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Beard S, Hall EJ, Bradbury J, Carter AJ, Gilbert S, O'Neill DG. Epidemiology of heat-related illness in dogs under UK emergency veterinary care in 2022. Vet Rec 2024; 194:e4153. [PMID: 38783549 DOI: 10.1002/vetr.4153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/22/2024] [Accepted: 04/05/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Dogs are exposed to increasing environmental risk for developing heat-related illness (HRI), with 2022 recorded as the hottest year to date in the UK and most of Europe. METHODS This study used VetCompass data to report the incidence risk, event fatality rate and canine risk factors for HRI in dogs presenting to Vets Now emergency care practices in the UK during 2022. RESULTS From the clinical records of 167,751 dogs under care at Vets Now emergency clinics in 2022, 384 HRI events were identified. The 2022 incidence risk of HRI within the Vets Now caseload was 0.23% (95% confidence interval [CI]: 0.21%‒0.25%), with an event fatality rate of 26.56% (95% CI: 21.66%-32.25%). Multivariable analysis identified breed, age and sex/neuter status as risk factors for HRI. Brachycephalic dogs had 4.21 times the odds of HRI compared to mesocephalic dogs (95% CI: 3.22‒5.49, p < 0.001). LIMITATIONS The clinical data used in this study were not primarily recorded for research and had some substantial levels of missing data (especially patient bodyweight). CONCLUSION In order to protect canine welfare, improved long-term mitigation strategies are urgently needed to minimise HRI risk and associated fatality in UK dogs.
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Affiliation(s)
- Sian Beard
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
| | - Emily J Hall
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Jude Bradbury
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Anne J Carter
- Department of Animal and Veterinary Sciences, Scottish Rural Colleges, Dumfries, UK
| | | | - Dan G O'Neill
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
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2
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Yanai M, Klainbart S, Dafna G, Segev G, Aroch I, Kelmer E. Thromboelastometry for assessment of hemostasis and disease severity in 42 dogs with naturally-occurring heatstroke. J Vet Intern Med 2024; 38:1483-1497. [PMID: 38685600 PMCID: PMC11099784 DOI: 10.1111/jvim.17041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/27/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Thromboelastometry (TEM) provides a comprehensive overview of the entire coagulation process and has not been evaluated in heatstroke-induced coagulopathies in dogs. OBJECTIVES To determine the diagnostic and prognostic utility of TEM in dogs with heatstroke. ANIMALS Forty-two client-owned dogs with heatstroke. METHODS Prospective observational study. Blood samples for intrinsic and extrinsic TEM (INTEM and EXTEM, respectively) were collected at presentation and every 12 to 24 hours for 48 hours. Coagulation phenotype (hypo-, normo-, or hypercoagulable) was defined based on TEM area under the 1st derivative curve (AUC). RESULTS Case fatality rate was 31%. Median TEM variables associated with death (P < .05 for all) included longer INTEM clotting time, lower AUC at presentation and at 12 to 24 hours postpresentation (PP), lower INTEM alpha angle, maximum clot firmness, and maximum lysis (ML) at 12 to 24 hours PP, and lower EXTEM ML at 12 to 24 hours PP. Most dogs were normo-coagulable on presentation (66% and 63% on EXTEM and INTEM, respectively), but hypo-coagulable 12 to 24 PP (63% for both EXTEM and INTEM). A hypo-coagulable INTEM phenotype was more frequent at presentation and 12 to 24 PP among nonsurvivors compared to survivors (55% vs 15% and 100% vs 50%, P = .045 and .026, respectively). AKI was more frequent (P = .015) in dogs with hypo-coagulable INTEM tracings at 12 to 24 hours. Disseminated intravascular coagulation was more frequent (P < .05) in dogs with a hypo-coagulable INTEM phenotype and in nonsurvivors at all timepoints. CONCLUSIONS AND CLINICAL RELEVANCE Hypocoagulability, based on INTEM AUC, is predictive of worse prognosis and occurrence of secondary complications.
