title: Retrospective evaluation of fluid overload and relationship to outcome in critically ill dogs.
abstract: OBJECTIVE
  To determine if critically ill dogs have an increased risk of fluid overload (FO) during hospitalization compared to less ill dogs, and to determine if FO is associated with increased mortality during hospitalization.
  
  
  METHODS
  Observational, case-control study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Thirty-four critically ill dogs and 15 comparatively healthy stable postoperative dogs with neuro-orthopedic disease.
  
  
  METHODS
  None.
  
  
  RESULTS
  Data recorded included underlying disease, body weight, and APPLEfast score at admission, single-day and composite APPLEfull scores during hospitalization, total fluid volume administered (L), total fluid volume output (L), and outcome. Percent FO (%FO) was calculated using the equation 100 × ([fluid volume administered - fluid volume lost]/1000 mL/L) - (% dehydration at admission), with fluid volume expressed as mL/kg of baseline body weight. Critically ill dogs developed greater %FO during hospitalization compared to stable postoperative dogs (12.1 ± 11.7% vs 0.5 ± 5.2%, P = 0.001), and half (8 out of 16) of the dogs with %FO ≥ 12% died. Composite APPLEfull scores were weakly positively correlated with %FO, whereas APPLEfast and single-day APPLEfull scores recorded at admission were not. The odds ratio for death was 1.08 for every percent increase in FO during hospitalization (95% confidence limits 1.012-1.59, P = 0.02).
  
  
  CONCLUSIONS
  Critically ill dogs are at increased risk for FO during hospitalization, and a weak but significant association exists between %FO, illness severity, and mortality. Prospective studies are warranted to confirm the findings of this retrospective study.
authors.affiliation: Department of Clinical Sciences, Colorado State University College of Veterinary Medicine, Fort Collins, CO.
authors.forename: Amanda A
authors.initials: AA
authors.lastname: Cavanagh
authors.affiliation: Department of Clinical Sciences, Colorado State University College of Veterinary Medicine, Fort Collins, CO.
authors.forename: Lauren A
authors.initials: LA
authors.lastname: Sullivan
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC.
authors.forename: Bernard D
authors.initials: BD
authors.lastname: Hansen
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000662:veterinary*; D000818:Animals; D016022:Case-Control Studies; D016638:Critical Illness; D004283:Dog Diseases / Q000209:etiology* / Q000401:mortality; D004285:Dogs; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects / Q000662:veterinary*; D006760:Hospitalization; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies
keywords: ICU; edema; fluid balance; illness severity scoring