title: Plasma lactate concentration as a prognostic biomarker in dogs with gastric dilation and volvulus.
abstract: Initial and serial plasma lactate concentrations can be used to guide decision making in individual dogs with GDV but care is necessary in phrasing conversations with owners. Published data suggests that survival is more likely and the chance of complications less in dogs with an initial plasma lactate of <4 mmol/L. An initial lactate >6 mmol/L makes gastric necrosis and greater expense more likely. However, because of the overlap between groups and the good overall survival rates, exploratory laparotomy should always be recommended irrespective of the plasma lactate concentration. Falls in plasma lactate of greater than ~40% after fluid resuscitation are likely to indicate better survival. If the initial plasma lactate concentration is moderately to severely increased (5->10 mmol/L) and a sustained increase in plasma lactate occurs after fluid resuscitation, the cause should be aggressively pursued. Many dogs with persistent hyperlactatemia over 24-48 hours do not survive.
authors.affiliation: Small Animal Specialist Hospital, New South Wales, Australia.
authors.forename: Erin
authors.initials: E
authors.lastname: Mooney
authors.affiliation: Rochester Veterinary Practice, Victoria, Australia.
authors.forename: Cameron
authors.initials: C
authors.lastname: Raw
authors.affiliation: Section of Emergency and Critical Care, Veterinary Hospital, University of Melbourne, Victoria, Australia. Electronic address: dez.hughes@unimelb.edu.au.
authors.forename: Dez
authors.initials: D
authors.lastname: Hughes
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood*; D004283:Dog Diseases / Q000097:blood*; D004285:Dogs; D013271:Gastric Dilatation / Q000097:blood / Q000662:veterinary*; D019344:Lactic Acid / Q000097:blood*; D013277:Stomach Volvulus / Q000097:blood / Q000662:veterinary*
chemical_list: D015415:Biomarkers; D019344:Lactic Acid
keywords: dog; gastric dilation and volvulus; gastric necrosis; lactate; prognosis; prognostic indicator