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Affiliation(s)
- Michal Yanai
- The Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and EnvironmentThe Hebrew University of JerusalemJerusalemIsrael
| | - Sigal Klainbart
- The Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and EnvironmentThe Hebrew University of JerusalemJerusalemIsrael
| | - Gal Dafna
- The Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and EnvironmentThe Hebrew University of JerusalemJerusalemIsrael
| | - Gilad Segev
- The Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and EnvironmentThe Hebrew University of JerusalemJerusalemIsrael
| | - Itamar Aroch
- The Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and EnvironmentThe Hebrew University of JerusalemJerusalemIsrael
| | - Efrat Kelmer
- The Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and EnvironmentThe Hebrew University of JerusalemJerusalemIsrael
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3
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Shipov A, Lenchner I, Milgram J, Libkind R, Klainbart S, Segev G, Bruchim Y. Aetiology, clinical parameters and outcome in 113 dogs surgically treated for septic peritonitis (2004-2020). Vet Rec 2023; 192:e2134. [PMID: 36066034 DOI: 10.1002/vetr.2134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 07/10/2022] [Accepted: 08/08/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Septic peritonitis (SP) is a common life-threatening condition. The aims of this study were to describe the aetiology, clinicopathological abnormalities, complications, treatment, outcome and prognosis of dogs with SP. METHODS Records of 113 dogs diagnosed and surgically treated for SP between 2004 and 2020 were reviewed. RESULTS Overall survival rate was 74.3%. Parameters at presentation that were significantly associated with mortality were lateral recumbency (p = 0.001) and elevated respiratory rate (p = 0.045). Hypotension during or after surgery (p < 0.001), liver injury (p < 0.001) and acute kidney injury (p < 0.001) were also more common in non-survivors. The source of contamination, number of surgeries or the location of perforation in cases of gastrointestinal tract perforation were not associated with mortality. Delta glucose (serum vs. abdominal) was available in 36 out of 113 dogs and the difference was more than 20 mg/dl in only 22 of out 36 (61.1%) cases. CONCLUSION Liver and kidney injuries play a role in mortality, and early diagnosis and intervention are recommended to prevent multiple organ dysfunction and death. The reported high sensitivity of delta glucose is questionable in diagnosis of SP.
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Affiliation(s)
- Anna Shipov
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Itzik Lenchner
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Josh Milgram
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Rivka Libkind
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Sigal Klainbart
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Gilad Segev
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yaron Bruchim
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Caldas GG, da Silva DOB, Junior DB. Heat stroke in dogs: Literature review. VET MED-CZECH 2022; 67:354-364. [PMID: 39100130 PMCID: PMC11295878 DOI: 10.17221/144/2021-vetmed] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/16/2022] [Indexed: 08/06/2024] Open
Abstract
Heat stroke is a clinical emergency secondary to a severe temperature increase due to the inefficiencies of heat dissipation mechanisms, causing central nervous system dysfunctions, which may lead to multiple organ dysfunction syndrome. Heat disturbances can be classified as "classic" or "exertional" ones and several predisposing factors are involved in their development. This review provides a broad approach to the pathophysiological mechanisms of this syndrome, and the diagnostic and treatment methods to facilitate their approach in clinical routine and increase the survival rate of patients.
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Affiliation(s)
| | | | - Durval Barauna Junior
- Veterinary Hospital of the Federal University San Francisco Valley, Petrolina, Brazil
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5
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Hall EJ, Carter AJ, Chico G, Bradbury J, Gentle LK, Barfield D, O’Neill DG. Risk Factors for Severe and Fatal Heat-Related Illness in UK Dogs—A VetCompass Study. Vet Sci 2022; 9:vetsci9050231. [PMID: 35622759 PMCID: PMC9144152 DOI: 10.3390/vetsci9050231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 04/28/2022] [Accepted: 05/06/2022] [Indexed: 02/04/2023] Open
Abstract
Heat-related illness (HRI) is predicted to increase in dogs due to rising global temperatures. This study evaluated retrospective VetCompass veterinary clinical records to explore geographical variability and ambient conditions associated with HRI events in UK dogs, and report the intrinsic (canine) and extrinsic (location, trigger, ambient weather) risk factors for severe disease and fatal outcome in dogs affected by HRI. Dogs living in London had the greatest odds for developing HRI compared with dogs living in the North West (OR 1.9, 95% CI 1.31–2.74). The median ambient temperature on days of HRI events was 16.9 °C. For dogs with HRI, age, bodyweight and trigger were risk factors associated with severe disease. Age, skull shape and clinical grade of HRI presentation were associated with a fatal outcome. Whilst the majority of HRI events overall were triggered by exertion, the risk of severe disease was greater in situations where dogs could not escape the heat source (vehicular confinement), and the risk of death in HRI cases was greater for those dogs with reduced capacity to thermoregulate (older and brachycephalic dogs). These results highlight the need for better owner awareness of the factors that increase the risk of severe and fatal HRI, as a first stage in protecting canine welfare in the face of rising global temperatures.
