Blood gas analysis and cooximetry in retired racing Greyhounds

Validation of Noninvasive Methemoglobin and Carboxyhemoglobin Measurements Using Pulse Co-Oximeter in Healthy Dogs

Purpose

To assess the agreement between pulse co-oximeter and blood co-oximeter in measuring methemoglobin (MetHb) and carboxyhemoglobin (COHb) in healthy, awake dogs.

Patients and Methods

Forty-five healthy dogs were enrolled in the study. Pulse co-oximetry was performed using the Masimo Radical 7 Pulse Co-Oximeter with a Rainbow® adhesive sensor. Simultaneously, venous blood samples were collected, and MetHb and COHb were immediately measured using a Stat Profile Prime Plus VET Critical Care Analyzer. Paired measurements of MetHb and COHb were evaluated via Spearman correlation, intra-class correlation (ICC), and Bland-Altman plots to evaluate the degree of agreement between the pulse co-oximeter and the blood co-oximeter.

Results

A total of 45 paired MetHb and COHb measurements were collected. There was a weak correlation between the pulse co-oximeter and the blood co-oximeter readings. The correlation coefficients for MetHb and COHb were 0.0 (95% CI, -0.3 to 0.3) and 0.03 (95% CI, -0.27 to 0.32), respectively. The ICC indicated poor agreement between the pulse and blood co-oximeter for MetHb (ICC = 0.00, 95% CI: -0.12 to 0.15) and COHb (ICC = 0.03, 95% CI: -0.27 to 0.33). Bland-Altman plots revealed low mean bias but wide limits of agreement, indicating that the pulse co-oximeter overestimated MetHb by on average of 0.7% (P < 0.0001) (95% LoA: -0.5 to 2.0) and COHb by on average 0.2% (P = 0.59) (95% LoA: -4.6 to 5.0).

Conclusion

Obtaining MetHb and COHb measurements with the Masimo Radical 7 Pulse Co-Oximeter is straightforward in healthy, awake dogs. However, the device does not provide accurate measurements compared to the blood co-oximeter, specifically in the range of MetHb and COHb in healthy dogs, based on the wide LoA.

Retrospective evaluation of carboxyhemoglobin and methemoglobin levels in dogs and cats with respiratory disease

OBJECTIVE

To evaluate carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels in dogs and cats with respiratory disease in the ICU.

DESIGN

Retrospective study.

SETTING

University veterinary teaching hospital.

ANIMALS

The ICU census was searched for dogs (n = 466) and cats (n = 97) hospitalized within the ICU between January 2016 and January 2019 in whom blood gas with co-oximetry was performed. Dogs and cats were stratified into those with primary respiratory and nonrespiratory categories; the underlying cause of the disease was also noted. Venous blood gas, co-oximeter, PaO₂ /FiO₂ (PF ratio), physical examination findings, and outcome were recorded.

MEASUREMENTS AND MAIN RESULTS

The median COHb and MetHb in dogs hospitalized in the ICU were 2.6% (0.1%-5.6%) and 1.1% (0.1%-2.9%), respectively. The median COHb and MetHb in cats hospitalized in the ICU were 2.2% (0.1%-5.4%) and 1.0% (0%-2.1%), respectively. Dogs with respiratory disease had a higher COHb than dogs without respiratory disease (median, 2.7% [range, 0.3%-5.0%] vs. 2.5% [0.1%-5.6%]; P = 0.0148). COHb was positively associated with survival in cats (median, 2.2% [range, 0.1%-5.4%] vs. 1.9% [0.1%-3.9%]; P = 0.0433). Both COHb and MetHb were higher in septic dogs than in nonseptic dogs (median COHb, 2.8% [range 0.3%-4.5%] vs. 2.6% [0.1%-5.6%]; P = 0.02 and median MetHb, 1.1% [0.1%-2.9%] vs. 1.1% [0.1%-2.4%]; P = 0.01, respectively).

CONCLUSIONS

There may be a positive association between COHb and respiratory disease in dogs; prospective studies are needed to evaluate this further. No association between COHb and respiratory disease in cats or MetHb and respiratory disease in either species was detected. Additional prospective studies are needed to determine whether COHb and MetHb are biomarkers for sepsis in dogs and whether COHb is an indicator of mortality in cats.

