Evaluation of a hand-held lactate analyzer in dogs

A hand-held lactate test device and a blood gas auto analyzer were compared. The objective of the study was to evaluate the performance of the hand-held device in dogs in a clinical setting. Blood lactate levels were evaluated on 30 samples from healthy client-owned dogs and 48 samples from client-owned dogs with various diseases. A blood sample was collected from each healthy dog by either jugular or cephalic venipuncture and from each sick dog from the jugular, cephalic, or saphenous vein, or from an arterial catheter if applicable. One and a half milliliters of the blood sample was immediately transferred to a heparinized vacutainer tube. Enough blood was then drawn from the heparinized tube to allow split sample simultaneous analysis with both machines. Samples from the sick dogs represented a wide range of clinically relevant lactate values. Good agreement between lactate values from both devices was obtained in both sick and healthy dogs. Lactate values in the healthy group (< 2.9 mmol/L with the hand-held device, < 2.6 mmol/L with the blood gas analyzer) were similar to those previously reported (< 2.5 mmol/L). The results of this study support the use of the hand-held device in dogs in a clinical setting.     

Use of the Accusport semi-automated analyser to determine blood lactate as an aid in the clinical assessment of horses with colic

The most useful diagnostic methods in the initial evaluation of horses with colic assess the morphological and functional status of the gastrointestinal tract and cardiovascular status. This evaluation is best achieved using a combination of clinical and laboratory data. Blood lactate concentration (BL) is one of these variables. BL rises mainly due to poor tissue perfusion and anaerobic glycolysis associated with shock, providing an indicator of both the severity of disease and its prognosis. A hand-held lactate meter, Accusport, provides a rapid (60 seconds), inexpensive dry-chemical-based determination of BL. This trial evaluated the Accusport's ability to provide BL data as an adjunct to the initial clinical evaluation of horses with colic. The accuracy of the Accusport was tested by evaluation of its interchangeability with the benchmark enzymatic kit evaluation of BL in a trial using data collected firstly from 10 clinically normal control horses and subsequently from 48 horses presented with signs of colic. The BL values were recorded together with the clinical variables of heart rate (HR), capillary refill time (CRT), haematocrit (Hct), and pain character and severity on the initial assessment of the colic horses. Information regarding choice of therapeutic management (medical or surgical) and eventual case outcome (full recovery or died/euthanased) was recorded. The Accusport was found to be interchangeable with the enzymatic kit for recording BL values in colic horses with BL < 10 mmol/l, which is within the BL range associated with survival. The interchangeability of an additional, laboratory-based wet chemical assay for BL, the Stat 7 was simultaneously evaluated for the colic and control horses. The Stat 7 was found to be interchangeable with the enzymatic kit for BL determination of colic horses. No linear associations between BL values with HR, CRT, Hct or pain assessment were observed. No relationship with either selection of therapeutic method or eventual case outcome was observed. All horses with BL >8 mmol/l died or were euthanased.     

The accuracy of the i-STAT portable analyser for measuring blood gases and pH in whole-blood samples from dogs

To assess the suitability of the i-STAT portable analyser for use by non-laboratory personnel, we measured blood gases and pH in venous blood samples from 100 dogs. Deming's regression and bias plots were used to compare i-STAT results with those obtained by laboratory professionals using two different autocalibrated benchtop analysers. Overall accuracy of the portable analyser proved excellent for pH, pO(2), and pCO(2) (r=0.978, 0.968 and 0.997, respectively), with Deming's regression slopes close to 1.00 (0.96, 0.97 and 1.08 for pH, pO(2), and pCO(2), respectively) and intercepts close to zero (0.28, 0.47 kPa and 0.46 kPa for pH, pO(2), and pCO(2), respectively). The accuracy of the i-STAT was also satisfactory for calculated parameters: bicarbonates, total CO(2), base excess and oxygen saturation. Our findings show this portable analyser to be a valid substitute for expensive benchtop analysers in situations requiring mobility, or when small numbers of tests are to be performed by users not specialized in laboratory techniques.     

Evaluation of the usefulness of the portable device Lactate Pro for measurement of lactate concentrations in equine whole blood.