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Affiliation(s)
- Emily J. Hall
- Department of Clinical Science and Services, The Royal Veterinary College, Herts AL9 7TA, UK;
- Correspondence: or
| | - Anne J. Carter
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Notts NG25 0QF, UK; (A.J.C.); (G.C.); (L.K.G.)
| | - Guaduneth Chico
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Notts NG25 0QF, UK; (A.J.C.); (G.C.); (L.K.G.)
| | - Jude Bradbury
- Royal College of Veterinary Surgeons, London WC2A 1EN, UK;
| | - Louise K. Gentle
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Notts NG25 0QF, UK; (A.J.C.); (G.C.); (L.K.G.)
| | - Dominic Barfield
- Department of Clinical Science and Services, The Royal Veterinary College, Herts AL9 7TA, UK;
| | - Dan G. O’Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Herts AL9 7TA, UK;
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6
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Hall EJ, Carter AJ, Farnworth MJ. Exploring Owner Perceptions of the Impacts of Seasonal Weather Variations on Canine Activity and Potential Consequences for Human-Canine Relationships. Animals (Basel) 2021; 11:ani11113302. [PMID: 34828033 PMCID: PMC8614552 DOI: 10.3390/ani11113302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/10/2021] [Accepted: 11/17/2021] [Indexed: 12/28/2022] Open
Abstract
Simple Summary Dog walking is important for maintaining the good health and welfare of pet dogs. Environmental factors such as weather conditions have been previously identified as potential barriers to dog walking but, so far, focus has been on the impact this has on the human. With more seasonal weather variation predicted due to climate change, it is unclear if weather also impacts on the willingness of dogs to undertake exercise and thus the overall activity levels of pet dogs. An online survey recruited 3153 respondents to outline the impact of summer and winter weather conditions on daily canine activity levels. Owners reported their dogs were more impacted by cold (48.2% less likely to exercise their dog in the cold) and ice (64.0% less likely), than rain (25.3% less likely). In hot weather, 81.7% of owners reported reduced exercise duration and 87.0% reported less vigorous exercise by their dogs. As extreme weather events are likely to become more commonplace, it is likely this will negatively impact dog activity levels. Climate change mitigation strategies must therefore include considerations for dogs, if our canine companions are to retain their positions of service and companionship. Abstract Climate change is leading to more instances of seasonal weather variation. Studies have explored the impact of adverse winter weather on dog walking, but the impact on the dog’s overall activity levels have not been previously considered. This study explored dog owner perceptions of the effects of both summer and winter weather on their dog’s activity levels. An international online survey recruited 3153 respondents between May and December 2018, to explore the impact of summer and winter weather conditions on baseline activity levels. Owners reported their dogs were more impacted by cold (48.2% less likely to exercise their dog in the cold) and ice (64.0% less likely), than rain (25.3% were less likely). In hot weather, over 80% of owners reported reduced exercise duration and vigour for their dogs. Carrying water or walking near water to facilitate activity in the summer was the most popular mitigation strategy (90.8%). Participation in dog sports appeared to reduce the impact of winter weather on canine activity and increase owner awareness of cooling strategies to facilitate summer activity. Strategies to promote safe activity participation are needed to maintain canine activity levels amidst rising global temperatures, including better understanding of cooling strategies for exercising dogs.
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Affiliation(s)
- Emily J. Hall
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Brackenhurst, Nottingham NG25 0QF, UK;
- Correspondence:
| | - Anne J. Carter
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Brackenhurst, Nottingham NG25 0QF, UK;
| | - Mark J. Farnworth
- Department of Veterinary Health & Animal Sciences, Harper Adams University, Newport TF10 8NB, UK;
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Cudney SE, Wayne A, Rozanski EA. Clothes dryer-induced heat stroke in three cats. J Vet Emerg Crit Care (San Antonio) 2021; 31:800-805. [PMID: 34499793 DOI: 10.1111/vec.13131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/15/2020] [Accepted: 06/03/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe the clinical course of 3 cats successfully treated following clothes dryer-induced heat stroke. CASE SERIES SUMMARY Three cats were treated after accidental clothes dryer-induced heat stroke. All cats fulfilled canine heat stroke criteria and showed evidence of heat injury, including neurological dysfunction, corneal and mucosal ulceration, and evidence of rhabdomyolysis. Coagulopathy, acute liver injury, acute kidney injury, cardiac dysfunction, and gastrointestinal signs were seen in cats with a longer duration of dryer exposure. NEW OR UNIQUE INFORMATION PROVIDED Describes the management of cats after inadvertent clothes dryer-induced heat stroke.
