Clinical features and outcome of septic shock in dogs: 37 Cases (2008-2015).

OBJECTIVES: To describe patient characteristics of dogs with septic shock, investigate markers of disease severity, and assess treatment impact on outcome. DESIGN: Retrospective study. SETTING: Single center, university veterinary teaching intensive care unit. ANIMALS: Thirty-seven dogs with septic shock. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Mean number of organ dysfunction was 3.24 ± 1.0, and included cardiovascular (100%), respiratory (73%), hematologic (68%), renal (49%), and hepatic (32%) dysfunction. The gastrointestinal tract was the most common source of sepsis. Mean blood pressure prior to resuscitation was 50 ± 8 mm Hg. All dogs were given IV fluids before vasopressor therapy with a mean rate of 12.1 ± 11.0 mL/kg/h. All dogs were given antimicrobials, administered within a mean of 4.3 ± 5.7 hours after diagnosis. Dopamine or norepinephrine was administered IV, respectively in 51.3% and 37.8% of dogs, with a mean duration of hypotension of 2.6 ± 3.0 hours. Mortality rate was 81.1%. Survivors were more likely to have a feeding tube (P = 0.007) and to have gastrointestinal sepsis (P = 0.012), and less likely to have respiratory dysfunction (P < 0.001). APPLEFull scores (P = 0.014) and time to antimicrobial therapy (P = 0.047) were identified as predictors of mortality. Treatment bundles consisting of 7 interventions that may improve outcomes in people with septic shock were evaluated. Survivors received 4.1 ± 1.3 interventions, whereas nonsurvivors received 2.4 ± 1.4 (P = 0.003). CONCLUSIONS: Septic shock in dogs confers a guarded prognosis. Early antimicrobial therapy and the utilization of treatment bundles may increase survivability in dogs with septic shock. More research is warranted to investigate the impact of specific interventions on survival.

Effect of transportation, time of sampling, and lymphocyte numbers on gamma interferon response to Mycobacterium bovis in cattle at time of slaughter.

Adapting the gamma interferon (IFNγ) assay for tuberculosis screening at points-of-concentration of cattle would improve global efforts to eradicate bovine tuberculosis. Two separate studies were conducted to evaluate if transportation of cattle, the time of blood collection, and total lymphocyte count affects the retention of a positive IFNγ assay result during slaughter of cattle experimentally sensitized with inactivated Mycobacterium bovis. Study 1 evaluated IFNγ assay responses to M. bovis and Mycobacterium avium stimulations in 5 cows (4 sensitized and 1 control) at the housing facility, after a 30-min transport to the slaughter facility, immediately before stunning, at commencement of exsanguination, and at 5 min after exsanguination commenced. Study 2 evaluated IFNγ assay responses to Mycobacterium antigen stimulations and total lymphocyte count in blood collected from 5 steers (4 sensitized and 1 control) at the housing facility, at commencement of exsanguination and at 2 successive 1-min intervals. The results indicated that blood obtained from sensitized cattle at commencement of exsanguination was more likely to remain positive than blood collected at successive time points; hence the time of blood collection is crucial to obtaining a useful IFNγ assay result for bovine tuberculosis at slaughter. The lymphocyte count progressively declined following exsanguination, and this decline might contribute to the reduction in the measured IFNγ. To compensate for the reduction in IFNγ production, a different set of positive cutoff values might be needed for blood collected at exsanguination. The current findings provide useful preliminary information necessary for making changes to the interpretation of the IFNγ assay on blood collected during exsanguination.