Blood lactate measurements are commonly used in exercising horses to determine the onset of lactate accumulation and in colic patients to assess clinical status and to indicate prognosis. To study the usability of a portable blood lactate meter based on dry chemistry (Lactate Pro), the data from this instrument were compared to data from a laboratory-used lactate meter based on wet chemistry (ABL 605 blood gas analyzer [ABL]). Heparinized blood samples were obtained from horses participating in a jumping experiment (n = 9), from horses cantering at maximal speed on a racetrack (n = 7), and from patients admitted to the Department of Equine Sciences at Utrecht University for severe colic (n = 13). Seventeen of these samples were tested in duplicate on both instruments to determine the repeatability of the measurements. Blood lactate concentrations measured with the Lactate Pro ranged from 0.8-17.6 mmol/liter and with the ABL from 1.0-18.6 mmol/liter. The correlation between lactate concentrations obtained using the Lactate Pro and values from the ABL was 0.90, and the relationship was represented by the following formula: y = 0.90 . x + 0.36, indicating a linear relationship between values produced by the ABL and Lactate Pro. The repeatability for the Lactate Pro was high (0.997), which is comparable to the ABL (0.999).     

Plasma lactate measurements in healthy beagle dogs

Plasma lactate concentrations were determined in venous blood samples collected from 60 healthy Beagles aged 5 to 9 months. The range of values (0.42 to 3.58 mmol/L) obtained with an enzymatic method in the present study was similar to values reported in smaller studies with the colorimetric procedures.     

Evaluation of a portable lactate analyzer (Lactate Scout) in dogs

BACKGROUND: Measurement of blood lactate concentration has become a common practice in canine medicine. However, the accuracy of portable lactate monitors has not been reported in dogs. OBJECTIVES: The aim of this study was to evaluate the accuracy and precision of a portable analyzer (Lactate-Scout) in measuring canine blood lactate concentration. METHODS: A preliminary study was performed to assess the effects of sample storage time and temperature on plasma lactate concentration. Blood samples obtained from 6 canine patients at our hospital were divided into 8 aliquots and stored at 4 degrees C and 20 degrees C; plasma lactate was measured in duplicate with a spectrophotometric system (Konelab) at 0, 30, 60, 120, and 240 minutes after the blood collection. Values were compared with those obtained immediately after blood collection. Lactate values obtained by the portable method also were compared with those obtained by the reference spectrophotometric analyzer on blood samples collected from 48 additional canine patients. RESULTS: There was no significant effect of storage time (P = .89) or temperature (P = .51) on plasma lactate levels. The correlation between lactate values measured with the Lactate-Scout and the Konelab method was r = .98 (slope = .81, 95% confidence interval = .73-.87; intercept = .20, 95% confidence interval = .13-.31). The level of agreement between the 2 methods was generally good for mean lactate concentrations <5 mmol/L. However, at higher lactate concentrations (5 of 48 samples), the values recorded by the Lactate-Scout analyzer were lower than those measured by the Konelab method. CONCLUSION: The Lactate-Scout analyzer is reliably comparable to a reference method for measuring whole blood lactate concentration in dogs; however, caution should be used when interpreting lactate values of 5 mmol/L and higher.     

Serial blood lactate concentrations in systemically ill dogs

BACKGROUND: Lactate concentration often is quantified in systemically ill dogs and interpreted based on human data. To our knowledge, there are no published clinical studies evaluating serial lactate concentrations as a prognostic indicator in ill dogs. OBJECTIVES: Our objective was to perform a prospective study, using multivariate analysis, to determine whether serial lactate concentrations were associated with outcome in ill dogs requiring intravenous fluids. METHODS: Eighty sick dogs had lactate concentrations evaluated, using an analyzer that measures lactate in the plasma fraction of heparinized whole blood, at 0 hours and 6 hours after initiation of treatment. Severity of illness and outcome (survivor, nonsurvivor) were determined by reviewing the patient's record 2 weeks after admission. Lactate concentrations, age, body weight, gender, and severity of illness were evaluated using multivariate analysis to determine their effects on outcome. RESULTS: Dogs with lactate concentrations greater than the reference interval at 6 hours were 16 times (95% confidence interval = 2.32-112.71 times, P <.01) more likely not to survive compared to dogs with lactate concentrations within the reference interval. Lactate concentrations above the reference interval at 0 hours were not significantly related to outcome. However, hyperlactatemia that did not improve by > or = 50% within 6 hours was significantly associated with mortality (P = .024). CONCLUSION: Dogs with a lactate concentration higher than the reference interval at 6 hours were more likely not to survive. These results indicate an association between lactate concentration and outcome and emphasize the importance of serial lactate concentrations in evaluating prognosis.     