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Affiliation(s)
- Sarah E Cudney
- ACCESS Specialty Animal Hospitals, Culver City, California, USA
| | - Annie Wayne
- Massachusetts Veterinary Referral Hospital, Ethos Veterinary Health, Woburn, Massachusetts, USA
| | - Elizabeth A Rozanski
- Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
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8
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Proposing the VetCompass clinical grading tool for heat-related illness in dogs. Sci Rep 2021; 11:6828. [PMID: 33767275 PMCID: PMC7994647 DOI: 10.1038/s41598-021-86235-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/11/2021] [Indexed: 01/31/2023] Open
Abstract
Heat-related illness is a potentially fatal condition in dogs. Rapid and accurate recognition of the severity can improve clinical management in affected dogs and lead to better outcomes. This study explored retrospective VetCompass veterinary clinical records to investigate the clinical signs recorded for dogs presenting with heat-related illness to primary-care veterinary practice from 2016 to 2018. The relative risk of death associated with these clinical signs was reported and used to develop a novel clinical grading tool. From the clinical records of 856 heat-related illness events, the most frequently recorded clinical signs were respiratory changes (68.73%) and lethargy (47.79%). The clinical signs with the highest relative risk of death were neurological dysfunction, gastrointestinal haemorrhage and bleeding disorders. The novel VetCompass Clinical Grading Tool for Heat-Related Illness in dogs defines three grades: mild (altered respiration, lethargy), moderate (gastrointestinal signs, a single seizure, episodic collapse) and severe (neurological dysfunction, gastrointestinal haemorrhage, bleeding disorders). This novel grading tool offers a simple, evidence-based device to improve recognition of heat-related illness in dogs and promote improved decision-making for earlier interventions such as cooling and hospitalisation. This could improve outcomes and protect the welfare of dogs in the face of rising global temperatures.
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9
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Hall EJ, Carter AJ, O’Neill DG. Dogs Don't Die Just in Hot Cars-Exertional Heat-Related Illness (Heatstroke) Is a Greater Threat to UK Dogs. Animals (Basel) 2020; 10:E1324. [PMID: 32751913 PMCID: PMC7459873 DOI: 10.3390/ani10081324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/24/2020] [Accepted: 07/28/2020] [Indexed: 12/21/2022] Open
Abstract
Heat-related illness will affect increasing numbers of dogs as global temperatures rise unless effective mitigation strategies are implemented. This study aimed to identify the key triggers of heat-related illness in dogs and investigate canine risk factors for the most common triggers in UK dogs. Using the VetCompassTM programme, de-identified electronic patient records of 905,543 dogs under primary veterinary care in 2016 were reviewed to identify 1259 heat-related illness events from 1222 dogs. Exertional heat-related illness was the predominant trigger (74.2% of events), followed by environmental (12.9%) and vehicular confinement (5.2%). Canine and human risk factors appear similar; young male dogs had greater odds of exertional heat-related illness, older dogs and dogs with respiratory compromise had the greatest odds of environmental heat-related illness. Brachycephalic dogs had greater odds of all three types of heat-related illness compared with mesocephalic dogs. The odds of death following vehicular heat-related illness (OR 1.47, p = 0.492) was similar to that of exertional heat-related illness. In the UK, exertional heat-related illness affects more dogs, and kills more dogs, than confinement in a hot vehicle. Campaigns to raise public awareness about heat-related illness in dogs need to highlight that dogs don't die just in hot cars.
