
authors.forename: Elke
authors.initials: E
authors.lastname: Rudloff
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000097:blood* / Q000401:mortality*; D004285:Dogs; D005260:Female; D013271:Gastric Dilatation / Q000097:blood / Q000401:mortality / Q000662:veterinary*; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D009336:Necrosis / Q000097:blood / Q000401:mortality / Q000662:veterinary; D012189:Retrospective Studies; D013277:Stomach Volvulus / Q000097:blood / Q000401:mortality / Q000662:veterinary*; D016019:Survival Analysis
chemical_list: D019344:Lactic Acid