Arterialized capillary blood used to determine the acid-base and blood gas status of dogs.

Blood samples were collected by microhematocrit tube from posterior medial margin of the shaved, but otherwise untreated, canine ear. Acid-base and blood gas values of these samples were compared with the values of samples obtained simultaneously from the carotid artery. The arterialized nature of capillary blood from the canine ear was demonstrated under various degrees of chemical restraint and during conditions of extreme hypoxic acidosis to hyperventilatory alkalosis. Once a week determinations of acid-base and blood gas status with such arterialized capillary blood from a group of awake dogs showed within-subject variance to be significantly less (P less than 0.05) than between-subject variance; thus, uniqueness of individual dogs was reliably revealed. This technique also was used to demonstrated breed differences for acid-base and blood gas characteristics.     

Lactate dehydrogenase isoenzymes in blood and cerebrospinal fluid from healthy beagles

Serum and CSF lactate dehydrogenase (LDH) activity and LDH isoenzyme profile, as well as total protein, were measured in samples obtained from 26 healthy Beagles. The LDH activity in serum was approximately 10 times that in the CSF. The CSF LDH isoenzyme profile was a mirror image of the serum LDH isoenzyme profile. Age was negatively correlated (ie, as age increased, the activity decreased) with LDH3 in CSF and LDH5 in serum and was positively correlated with LDH1 in serum. Seemingly, simultaneous measurement of serum and CSF LDH activity and LDH isoenzyme profile can aid in establishing status of the blood-brain barrier, whether brain damage exists and whether other organ systems are involved.     

The immunophenotype of peripheral blood lymphocytes in clinically healthy dogs and dogs with lymphoma in remission

Lymphoma is a common cancer of dogs that frequently is treated with chemotherapy or radiation therapy. Response to therapy is variable and currently available diagnostic tests do not reliably predict response to therapy. Treatment for lymphoma often results in lymphopenia, but it is unknown whether the changes in circulating lymphocytes result from generalized or specific reduction of lymphocytes. In this study, blood lymphocytes from 12 clinically healthy dogs, 10 dogs in remission because of treatment for B-cell lymphoma, and 8 dogs in remission from T-cell lymphoma were analyzed by flow cytometry by using a panel of 20 antibodies reactive with canine leukocyte antigens. Results identified similar lymphocyte parameters in treated dogs regardless of the type of lymphoma. Treated dogs had >50% reduction in blood lymphocyte concentration, and an absolute decrease in most subsets of lymphocytes. Both groups of treated dogs had relative increases in the proportion of CD3+, T-cell receptor (TCR)αβ+, and CD90+ lymphocytes, and a decreased proportion of CD45RA+ cells. In addition, dogs with T-cell lymphoma in remission had a significant increase in the proportion of CD49d+ lymphocytes. These findings were interpreted as representing likely suppression of lymphocyte regeneration by chemotherapy, with a relative increase in the proportion of memory over naïve lymphocytes. Lack of correlation with the T- or B-cell origin of the initial lymphoma suggested that, by using flow cytometric methods, residual circulating neoplastic cells could not be detected. However, the changes in the lymphocyte profile of dogs treated with chemotherapy may have relevance to their immunocompetence.     

Arterial blood gas tensions in healthy aged dogs.

Twenty-four healthy dogs > 8 years old were recruited. In each instance, arterial blood gas tensions were analyzed. The alveolar-to-arterial oxygen gradient (P[A-a]O2) was calculated to assess adequacy of pulmonary gas exchange. Thoracic radiographs were evaluated to ensure lack of visible signs of pulmonary disease and that lung features were similar to those in aged dogs of previous reports. Unlike findings in aged human beings, arterial partial pressure of oxygen (PaO2) was not decreased in this group of aged dogs (mean +/- SD, 102.9 +/- 7.8 mm of Hg). Similarly, P(A-a)O2 also was not increased. The thoracic radiographic findings were consistent with those of previous reports of pulmonary changes in aged dogs. The extent of radiographic abnormalities and the PaO2 were not correlated.     