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Affiliation(s)
- Emily J. Hall
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Brackenhurst, Southwell, Notts NG25 0QF, UK;
| | - Anne J. Carter
- School of Animal, Rural and Environmental Sciences, Nottingham Trent University, Brackenhurst, Southwell, Notts NG25 0QF, UK;
| | - Dan G. O’Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA, UK;
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10
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Gogolski SM, O'Brien C, Lagutchik MS. Retrospective analysis of patient and environmental factors in heat-induced injury events in 103 military working dogs. J Am Vet Med Assoc 2020; 256:792-799. [PMID: 32176578 DOI: 10.2460/javma.256.7.792] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Incidence and risk factors for heat-related illness (heatstroke) in UK dogs under primary veterinary care in 2016. Sci Rep 2020; 10:9128. [PMID: 32555323 PMCID: PMC7303136 DOI: 10.1038/s41598-020-66015-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 05/13/2020] [Indexed: 12/26/2022] Open
Abstract
As climate change causes global temperatures to rise, heat-related illness, a potentially fatal condition in dogs, will become an ever-greater threat. This study aimed to report the incidence, fatality and canine risk factors of heat-related illness in UK dogs under primary veterinary care in 2016. The VetCompassTM programme collects de-identified electronic patient records from UK veterinary practices for research. From the clinical records of 905,543 dogs under veterinary care in 2016, 395 confirmed heat-related illness events were identified. The estimated 2016 incidence of heat-related illness was 0.04% (95% CI 0.04-0.05%), with an event fatality rate of 14.18% (95% CI 11.08 – 17.96%). Multivariable analysis identified significant risk factors including breed (e.g. Chow Chow, Bulldog and French Bulldog), higher bodyweight relative to the breed/sex mean and being over two years of age. Dogs with a brachycephalic skull shape and dogs weighing over 50 kg were also at greater risk. As we move into an ever-warmer world, veterinary professionals may need to include resistance to heat-related illness amongst their rationales when advising owners on breed selection. Breeding for good respiratory function and maintaining a healthy bodyweight should be considered key welfare priorities for all dogs to limit the risk of heat-related illness.
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Bruchim Y, Aroch I, Nivy R, Baruch S, Abbas A, Frank I, Fishelson Y, Codner C, Horowitz M. Impacts of previous heatstroke history on physiological parameters eHSP72 and biomarkers of oxidative stress in military working dogs. Cell Stress Chaperones 2019; 24:937-946. [PMID: 31402428 PMCID: PMC6717235 DOI: 10.1007/s12192-019-01020-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/02/2019] [Accepted: 07/05/2019] [Indexed: 01/15/2023] Open
Abstract
Heatstroke (HS) is an acute, progressive life-threatening emergency. Animals, including military working dogs (IDFMWD), rapidly activate cytoprotective processes, e.g., heat shock proteins (HSPs) and antioxidative molecules, in response to heat stress. We hypothesized that serum HSPs (eHSP72) and oxidative stress markers would differ in IDFMWD with a history of HS compared with controls and thus could be used to detect susceptibility to recurrent HS. eHSPs concentration, oxidative stress markers, and systemic physiological parameters were studied in dogs with and without histories of HS, undergoing indoor or outdoor training. Treadmill physical performance tests (PPTs) were conducted indoors at 22 °C (groups C-I and HS-I) or outdoors under heat stress conditions of 36 °C; 60% humidity (groups C-O and HS-O). Pre-, immediately post-, and 45 min post-PPT heart rate (HR), respiratory rate, and rectal temperature (Tre) were recorded in all dogs. Likewise, blood samples were collected and eHSP72, venous blood gas analysis, and lactate and creatine kinase activity (CK) were assayed. Serum uric acid (sUA) and total serum redox potential (TRP) were measured only in the indoor group. Immediately post-PPT under both environmental conditions, Tre, HR, eHSP, sUA, and TRP (only measured in indoor PPT) significantly (P < 0.05) increased, whereas venous blood pH and bicarbonate decreased significantly (P < 0.05). Between groups comparisons demonstrated significant differences in basal HR and post-PPT Tre immediately after outdoor PPT. eHSP72 induction, CK, sUA, and serum TRP remained significantly higher in the HS group during post-PPT recovery. Taken together, animals with a history of HS have different results, and this signature of previous HS may predict altered heat sensitivity.
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Affiliation(s)
- Yaron Bruchim
- The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
- Laboratory of Environmental Physiology, Faculty of Dentistry, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Itamar Aroch
- The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ran Nivy
- The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shelly Baruch
- The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Atallah Abbas
- Laboratory of Environmental Physiology, Faculty of Dentistry, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ilan Frank
- Israel Defense Force Military Working Dog Unit, Jerusalem, Israel
| | - Yuval Fishelson
- Israel Defense Force Military Working Dog Unit, Jerusalem, Israel
| | - Carolina Codner
- The Hebrew University Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michal Horowitz
- Laboratory of Environmental Physiology, Faculty of Dentistry, The Hebrew University of Jerusalem, Jerusalem, Israel.