Precapillary pulmonary gas exchange is similar for oxygen and inert gases

KEY POINTS

Precapillary gas exchange for oxygen has been documented in both humans and animals. It has been suggested that, if precapillary gas exchange occurs to a greater extent for inert gases than for oxygen, shunt and its effects on arterial oxygenation may be underestimated by the multiple inert gas elimination technique (MIGET). We evaluated fractional precapillary gas exchange in canines for O2 and two inert gases, sulphur hexafluoride and ethane, by measuring these gases in the proximal pulmonary artery, distal pulmonary artery (1 cm proximal to the wedge position) and systemic artery. Some 12-19% of pulmonary gas exchange occurred within small (1.7 mm in diameter or larger) pulmonary arteries and this was quantitatively similar for oxygen, sulphur hexafluoride and ethane. Under these experimental conditions, this suggests only minor effects of precapillary gas exchange on the magnitude of calculated shunt and the associated effect on pulmonary gas exchange estimated by MIGET.

ABSTRACT

Some pulmonary gas exchange is known to occur proximal to the pulmonary capillary, although the magnitude of this gas exchange is uncertain, and it is unclear whether oxygen and inert gases are similarly affected. This has implications for measuring shunt and associated gas exchange consequences. By measuring respiratory and inert gas levels in the proximal pulmonary artery (P), a distal pulmonary artery 1 cm proximal to the wedge position (using a 5-F catheter) (D) and a systemic artery (A), we evaluated precapillary gas exchange in 27 paired samples from seven anaesthetized, ventilated canines. Fractional precapillary gas exchange (F) was quantified for each gas as F = (P - D)/(P - A). The lowest solubility inert gases, sulphur hexafluoride (SF6 ) and ethane were used because, with higher solubility gases, the P-A difference is sufficiently small that experimental error prevents accurate assessment of F. Distal samples (n = 12) with oxygen (O2 ) saturation values that were (within experimental error) equal to or above systemic arterial values, suggestive of retrograde capillary blood aspiration, were discarded, leaving 15 for analysis. D was significantly lower than P for SF6 (D/P = 88.6 ± 18.1%; P = 0.03) and ethane (D/P = 90.6 ± 16.0%; P = 0.04), indicating partial excretion of inert gas across small pulmonary arteries. Distal pulmonary arterial O2 saturation was significantly higher than proximal (74.1 ± 6.8% vs. 69.0 ± 4.9%; P = 0.03). Fractional precapillary gas exchange was similar for SF6 , ethane and O2 (0.12 ± 0.19, 0.12 ± 0.20 and 0.19 ± 0.26, respectively; P = 0.54). Under these experimental conditions, 12-19% of pulmonary gas exchange occurs within the small pulmonary arteries and the extent is similar between oxygen and inert gases.

Intra-pulmonary arteriovenous anastomoses and pulmonary gas exchange: evaluation by microspheres, contrast echocardiography and inert gas elimination

KEY POINTS

Imaging techniques such as contrast echocardiography suggest that anatomical intra-pulmonary arteriovenous anastomoses (IPAVAs) are present at rest and are recruited to a greater extent in conditions such as exercise. IPAVAs have the potential to act as a shunt, although gas exchange methods have not demonstrated significant shunt in the normal lung. To evaluate this discrepancy, we compared anatomical shunt with 25-µm microspheres to contrast echocardiography, and gas exchange shunt measured by the multiple inert gas elimination technique (MIGET). Intra-pulmonary shunt measured by 25-µm microspheres was not significantly different from gas exchange shunt determined by MIGET, suggesting that MIGET does not underestimate the gas exchange consequences of anatomical shunt. A positive agitated saline contrast echocardiography score was associated with anatomical shunt measured by microspheres. Agitated saline contrast echocardiography had high sensitivity but low specificity to detect a ≥1% anatomical shunt, frequently detecting small shunts inconsequential for gas exchange.

ABSTRACT

The echocardiographic visualization of transpulmonary agitated saline microbubbles suggests that anatomical intra-pulmonary arteriovenous anastomoses are recruited during exercise, in hypoxia, and when cardiac output is increased pharmacologically. However, the multiple inert gas elimination technique (MIGET) shows insignificant right-to-left gas exchange shunt in normal humans and canines. To evaluate this discrepancy, we measured anatomical shunt with 25-µm microspheres and compared the results to contrast echocardiography and MIGET-determined gas exchange shunt in nine anaesthetized, ventilated canines. Data were acquired under the following conditions: (1) at baseline, (2) 2 µg kg-1  min-1 i.v. dopamine, (3) 10 µg kg-1  min-1 i.v. dobutamine, and (4) following creation of an intra-atrial shunt (in four animals). Right to left anatomical shunt was quantified by the number of 25-µm microspheres recovered in systemic arterial blood. Ventilation-perfusion mismatch and gas exchange shunt were quantified by MIGET and cardiac output by direct Fick. Left ventricular contrast scores were assessed by agitated saline bubble counts, and separately by appearance of 25-µm microspheres. Across all conditions, anatomical shunt measured by 25-µm microspheres was not different from gas exchange shunt measured by MIGET (microspheres: 2.3 ± 7.4%; MIGET: 2.6 ± 6.1%, P = 0.64). Saline contrast bubble score was associated with microsphere shunt (ρ = 0.60, P < 0.001). Agitated saline contrast score had high sensitivity (100%) to detect a ≥1% shunt, but low specificity (22-48%). Gas exchange shunt by MIGET does not underestimate anatomical shunt measured using 25-µm microspheres. Contrast echocardiography is extremely sensitive, but not specific, often detecting small anatomical shunts which are inconsequential for gas exchange.

