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Casalta H, Bayrou C, Djebala S, Eppe J, Gille L, Gommeren K, Marduel E, Sartelet A, Seys C, Versyp J, Grulke S. Evaluation of Blood Lactate, Heart Rate, Blood Pressure, and Shock Index, and Their Association with Prognosis in Calves. Vet Sci 2024; 11:45. [PMID: 38275927 PMCID: PMC10819515 DOI: 10.3390/vetsci11010045] [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: 11/14/2023] [Revised: 12/26/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Diseases in young calves received as emergencies are often associated with hypovolemic and/or septic shocks. The objectives of our study were to (1) assess the correlation between clinical hemodynamic parameters and blood L-lactates (LAC), systolic blood pressure (SBP), and the shock index (SI) recorded upon arrival; and (2) to evaluate how these parameters were related to short-term outcomes in calves under 4 months of age presented as emergencies. We conducted a single-observer prospective observational study on calves aged from 1 day to 4 months, presented to the Veterinary Clinic for Ruminants of Liège from December 2020 to May 2022. Forty-five calves were included in the study. The statistical analysis revealed a significant correlation between LAC and heart rate (r = 0.570; p < 0.05) and LAC and SI (r = 0.373; p < 0.05). A high LAC value at admission was significantly associated with a negative outcome (death) (p < 0.05). In calves suffering from obstructive digestive diseases, the SI was related to the outcome and the analysis indicated a cut-off value of 1.13 (Se = 0.77, Spe = 1). In conclusion, in our study, the initial blood L-lactate value was correlated with heart rate, the shock index, and the clinical shock score, and admission hyperlactatemia was associated with a poor prognosis in calves under 4 months of age. In this cohort, the shock index in calves suffering from digestive diseases was linked with mortality.
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Affiliation(s)
- Hélène Casalta
- Clinical Department of Production Animals, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium; (C.B.); (J.E.); (A.S.); (C.S.); (J.V.)
| | - Calixte Bayrou
- Clinical Department of Production Animals, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium; (C.B.); (J.E.); (A.S.); (C.S.); (J.V.)
| | - Salem Djebala
- Independent Researcher, Muckerstaff Granard, N39AN52 Co Longford, Ireland;
| | - Justine Eppe
- Clinical Department of Production Animals, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium; (C.B.); (J.E.); (A.S.); (C.S.); (J.V.)
| | - Linde Gille
- Independent Researcher, 1170 Watermael-Boitsfort, Belgium
| | - Kris Gommeren
- Clinical Department of Companions Animals, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium;
| | - Eva Marduel
- Independent Researcher, 44200 Nantes, France;
| | - Arnaud Sartelet
- Clinical Department of Production Animals, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium; (C.B.); (J.E.); (A.S.); (C.S.); (J.V.)
| | - Celine Seys
- Clinical Department of Production Animals, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium; (C.B.); (J.E.); (A.S.); (C.S.); (J.V.)
| | - Jérôme Versyp
- Clinical Department of Production Animals, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium; (C.B.); (J.E.); (A.S.); (C.S.); (J.V.)
| | - Sigrid Grulke
- Clinical Department of Equines, Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium;
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Le Page T, Buczinski S, Dubuc J, Labonté J, Roy JP. Development of a Nomogram to Estimate the 60-Day Probability of Death or Culling Due to Severe Clinical Mastitis in Dairy Cows at First Veterinary Clinical Evaluation. Vet Sci 2023; 10:vetsci10040268. [PMID: 37104423 PMCID: PMC10141895 DOI: 10.3390/vetsci10040268] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/26/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
Severe clinical mastitis is a frequent disease of dairy cattle. An effective mean of predicting survival despite treatment would be helpful for making euthanasia decisions in poor prognosis cases. The objective was to develop a nomogram for prediction of death or culling in the 60 days following a severe mastitis episode in dairy cows at first veterinary visit in farm settings. A total of 224 dairy cows presenting severe clinical mastitis and examined for the first time by a veterinarian were included in a prospective study. Clinical and laboratory (complete blood cell count, L-lactate, cardiac troponin I, milk culture) variables were recorded. Animals were followed for 60 days. A nomogram was built with an adaptive elastic-net Cox proportional hazards model. Performances and relevance were evaluated by area under the receiver operating characteristic curve (AUC), Harrell’s concordance index (C-index), calibration curve, decision curve analysis (DCA) and misclassification cost term (MCT). The nomogram included: lactation number, recumbency, depression intensity, capillary refilling time, ruminal motility rate, dehydration level, lactates concentration, hematocrit, band neutrophils count, monocyte count, and milk bacteriology. The AUC and C-index showed a good calibration and ability to discriminate. The DCA suggested that the nomogram was clinically relevant. Euthanizing animals having less than 25% probability of survival is economically optimal. It could be used for early euthanasia decisions in animals that would not survive despite treatment. To facilitate the use of this nomogram by veterinarians, a web-based app was developed.