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Goggs R, Mastrocco A, Brooks MB. Retrospective evaluation of 4 methods for outcome prediction in overt disseminated intravascular coagulation in dogs (2009-2014): 804 cases. J Vet Emerg Crit Care (San Antonio) 2018; 28:541-550. [PMID: 30302935 DOI: 10.1111/vec.12777] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/01/2017] [Accepted: 04/13/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The clinical diagnosis of disseminated intravascular coagulation (DIC) in dogs is challenging. It was hypothesized that dogs with laboratory abnormalities consistent with overt DIC have increased mortality and hence survival could be used to evaluate the performance of DIC scoring systems. Four DIC scoring systems were compared in clinically ill dogs: The International Society of Thrombosis and Haemostasis (ISTH) score; a previously published veterinary DIC score; a system using in-house reference intervals (RIs) for coagulation assays; and the published veterinary DIC score modified by use of in-house RI values. DESIGN Retrospective cohort study. SETTING University teaching hospital. ANIMALS Eight hundred four client-owned dogs with underlying disorders associated with DIC. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records were reviewed to identify dogs for which a coagulation panel consisting of coagulation times, D-dimer concentration, antithrombin activity, fibrinogen concentration, and platelet count had been analyzed. Four methods for overt DIC scoring were then applied, and the ability of these scores to predict mortality was evaluated. Use of institution RIs for diagnosis of overt DIC provided the most accurate prognostic assessment. A score based on abnormalities in 3 of 6 parameters to identify overt DIC was 72.7% sensitive and 80.9% specific for mortality and was accurate in 78.4% of cases. The mortality rate of dogs diagnosed with overt DIC via this method was 62.5%, compared to 12.9% in the dogs not in overt DIC, a relative risk of nonsurvival of 4.84 (95% confidence interval 3.80-6.16). CONCLUSIONS In dogs at-risk for DIC, an in-house RI scoring system accurately predicted mortality. With further prospective validation, this system holds promise as a diagnostic tool for consistent characterization of overt DIC in clinical studies and clinical practice.
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Affiliation(s)
- Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, 14853
| | - Alicia Mastrocco
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, 14853
| | - Marjory B Brooks
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, 14853
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Segev G, Bruchim Y, Berl N, Cohen A, Aroch I. Effects of fenoldopam on kidney function parameters and its therapeutic efficacy in the management of acute kidney injury in dogs with heatstroke. J Vet Intern Med 2018; 32:1109-1115. [PMID: 29575360 PMCID: PMC5980265 DOI: 10.1111/jvim.15081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/28/2017] [Accepted: 01/30/2018] [Indexed: 01/11/2023] Open
Abstract
Background Acute kidney injury (AKI) is common in dogs, but evidence of efficacy of its treatment is lacking. Objective To evaluate the efficacy of fenoldopam in the management of AKI. Animals Forty dogs with naturally occurring heatstroke. Methods Dogs were prospectively enrolled and divided into treatment and the placebo groups (fenoldopam, constant rate infusion [CRI] of 0.1 µg/kg/min or saline, respectively). Urine production (UP) was measured using a closed system. Urinary clearances were performed at 4, 12, and 24 hours after presentation to estimate the effect of fenoldopam on UP, glomerular filtration rate (GFR) and sodium fractional excretion (NaFE). Results At presentation, severity of heatstroke, based on a previously developed scoring system, was similar between the study groups, but was significantly worse in nonsurvivors compared with survivors. Fenoldopam administration was not associated with hypotension. Overt AKI was diagnosed, based on the International Renal Interest Society guidelines in 22/40 (55%) of the dogs. Overall, 14/40 dogs (35%) died, with no significant (P = .507) mortality rate difference between the fenoldopam (6/20 dogs; 30%) and placebo (8/20; 40%) groups. The proportion of dogs with AKI did not differ between the fenoldopam and the placebo groups (9/20; 45% versus 13/20; 65%, respectively; P = .204). There were no differences in UP, GFR, and NaFE between the fenoldopam and the placebo groups. Conclusion and Clinical Importance Fenoldopam CRI at 0.1 µg/kg/min did not have a clinically relevant effect on kidney function parameters in dogs with severe heatstroke‐associated AKI.