Assessment of renal blood flow in dogs: analysis of 131I-hippuran blood clearance in healthy dogs and in dogs with proteinuria

In 30 clinically healthy dogs (weights 7.5 to 57 kg) and in 41 proteinuric dogs the 131I-hippuran blood disappearance curve after single injection was determined (0 to 90 minutes), described by a bi-exponential function and analysed according to a two compartment model. The dependence of the blood clearance (C), representing an effective renal blood flow, on the bodyweight (W) (kg) could be described with both a linear function (C = 61 + 13.2 W ml min-1) and a power function (C = 30.56 W0.79 ml min-1) in the healthy dogs. The results of the regression between blood clearance and bodyweight were reproducible (r = 0.92, n = 10 residual error 12 per cent, P less than 0.01).     

Endoscopic evaluation of the gastroduodenal mucosa to determine the safety of short-term concurrent administration of meloxicam and dexamethasone in healthy dogs

OBJECTIVE: To evaluate the safety, with respect to the development of gastric ulcers and erosions, of concurrent administration of meloxicam and dexamethasone for 3 days to healthy dogs. ANIMALS: 20 conditioned purpose-bred research Beagles. PROCEDURE: Seven days prior to treatment, dogs were anesthetized for endoscopic evaluation of the upper portion of the gastrointestinal tract (ie, the gastric and duodenal mucosa). Five regions of the gastroduodenal area were scored by 2 investigators. Dogs were randomly assigned to 1 of 4 treatment groups as follows: saline-saline, dexamethasone-saline, saline-meloxicam, and dexamethasone-meloxicam groups. On days 1, 2, and 3, dogs received either dexamethasone or saline (0.9% NaCl) solution injections SC twice daily. On days 2, 3, and 4, dogs received either meloxicam or saline solution injections SC once daily. On day 2, dogs were anesthetized for a sham surgery (ie, electrostimulation). On day 5, the gastroduodenal area of each dog was reevaluated by use of endoscopic evaluation and histologic examination of biopsy specimens. RESULTS: The total endoscopic score of the dexamethasone-meloxicam group was significantly greater than the scores of the other groups. The dexamethasone-saline group had a mean cumulative score that was significantly greater than the saline-meloxicam or saline-saline groups. Endoscopic scores of the saline-meloxicam group were not significantly different from scores of the saline-saline group. No significant differences in histologic findings were found between groups. CONCLUSIONS AND CLINICAL RELEVANCE: In healthy dogs, meloxicam appears to be safe with regard to adverse effects on the gastrointestinal tract. Concurrent administration of dexamethasone and meloxicam is more likely to cause gastric erosions than meloxicam administration alone.     

The effects of diminazene aceturate on systemic blood pressure in clinically healthy adult dogs

Diminazene aceturate is a commonly used antibabesial agent. It has been postulated that diminazine may induce a decrease in blood pressure and exacerbate the hypotension presented in dogs with babesiosis. This study was undertaken to assess the effect of diminazine aceturate on the blood pressure of healthy dogs. Six healthy German shepherd dogs between 18 and 24 months of age with a mean weight of 30.4 +/- 2.75 kg were used. Blood pressure was directly measured at the following time intervals: -5, 0, 5, 10, 15, 20, 25, 30, 35, 40, 50, 60, 90 and 120 minutes after treatment with diminazine aceturate (4.2 mg/kg) intramuscularly. No statistical difference (P > 0.05) was found in blood pressure between any of the time intervals. An increase in heart rate was seen 5 minutes after the administration of diminazine aceturate but no change in blood pressure was evident. This study concluded that diminazene aceturate in its current formulation with antipyrine does not alter blood pressure in healthy adult dogs.     

Analysis of blood clotting with the total thrombus analysis system in healthy dogs

To date, coagulation tests are unable to reflect in vivo coagulation status in the same system, including platelet function, fibrin clot formation, and whole blood flow. The Total Thrombus Analysis System (T-TAS), which is a microfluidic assay that simulates conditions in vivo, measures whole blood flow at defined shear rates under conditions designed to assess platelet function (PL-chip) or coagulation and fibrin clot formation (AR-chip). The T-TAS records occlusion start time, occlusion time, and area under the curve. We evaluated this test in healthy control dogs. We also investigated the effect in vivo of acetylsalicylic acid (ASA), and the effect in vitro of an anticoagulation drug (dalteparin; low-molecular-weight heparin; LMWH). The CV of the AUC of both chips was good (CVs of 6.45% [PL] and 1.57% [AR]). The inhibition of platelet function by ASA was evident in the right-shift in the PL test pressure curve. The right-shift in the AR test pressure curves showed that the administration of LMWH inhibited both platelets and the coagulation cascade. The T-TAS may be useful in the evaluation of canine blood coagulation.