ABSTRACT
OBJECTIVE: To determine whether multiple organ dysfunction syndrome (MODS) could be identified in dogs with sepsis secondary to gastrointestinal tract leakage, and whether the number of affected organ systems was significantly associated with mortality rate. DESIGN: Multicenter retrospective case series. ANIMALS: 114 dogs. PROCEDURES: Medical records for dogs treated surgically because of sepsis secondary to gastrointestinal tract leakage between 2003 and 2007 were reviewed. Sepsis was diagnosed on the basis of results of bacterial culture of peritoneal fluid, gross evidence of gastrointestinal tract leakage at surgery, or both. Renal dysfunction was defined as a > or = 0.5 mg/dL increase in serum creatinine concentration after surgery. Cardiovascular dysfunction was defined as hypotension requiring vasopressor treatment. Respiratory dysfunction was defined as a need for supplemental oxygen administration or mechanical ventilation. Hepatic dysfunction was defined as a serum bilirubin concentration > 0.5 mg/dL. Dysfunction of coagulation was defined as prolonged prothrombin time, prolonged partial thromboplastin time, or platelet count < or = 100,000/microL. RESULTS: 89 (78%) dogs had dysfunction of 1 or more organ systems, and 57 (50%) dogs had MODS. Mortality rate increased as the number of dysfunctional organ systems increased. Mortality rate was 70% (40/57) for dogs with MODS and 25% (14/57) for dogs without. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that MODS, defined as dysfunction of at least 2 organ systems, can be identified in dogs with sepsis and that organ system dysfunction increased the odds of death.
Subject(s)
Dog Diseases/epidemiology , Dog Diseases/mortality , Multiple Organ Failure/veterinary , Sepsis/veterinary , Animals , Dog Diseases/pathology , Dogs , Female , Gastrointestinal Tract/injuries , Male , Multiple Organ Failure/epidemiology , Multiple Organ Failure/mortality , Multiple Organ Failure/pathology , Prognosis , Retrospective Studies , Sepsis/epidemiology , Sepsis/mortality , Sepsis/pathology , Severity of Illness IndexABSTRACT
The objectives of this study were (1) to evaluate the indications, complications and outcomes of multiple red cell transfusions (MrcTs) in cats; of these cats (2) to describe those that received massive transfusion and (3) compare them with those who received MrcTs over a longer time course. Twenty-seven cats were identified which received a total of 110 transfusions, with a median of three transfusions (range 3-15) per cat. The transfusions consisted of 47 units of whole blood and 63 units of packed red blood cells. The median age of cats was 6 years (range 6 months to 15 years). Cats were hospitalized for a median of 6 days, with a range of 1-38 days. No acute transfusion reactions were documented, although due to the critical nature of the cats, they may not have been appreciated. Sixteen cats survived to discharge and 11 died or were euthanased. Indications (and % survival) for transfusions included bone marrow failure (n=8; 50%); surgical loss (n=4; 100%), sepsis (n=3; 0%), neoplasia (n=3; 33%), acute renal failure (n=3; 66%), trauma (n=2; 100%), gastrointestinal bleeding (n=1; 100%), and cats with multiple disease processes (n=3; 33%). MrcTs are well-tolerated in cats and may be associated with a favorable outcome.