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Affiliation(s)
- Gilad Segev
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
| | - Yaron Bruchim
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
| | - Noga Berl
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
| | - Adar Cohen
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
| | - Itamar Aroch
- Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel
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Bruchim Y, Ginsburg I, Segev G, Mreisat A, Avital Y, Aroch I, Horowitz M. Serum histones as biomarkers of the severity of heatstroke in dogs. Cell Stress Chaperones 2017; 22:903-910. [PMID: 28643239 PMCID: PMC5655374 DOI: 10.1007/s12192-017-0817-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 05/04/2017] [Accepted: 05/31/2017] [Indexed: 02/06/2023] Open
Abstract
Heatstroke is associated with systemic inflammatory response syndrome, leading to multiple organ dysfunction and death. Currently, there is no specific treatment decreasing hyperthermia-induced inflammatory/hemostatic derangements. Emerging studies indicate that histones leaking from damaged cells into the extracellular space are toxic, pro-inflammatory, and pro-thrombotic. We therefore hypothesize that serum histones (sHs) are elevated during heatstroke and are associated with the severity of the disease. Sixteen dogs with heatstroke and seven healthy controls were included in the study. Median serum histones (sHs) upon admission in dogs with heatstroke were significantly higher (P = 0.043) compared to that in seven controls (13.2 vs. 7.3 ng/mL, respectively). sHs level was significantly higher among non-survivors and among dogs with severe hemostatic derangement (P = 0.049, median 21.4 ng/mL vs. median 8.16 ng/mL and P = 0.038, 19.0 vs. 7.0 ng/mL, respectively). There were significant positive correlation between sHs and urea (r = 0.8, P = 0.02); total CO2 (r = 0.661, P = 0.05); CK (r = 0.678, P = 0.04); and prothrombin time (PT) 12 h post presentation (r = 0.888, P = 0.04). The significant positive correlation between sHs and other heatstroke severity biomarkers, and significant increase among severely affected dogs, implies its role in inflammation/oxidation/coagulation during heatstroke. sHs, unlike other prognostic and severity biomarkers in heatstroke, can be pharmacologically manipulated, offering a potential therapeutic target.
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Affiliation(s)
- Yaron Bruchim
- Department of Small Animal Emergency and Critical Care, Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Isaac Ginsburg
- Faculty of Dental Medicine, Institute for Dental Sciences, Hebrew University, Hadassah Medical Center, Jerusalem, Israel
| | - Gilad Segev
- Department of Small Animal Emergency and Critical Care, Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ahmad Mreisat
- Laboratory of Environmental Physiology, Hadassah Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yochai Avital
- Department of Small Animal Emergency and Critical Care, Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Itamar Aroch
- Department of Small Animal Emergency and Critical Care, Veterinary Teaching Hospital, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michal Horowitz
- Laboratory of Environmental Physiology, Hadassah Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel
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16
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Bruchim Y, Horowitz M, Aroch I. Pathophysiology of heatstroke in dogs - revisited. Temperature (Austin) 2017; 4:356-370. [PMID: 29435477 PMCID: PMC5800390 DOI: 10.1080/23328940.2017.1367457] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/09/2017] [Accepted: 08/10/2017] [Indexed: 01/09/2023] Open
Abstract
Heatstroke results from a failure to dissipate accumulated heat during exposure to hot environments, or during strenuous physical exercise under heat stress. It is characterized by core body temperatures > 41°C, with central nervous system dysfunction. Functional morphology and thermoregulatory effectors differences between dogs and humans may require special heatstroke protective adaptations in dogs, however, the risk factors for developing heatstroke are similar in both. In dogs, these include hot, especially highly humid environments, excessive physical activity, obesity, large (>15 kg) body weight, being of certain breed (e.g., Labrador retrievers and brachycephalic breeds), upper airway obstruction and prolonged seizures. Lack of acclimation to heat and physical fitness decreases the survival of heat stroked dogs. At the systemic level, blood pooling within the large internal organs (e.g., spleen, liver) is a major contributor to the development of shock and consequent intestinal ischemia, hypoxia and endothelial hyperpermeability, commonly occurring in heatstroke patients. Evoked serious complications include rhabdomyolysis, acute kidney injury, acute respiratory distress syndrome and ultimately, sepsis and disseminated intravascular coagulation. The most common clinical signs in dogs include acute collapse, tachypnea, spontaneous bleeding, shock signs and mental abnormalities, including depression, disorientation or delirium, seizures, stupor and coma. In such dogs, presence of peripheral blood nucleated red blood cells uniquely occurs, and is a highly sensitive diagnostic and prognostic biomarker. Despite early, appropriate body cooling, and intensive supportive treatment, with no available specific treatment to ameliorate the severe inflammatory and hemostatic derangements, the mortality rate is around 50%, similar to that of human heatstroke victims. This review discusses the pathophysiology of canine heatstroke from a veterinarian's point of view, integrating new and old studies and knowledge.