Platelet closure time in anesthetized Greyhounds with hemorrhagic shock treated with hydroxyethyl starch 130/0.4 or 0.9% sodium chloride infusions

OBJECTIVE

To measure platelet closure time (PCT) in dogs during controlled hemorrhagic shock and after fluid resuscitation with hydroxyethyl starch (HES) 130/0.4 or 0.9% sodium chloride.

DESIGN

Experimental interventional study.

SETTING

University veterinary teaching hospital.

ANIMALS

Eleven healthy Greyhounds.

INTERVENTIONS

Dogs were anesthetized and had 48 mL/kg of blood removed to induce hemorrhagic shock. Dogs received 20 mL/kg of HES 130/0.4 (n = 6) or 80 mL/kg of 0.9% sodium chloride (NaCl; n = 5) intravenously over 20 minutes. PCT was measured using the Platelet Function Analyzer-100 with collagen and adenosine-diphosphate cartridges at: T0 = 60 minutes after induction of anesthesia prior to hemorrhage, T1 = during hemorrhagic shock, and T2 = 40 minutes after completion of fluid bolus. Packed cell volume and platelet count were concurrently measured.

MEASUREMENT AND MAIN RESULTS

Hemorrhagic shock did not significantly change PCT, with no difference between T0 and T1. Both the HES 130/0.4 and 0.9% NaCl group had a significantly increased mean PCT at T2 of 91.4 seconds (95% CI 69.3-113.4) and 95.5 seconds (95% CI 78.2-112.8), respectively, compared to T1. The magnitude of change was significantly greater for the 0.9% NaCl group than the HES 130/0.4 group. There was no difference in the magnitude of change in PCV and platelet count between the 2 groups. The PCV and platelet count were >25% and >100,000/μL, respectively, in all dogs, except for dogs in the HES 130/0.4 group at T2 where platelet counts were <100,000/μL.

CONCLUSION

Controlled hemorrhagic shock in Greyhounds under anesthesia did not cause a significant change in PCT. Both HES 130/0.4 and 0.9% NaCl administration after induction of shock increased PCT. These results do not support that HES 130/0.4 causes relevant platelet dysfunction beyond hemodilution.

Effect of ascorbic acid on storage of Greyhound erythrocytes

OBJECTIVE

To assess changes in biochemical and biophysical properties of canine RBCs during cold (1° to 6°C) storage in a licensed RBC additive solution (the RBC preservation solution designated AS-1) supplemented with ascorbic acid.

SAMPLE

Blood samples from 7 neutered male Greyhounds; all dogs had negative results when tested for dog erythrocyte antigen 1.1.

PROCEDURES

Blood was collected into citrate-phosphate-dextrose and stored in AS-1. Stored RBCs were supplemented with 7.1mM ascorbic acid or with saline (0.9% NaCl) solution (control samples). Several biochemical and biophysical properties of RBCs were measured, including percentage hemolysis, oxygen-hemoglobin equilibrium, and the kinetic rate constants for O2 dissociation, carbon monoxide association, and nitric oxide dioxygenation.

RESULTS

Greyhound RBCs stored in AS-1 supplemented with ascorbic acid did not have significantly decreased hemolysis, compared with results for the control samples, during the storage period.

CONCLUSIONS AND CLINICAL RELEVANCE

In this study, ascorbic acid did not reduce hemolysis during storage. Several changes in stored canine RBCs were identified as part of the hypothermic storage lesion.

Haematological and biochemical variations among eight sighthound breeds

OBJECTIVE

The aim of the study was to compare the haematological and biochemical profiles of eight sighthound breeds.

DESIGN

Samples were taken from 192 individuals of the sighthound breeds (Whippet, Greyhound, Italian Greyhound, Sloughi, Saluki, Borzoi, Pharaoh Hound and Azawakh). Routine haematological and biochemical examinations were performed and the results were evaluated statistically.

