Prognostic utility of pre- and postoperative plasma l-lactate measurements in hospitalized cows with acute abdominal emergencies.

Giertzuch, S.; Lorch, A.; Lausch, C. K.; Knubben-Schweizer, G.; Trefz, F. M. (2020). Prognostic utility of pre- and postoperative plasma l-lactate measurements in hospitalized cows with acute abdominal emergencies. Journal of dairy science, 103(12), pp. 11769-11781. American Dairy Science Association 10.3168/jds.2020-19102

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The aim of the present analyses was to compare the prognostic value of pre- and postoperative l-lactate measurements in hospitalized cows requiring surgical intervention for an acute abdominal emergency, such as gastrointestinal ileus or peritonitis. For this purpose, we analyzed data from retro- and prospective case series, consisting of 754 and 98 cows, respectively. Plasma l-lactate concentrations (L-LAC) were determined upon admission to the hospital (both study populations), immediately before initiation of surgical intervention (prospective study population), and 6, 12, 24, 48, and 72 h later (prospective study population). The outcome of cows was evaluated until hospital discharge (both study populations) and 3 mo after discharge by a phone call to the farmer (prospective study population). A negative outcome was defined as death or euthanasia during hospitalization, or if discharged animals had an unsatisfied owner or were culled for medical reasons that were directly related to the initial abdominal emergency. For the retrospective study population, the overall survival rate until hospital discharge was 66%. Cows with a negative outcome (median: 6.81 mmol/L) had significantly higher L-LAC than cows with a positive outcome (3.66 mmol/L) of therapy. At the individual diagnosis level, L-LAC was associated with mortality in cows with a diagnosis of abomasal volvulus, local peritonitis, hemorrhagic bowel syndrome, and jejunal volvulus. Considering the whole study population, the area under the receiver operating characteristic curve was 0.66. For the prospective study population, the proportion of cows with a positive outcome was 65% until hospital discharge and 61% after the 3-mo observation period. At all sampling times, before and during the first 12 h after surgical intervention, cows with a negative outcome had significantly higher L-LAC than cows with a positive outcome. The largest area under the receiver operating characteristic curve for L-LAC was observed at 6 h (0.89). A cut-point of 1.77 mmol/L was identified, which had a sensitivity and specificity for predicting a negative outcome until hospital discharge of 88.9 and 73.4%, respectively. The present analyses confirmed previous findings in calves and show that persistent hyper-l-lactatemia during the early postoperative period is a more reliable indicator for a negative outcome than hyper-l-lactatemia before initiation of surgical intervention.

Item Type:

Journal Article (Original Article)

Division/Institute:

05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV)
05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > Clinic for Ruminants

UniBE Contributor:

Trefz, Florian Markus

Subjects:

500 Science > 590 Animals (Zoology)
600 Technology > 610 Medicine & health
600 Technology > 630 Agriculture

ISSN:

0022-0302

Publisher:

American Dairy Science Association

Language:

English

Submitter:

Nathalie Viviane Zollinger

Date Deposited:

30 Sep 2020 11:01

Last Modified:

24 Nov 2020 01:32

Publisher DOI:

10.3168/jds.2020-19102

PubMed ID:

32981725

Uncontrolled Keywords:

cow gastrointestinal ileus hyper-l-lactatemia mortality peritonitis

BORIS DOI:

10.7892/boris.146752

URI:

https://boris.unibe.ch/id/eprint/146752

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