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Affiliation(s)
- Yaron Bruchim
- The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem
- Laboratory of Environmental Physiology, Hadassah Medical Center, The Hebrew University of Jerusalem
| | - Michal Horowitz
- Laboratory of Environmental Physiology, Hadassah Medical Center, The Hebrew University of Jerusalem
| | - Itamar Aroch
- The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem
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Segev G, Langston C, Takada K, Kass PH, Cowgill LD. Validation of a Clinical Scoring System for Outcome Prediction in Dogs with Acute Kidney Injury Managed by Hemodialysis. J Vet Intern Med 2016; 30:803-7. [PMID: 26995335 PMCID: PMC4913579 DOI: 10.1111/jvim.13930] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 12/02/2022] Open
Abstract
Background A scoring system for outcome prediction in dogs with acute kidney injury (AKI) recently has been developed but has not been validated. Hypothesis The scoring system previously developed for outcome prediction will accurately predict outcome in a validation cohort of dogs with AKI managed with hemodialysis. Animals One hundred fifteen client‐owned dogs with AKI. Methods Medical records of dogs with AKI treated by hemodialysis between 2011 and 2015 were reviewed. Dogs were included only if all variables required to calculate the final predictive score were available, and the 30‐day outcome was known. A predictive score for 3 models was calculated for each dog. Logistic regression was used to evaluate the association of the final predictive score with each model's outcome. Receiver operating curve (ROC) analyses were performed to determine sensitivity and specificity for each model based on previously established cut‐off values. Results Higher scores for each model were associated with decreased survival probability (P < .001). Based on previously established cut‐off values, 3 models (models A, B, C) were associated with sensitivities/specificities of 73/75%, 71/80%, and 75/86%, respectively, and correctly classified 74–80% of the dogs. Conclusions and Clinical Relevance All models were simple to apply and allowed outcome prediction that closely corresponded with actual outcome in an independent cohort. As expected, accuracies were slightly lower compared with those from the previously reported cohort used initially to develop the models.
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Affiliation(s)
- G Segev
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Israel
| | - C Langston
- The Ohio State University Veterinary Medical Center, School of Veterinary Medicine, University of California, Davis, CA
| | - K Takada
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA
| | - P H Kass
- Department of Population Heath and Reproduction, University of California, Davis, CA
| | - L D Cowgill
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, CA
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Bruchim Y, Segev G, Kelmer E, Codner C, Marisat A, Horowitz M. Hospitalized dogs recovery from naturally occurring heatstroke; does serum heat shock protein 72 can provide prognostic biomarker? Cell Stress Chaperones 2016; 21:123-130. [PMID: 26441274 PMCID: PMC4679735 DOI: 10.1007/s12192-015-0645-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/17/2015] [Accepted: 09/22/2015] [Indexed: 10/23/2022] Open
Abstract
Heatstroke is a serious illness in dogs characterized by core temperatures above 41°C with central nervous system dysfunction. Experimental heatstroke models have tried to correlate biomarker levels with the severity of the syndrome. Serum heat shock protein (eHSP70) levels were recently evaluated as a biomarker of heat tolerance and acclimation, their role as a marker of heatstroke is inconclusive. Here, we monitored eHSP70 levels in correlation with systemic biomarkers in 30 naturally occurring canine heatstroke cases. Thirty dogs diagnosed with environmental (33%) or exertional (66%) heatstroke admitted to hospital (0-14 h post-injury) were tested for biomarkers of organ damage and coagulation parameters. eHSP70 levels were measured upon admission and 4, 12, and 24 h later (T1, T2, and T3, respectively). No differences were found between exertional and environmental heatstroke cases. The eHSP profile demonstrated an inverted bell shape, with the lowest levels at the 12 h time point. A positive correlation between eHSP70, lactate, and aPPT was also noted at T2 in all the dogs in the study. Twenty-four h after presentation, eHSP70 levels returned to those measured upon admission, this change was only significant in the survivors. The obtained results suggest that eHSP72 level profile may be predictive of survival.
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