RESULTS

There were significant differences in haematology and clinical biochemistry among the sighthound breeds. The most similar laboratory profile to Greyhounds was found in Whippets. Italian Greyhounds had significantly higher alanine aminotransferase activity than other sighthounds, except Pharaoh Hounds.

CONCLUSION

Application of the Greyhound laboratory profile to other sighthounds is not recommended because of the frequent differences in haematological and clinical biochemical reference intervals.

Hematologic differences between Dachshunds and mixed breed dogs

BACKGROUND

Healthy Dachshunds, like Greyhounds, are reported to have a higher HCT than other dog breeds; however, there appears to be no objective information to support this observation.

OBJECTIVE

The purpose of this study was to determine whether RBC counts, indices, and total and differential WBC counts differ between Dachshunds and mixed breed dogs.

METHODS

In this retrospective study, CBC data and total solids were compared between 61 healthy Dachshunds and 60 mixed breed dogs that were presented for health check, dental prophylaxis, or neutering to a university and a private clinic.

RESULTS

Dachshunds had higher mean PCV (52% vs 50%; P = .047), mean HCT (52% vs 48%; P = .0003), mean RBC count (7.7 × 10(6) /μL vs 7.1 × 10(6) /μL; P = .0004), and mean HGB concentration (18.2 g/dL vs 16.8 g/dL; P = .0003) than mixed breed dogs. There were slight differences in HCT and HGB concentration between clinics (P < .05). There was no evidence of a difference in MCV, MCHC, and total solids between breeds (P > .5). More Dachshunds than mixed breed dogs had RBC variables above the reference interval: 29% vs 2% for HCT (P = .001); 40% vs 7% for HGB concentration (P = .0006); and 26% vs 5% for RBC count (P = .01). There were statistically significant but clinically unimportant differences in differential WBC counts.

CONCLUSIONS

Compared with mixed breed dogs, Dachshunds have higher PCV, HCT, RBC count, and HGB concentration. Veterinarians should consider these differences when interpreting CBCs.

Effects of racing on reticulocyte concentrations in Greyhounds

BACKGROUND

Greyhounds have several hematologic variables that are outside of the respective reference intervals of other dog breeds. In addition, increases in HCT, total protein and HGB concentration, and RBC and WBC counts occur immediately after exercise; these values return to resting values within a few hour after racing.

OBJECTIVE

This study evaluated the effects of exercise on the concentration of reticulocytes in circulating blood in racing Greyhounds. We hypothesized that reticulocyte numbers are significantly increased immediately after a race, and return to baseline within one to 2 h postrace.

METHODS

Fifty actively racing Greyhounds at the Wheeling Island Racetrack and Casino were included in the study. Samples were collected by jugular venipuncture one day prior to racing at the kennel (resting), immediately after racing, and one to 2 h after the race (recovery). Reticulocyte counts were determined with an IDEXX ProCyte Dx Hematology Analyzer (IDEXX Laboratories, Inc., Westbrook, ME, USA). Due to a nonparametric distribution, the results were statistically compared using the Friedman test.

RESULTS

Reticulocyte concentrations were significantly different among the 3 sample collection times (P < .0001). There was a significant increase in reticulocyte concentration immediately after racing (P < .001); one to 2 h after racing, the reticulocyte numbers decreased significantly (P < .001) to counts comparable to resting samples.

CONCLUSION

The increase in reticulocyte concentration is probably related to splenic contraction secondary to the release of catecholamines, although premature bone marrow release could also account for these changes. Thus, it is important to consider a Greyhound's activity and degree of excitement when interpreting selected hematologic data in a clinical setting.

Clinical pathology of Greyhounds and other sighthounds

Owing to the development of Greyhounds as racing sighthounds, these dogs have acquired unique physiologic adaptations that distinguish them from other breeds. Reference intervals for many analytes in retired racing Greyhounds (RRGs) differ from those of other breeds; most of the hematologic differences have also been described in other sighthounds. In this review, we provide a survey of the literature on clinical pathology of Greyhounds and other sighthounds and results of laboratory testing, including analysis of CBCs, biochemical profiles, coagulation tests, and blood gases, in RRGs at The Ohio State University. Major clinicopathologic differences in this breed include higher RBC mass, creatinine concentration, glomerular filtration rate, activities of hepatic enzymes, and concentration of cardiac troponin, as well as lower WBC, neutrophil, and platelet counts, thromboelastographic values, and concentrations of serum haptoglobin, total globulins, and T4.