Canis ISSN: 2398-2942

Lactate measurement

Contributor(s): Dan Holden, Elisa Mazzaferro, Duana Mcbride

Introduction

  • Generation of lactate by anaerobic metabolic processes and its subsequent quantitative assessment allows evaluation of presence and severity of tissue hypoperfusion.
  • Lactate measurement in cavitary effusions can also be diagnostically valuable.
  • Recent developments in point-of-care laboratory testing have allowed more rapid assessment of patient lactate status and increased its clinical usefulness.

Definitions

  • Hyperlactatemia = higher than normal blood lactate concentration.
  • Acidemia = blood pH < 7.35.
  • Acidosis = process that on its own will result in a fall in blood pH below 7.35.
  • Lactic acidosis = a state produced when production of lactate exceeds its clearance and results in fall in pH below 7.35.
  • Normal lactate concentrations in plasma of dogs should be < 2.5 mmol/l.

Lactate and cellular physiology

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Practical aspects of lactate measurement

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Causes of hyperlactatemia

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Prognostic value of plasma lactate

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Therapy of hyperlactatemia

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Further Reading

Publications

Refereed papers

  • Recent references from VetMed Resource and PubMed.
  • Cortellini S et al (2015) Plasma lactate concentrations in septic peritonitis: A retrospective study of 83 dogs (2007-2012). J Vet Emerg Crit Care (San Antonio) 25(3), 388-395 PubMed.
  • Proot J L et al (2015) Analysis of lactate concentrations in canine synovial fluid. Vet Comp Orthop Traumatol 28(5), 301-305 PubMed.
  • Beer K A et al (2013) Evaluation of plasma lactate concentration and base excess at the time of hospital admission as predictors of gastric necrosis and outcome and correlation between those variables in dogs with gastric dilatation-volvulus: 78 cases (2004-2009). JAVMA 242(1), 54-58 PubMed.
  • Green T I et al (2011) Evaluation of initial plasma lactate values as a predictor of gastric necrosis and initial and subsequent plasma lactate values as a predictor of survival in dogs with gastric dilatation-volvulus: 84 dogs (2003-2007). J Vet Emerg Crit Care (San Antonio) 21(1), 36-44 PubMed.
  • Holahan M L et al (2010) The association of blood lactate concentration with outcome in dogs with idiopathic immune-mediated hemolytic anemia: 173 cases (2003-2006). J Vet Emerg Crit Care (San Antonio) 20(4), 413-420 PubMed.
  • Zacher L A et al (2010) Association between outcome and changes in plasma lactate concentration during presurgical treatment in dogs with gastric dilatation-volvulus: 64 cases (2002-2008). JAVMA 236(8), 892-897 PubMed.
  • Parsons K J et al (2009) A retrospective study of surgically treated cases of septic peritonitis in the cat (2000-2007). JSAP 50(10), 518-524 PubMed.
  • Buriko Y et al (2008) Severe soft tissue infections in dogs: 47 cases (1996-2006). J Vet Emerg Crit Care 18(6), 608-618.
  • Pang D S & Boysen S (2007) Lactate in veterinary critical care: pathophysiology and management. JAAHA 43(5), 270-279 PubMed.
  • Stevenson C K et al (2007) Evaluation of the Accutrend for lactate measurement in dogs. Vet Clin Pathol 36(3), 261-266 PubMed.
  • Jacobson L S & Lobetti R G (2005) Glucose, lactate, and pyruvate concentrations in dogs with babesiosis. Am J Vet Res 66 (2), 244-250 PubMed.
  • Nel M et al (2004) Prognostic value of blood lactate, blood glucose, and hematocrit in canine babesiosis. JVIM 18(4), 471-476 PubMed.
  • Rand J S, Kinnaird E, Baglioni A, Blackshaw J & Priest J (2002) Acute stress hyperglycemia in cats is associated with struggling and increased concentrations of lactate and norepinephrine. J Vet Intern Med 16(2),123-132 PubMed.
  • De Papp E, Drobatz K J & Hughes D (1999)Plasma lactate concentration as a predictor of gastric necrosis and survival among dogs with gastric dilatation-volvulus: 102 cases (1995-1998). JAVMA 215(1), 49-52 PubMed.
  • Hughes D, Rozanski E R, Shofer F S, Laster L L & Drobatz K J (1999) Effect of sampling site, repeated sampling, pH, and PCO2 on plasma lactate concentration in healthy dogs. Am J Vet Res 60(4), 521-524 PubMed.
  • Lagutchik M S, Ogilvie G K, Hackett T B & Wingfield W E (1998) Increased lactate concentrations in ill and injured dogs. J Vet Emerg & Crit Care 8(2), 117-127.
  • Lagutchik M S, Ogilvie G K, Wingfield W E & Hackett T B (1996) Lactate kinetics in veterinary critical care: a review. J Vet Emerg & Crit Care 6(2), 81-95.
  • Mizock B A & Falk J L (1993) Lactic acidosis in critical illness. A review. Crit Care Med 20(1), 80-9 3PubMed.
  • Weil M H & Afifi A A (1970) Experimental and clinical studies on lactate and pyruvate as indicators of the severity of acute circulatory failure (shock). Circulation 41(6), 989-1001 PubMed.

Other sources of information

  • Silverstein D C & Hopper K (2015) Small Animal Critical Care Medicine. Elsevier, 2nd edn.
  • Hughes D (1999) Lactate measurement: diagnostic, therapeutic, and prognostic implications. In: Kirk's Current Veterinary Therapy XIII. Ed J D Bonagura. Philadelphia: WB Saunders. pp 112-116.


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