Hyperlactatemia and serial lactate measurements in sick cats.

OBJECTIVES: To document the incidence of hyperlactatemia in sick cats hospitalized for emergency care and to evaluate the prognostic utility of serial lactate measurements in cats with hyperlactatemia. DESIGN: Prospective observational study over a 10-month period (July 2010-May 2011). SETTING: Private veterinary referral center with 24-hour hospital care. ANIMALS: One hundred and twenty-three privately owned cats admitted to a private referral center. INTERVENTIONS: Blood was collected by direct venipuncture from the jugular or medial saphenous vein at the time of hospital admission and at 6 and 24 hours following admission. MEASUREMENTS AND MAIN RESULTS: The median plasma lactate concentration for all cats at admission (T0) was 1.89 mmol/L (17.0 mg/dL) (range: 0.3-12.48). Twenty-three percent (28/123) of cats admitted were hyperlactatemic (ie, >2.87 mmol/L; >25.86 mg/dL) upon admission. Lactate concentration at presentation and serial lactate measurements were not found to be related with survival to discharge or correlated with duration of hospitalization. The overall survival rate of all cats in this study was 81%. CONCLUSIONS: This study demonstrated that the incidence of hyperlactatemia in sick cats being admitted for hospitalization in a private referral center was 23%, and that lactate concentration on admission and serial lactate measurements over time were not prognostic in this group of hospitalized cats. Future studies are needed to evaluate the prognostic utility of lactate and serial lactate measurements in specific disease states and in a larger population of critically ill cats.

Clinical presentation and management of suspected ribavirin toxicosis in a dog.

A 5-month-old pit bull terrier was presented for evaluation of progressive lethargy, vomiting, diarrhea, and anorexia 45 hours after ingestion of 625 mg/kg body weight (BW) (9000 mg) of the antiviral medication, ribavirin. Abnormalities that were detected included dehydration, tachycardia, elevated liver enzymes, and prolonged prothrombin time. The dog was discharged after 5 days of aggressive supportive care consisting of intravenous fluids, antiemetics, gastroprotectants, hepatoprotectants, dextrose supplementation, and vitamin B/K1 supplementation.

Présentation clinique et gestion d'une toxicose à la ribavirine suspectée chez un chien. Un chien Pit bull Terrier âgé de 5 mois a été présenté pour l'évaluation d'un abattement progressif, de vomissements, de diarrhée et d'une anorexie 45 heures après l'ingestion de 625 mg/kg poids corporel (PC) du médicament antiviral ribavirine. Les anomalies détectées incluaient la déshydratation, la tachycardie, des enzymes hépatiques élevés et un temps de prothrombine prolongé. Le chien a reçu son congé après 5 jours de soins de soutien agressifs composés de liquides intraveineux, d'antiémétiques, de gastroprotectants, d'hépatoprotectants, de supplémentation en dextrose et de supplémentation en vitamine B/K1.(Traduit par Isabelle Vallières).

Successful treatment of Solanum dulcamara intoxication in a Labrador retriever puppy.

A 10-week-old intact male Labrador retriever dog was presented for acute onset of weakness, ataxia, and generalized muscle tremors. The puppy was suffering respiratory and central nervous system (CNS) depression, was mildly pyrexic, and vomited plant material that was identified as creeping nightshade (Solanum dulcamara). He responded well to supportive care and was discharged successfully. To the authors' knowledge, this is the first report of Solanum dulcamara toxicity occurring in a dog.

Traitement réussi d'une intoxication parSolanum dulcamarachez un chiot Labrador retriever. Un chien Labrador retriever mâle intact âgé de 10 semaines a été présenté pour l'apparition aiguë de faiblesse, d'ataxie et des tremblements musculaires généralisés. Le chiot souffrait d'une dépression du système respiratoire et du système nerveux central (SNC), présentait une pyrexie légère et vomissait du matériau végétal qui a été identifié comme étant de la morelle douce-amère (Solanum dulcamara). Il a bien répondu à des soins de soutien et a reçu un congé pour un traitement réussi. À la connaissance des auteurs, c'est le premier rapport d'une toxicité de Solanum dulcamara se produisant chez un chien.(Traduit par Isabelle Vallières).

Plasma lactate measurements in healthy cats.

OBJECTIVES: The primary objective was to determine if venous plasma lactate is affected by struggling during venipuncture in clinically normal, healthy cats. Additional objectives were to evaluate the effects of venipuncture site, age, sex, and time (0-24 h) on plasma lactate concentrations in healthy cats. DESIGN: Prospective clinical study. SETTING: Private veterinary referral center. ANIMALS: Twenty-one healthy, privately owned, sexually altered, adult cats. INTERVENTIONS: Blood was collected via jugular or medial saphenous venipuncture at the time of study entry and at 6 and 24 hours later. MEASUREMENTS AND MAIN RESULTS: In healthy cats, there were no significant differences in lactate concentrations statified by degree of struggling at time 0 (P = 0.33), time 6 (P = 0.23), or at time 24 (P = 0.41), venipuncture site (P = 0.58), age (P = 0.62), sex (P = 0.06), or time (P = 0.13). Most cats had mild to moderate struggling scores. Venous plasma lactate concentrations for this group of healthy adult cats had a mean of 1.63 mmol/L; 95% CI: 1.34-1.92, SD: 0.62, and a minimum-maximum range of 0.37-2.81 mmol/L. CONCLUSIONS: The occurrence of mild to moderate struggling during venipuncture, venipuncture site, age, sex, and time did not affect plasma lactate concentrations in this group of healthy cats. Our results suggest that plasma lactate can be reliably measured in cats. Further studies are warranted in sick cats to determine if plasma lactate measurements can be utilized as a diagnostic or prognostic biomarker.

Severe burn injury, burn shock, and smoke inhalation injury in small animals. Part 1: burn classification and pathophysiology.

OBJECTIVE: To review the literature related to severe burn injury (SBI), burn shock, and smoke inhalation injury in domestic animals. Current animal- and human-based research and literature were evaluated to provide an overview of thermal burn classification and the pathophysiology of burn shock and smoke inhalation injury. ETIOLOGY: Severe burn injury, burn shock, and smoke inhalation injury may be encountered as a result of thermal injury, radiation injury, chemical injury, or electrical injury. DIAGNOSIS: Burns can be subdivided based on the amount of total body surface area (TBSA) involved and the depth of the burn. Local burn injuries involve <20% of the TBSA whereas SBI involves >20-30% of the TBSA. The modern burn classification system classifies burns by increasing depth: superficial, superficial partial-thickness, deep partial-thickness, and full-thickness. SUMMARY: Local burn injury rarely leads to systemic illness whereas SBI leads to significant metabolic derangements that require immediate and intensive management. SBI results in a unique derangement of cardiovascular dysfunction known as "burn shock." The physiologic changes that occur with SBI can be divided into 2 distinct phases; the resuscitation phase and the hyperdynamic hypermetabolic phase. The resuscitation phase occurs immediately following SBI and lasts for approximately 24-72 hours. This period of hemodynamic instability is characterized by the release of inflammatory mediators, increased vascular permeability, reduced cardiac output, and edema formation. The hyperdynamic hypermetabolic phase begins approximately 3-5 days after injury. This phase is characterized by hyperdynamic circulation and an increased metabolic rate that can persist up to 24 months post burn injury in people.

Severe burn injury, burn shock, and smoke inhalation injury in small animals. Part 2: diagnosis, therapy, complications, and prognosis.

OBJECTIVE: To review the evaluation and treatment of patients suffering from severe burn injury (SBI), burn shock, and smoke inhalation injury. Potential complications and prognosis associated with SBI are also discussed. DIAGNOSIS: Diagnosis of burn injury and burn shock is based on patient history and clinical presentation. Superficial burn wounds may not be readily apparent for the first 48 h whereas more severe wounds will be evident at presentation. Patients are diagnosed with local or SBI by estimating total body surface area involved using the 'Rule of Nines' or the Lund-Browder chart adapted from the human literature. THERAPY: Patients suffering from SBI require immediate and aggressive fluid therapy. Burn wounds require prompt cooling to prevent progressive tissue damage. Due to significant pain associated with burn wounds and therapeutic procedures, multimodal analgesia is recommended. Daily wound management including hydrotherapy, topical medications, and early wound excision and grafting is necessary with SBI. COMPLICATIONS: There are numerous complications associated with SBI. The most common complications include infections, hypothermia, intra-abdominal hypertension, and abdominal compartment syndrome. PROGNOSIS: The prognosis of SBI in domestic animals is unknown. Based on information derived from human literature, patients with SBI and concomitant smoke inhalation likely have a worse prognosis than those with SBI or smoke inhalation alone.

The prevalence and significance of hyperglycemia in hospitalized cats.

OBJECTIVE: To report the prevalence of hyperglycemia in cats admitted to a veterinary hospital and to determine if hyperglycemic cats had increased morbidity and mortality when compared with normoglycemic cats. DESIGN - Retrospective clinical study. SETTING: Community-based referral hospital. ANIMALS: Nondiabetic cats admitted to the hospital. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The medical records of nondiabetic cats admitted to the hospital over a 1-year period were reviewed. There were 182 cats that met the criteria for inclusion in the study. Information obtained included signalment, length of hospitalization, initial and highest blood glucose measurement, diagnosis, treatment, and final disposition. Sixty-three percent of cats (116/182) were hyperglycemic at the time of presentation. Total incidence of hyperglycemia at any point during hospitalization was 64% (118/182). No association was found between hyperglycemia either initially or at any point during the hospitalization and mortality. However, a significant association was documented between the presence of hyperglycemia and increased length of hospitalization (LOH) (P=0.04). The duration of LOH was also significantly associated with the degree of hyperglycemia (P=0.01). A number of different disease processes were represented in the study population. However, the number of cats in each disease category was small and no association could be found between any of them and blood glucose affecting mortality and morbidity. CONCLUSION: The prevalence of hyperglycemia in feline patients admitted to a primary referral hospital was 64%. Cats with hyperglycemia had a longer LOH when compared with normoglycemic cats; however, presence of hyperglycemia did not impact mortality in this population of cats.