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Affiliation(s)
- Thomas Le Page
- Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Sébastien Buczinski
- Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Jocelyn Dubuc
- Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Josiane Labonté
- Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Jean-Philippe Roy
- Faculté de Médecine Vétérinaire, Université de Montréal, Montreal, QC H3T 1J4, Canada
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Ultrasonographical Assessment of Caudal Vena Cava Size through Different Views in Healthy Calves: A Pilot Study. Vet Sci 2022; 9:vetsci9070308. [PMID: 35878325 PMCID: PMC9322146 DOI: 10.3390/vetsci9070308] [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: 04/21/2022] [Revised: 06/08/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Ultrasonographic measurements of the caudal vena cava (CVC) and aorta (Ao) are known as reliable tools to assess intravascular volume status in humans. The aim of this study was to evaluate the feasibility of obtaining ultrasonographical measurements of CVC and Ao in two different views, assess intra- and interobserver variability, and study the effect of sex, age, body weight, and breed on measurements in healthy calves. The diameter and area of CVC and Ao were measured by a single investigator in two anatomic sites (subxiphoid and paralumbar window) in 48 calves aged less than 60 days and then repeated 2.5 months after the first assessment. For intra- and interobserver variability assessment, CVC and Ao measurements were repeated by three observers on five randomly selected calves. CVC and Ao measurements were easily obtained in PV and more difficult to obtain in SV. CVC and Ao area in PV showed high repeatability and reproducibility. A positive correlation was highlighted between age and CVC and Ao measurements in both sites. In conclusion, CVC size assessment by point of care ultrasound can be easily performed at a paralumbar site in calves under 4 months of age and could be used to assess intravascular volume status.
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Lausch C, Lorch A, Giertzuch S, Rieger A, Trefz F. Additive prognostic value of preoperative plasma glucose concentrations in calves undergoing abdominal surgery. JDS COMMUNICATIONS 2021; 2:387-392. [PMID: 36337104 PMCID: PMC9623730 DOI: 10.3168/jdsc.2021-0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/16/2021] [Indexed: 06/16/2023]
Abstract
Surgical abdominal emergencies in calves are associated with a guarded prognosis, especially if neonates are affected. Because hypoglycemia has been associated with sepsis and endotoxemia, this study aimed to assess the prognostic relevance of preoperative plasma glucose concentrations (GLUC) in calves requiring surgery for an acute abdominal disorder. For this purpose, data from retrospective and prospective case series were analyzed, consisting of 586 and 83 hospitalized calves, respectively. The outcomes of calves were evaluated until hospital discharge (both study populations) and for 3 mo following discharge by a phone call to the farmer (prospective study population). For the retrospective study population, the overall survival rate was 31.2%. Calves with a negative outcome (NO) had significantly lower median GLUC (4.3 mmol/L) than calves with a positive outcome (PO; 5.0 mmol/L). The survival rates of calves with GLUC <2.4 mmol/L and 2.4 to 3.1 mmol/L were 3.6 and 8.3%, respectively. The inclusion of GLUC improved a previous prognostic model based on plasma l-lactate concentration and age. The resulting analyses indicated that NO was associated with low age (<7 d), hyper-l-lactatemia (>8.84 mmol/L), and GLUC <4.4 mmol/L (age 7-20 d) and <3.3 mmol/L (age ≥21 d), respectively. The area under the receiver operating characteristic curve of this model was 0.79 (95% confidence interval: 0.76-0.83) and the resulting sensitivity and specificity for NO at the optimal probability cut-point of 0.69 were 66.7 and 85.8%, respectively. For the prospective study population, the established model had sensitivity and specificity for predicting NO after 3 mo (proportion 24%) of 61.9 and 85%, respectively. In both study populations, hypoglycemia was significantly associated with intraoperative evidence of a septic process within the abdominal cavity. The present analyses show that hypoglycemia was highly indicative of a poor prognosis and serious intraoperative findings such as peritonitis. Determination of GLUC should therefore be part of the diagnostic work-up in calves suffering from an acute abdominal emergency.
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Affiliation(s)
- C.K. Lausch
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleissheim, Germany
| | - A. Lorch
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleissheim, Germany
| | - S. Giertzuch
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleissheim, Germany
| | - A. Rieger
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleissheim, Germany
| | - F.M. Trefz
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleissheim, Germany
- Clinic for Ruminants, Vetsuisse-Faculty, University of Bern, Bremgartenstrasse 109a, 3012 Bern, Switzerland
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Gomez DE, Bedford S, Darby S, Palmisano M, MacKay RJ, Renaud DL. Acid-base disorders in sick goats and their association with mortality: A simplified strong ion difference approach. J Vet Intern Med 2020; 34:2776-2786. [PMID: 33140905 PMCID: PMC7694813 DOI: 10.1111/jvim.15956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 12/16/2022] Open
Abstract
Objectives To investigate the acid‐base status of sick goats using the simplified strong ion difference (sSID) approach, to establish the quantitative contribution of sSID variables to changes in blood pH and HCO3− and to determine whether clinical, acid‐base, and biochemical variables on admission are associated with the mortality of sick goats. Animals One hundred forty‐three sick goats. Methods Retrospective study. Calculated sSID variables included SID using 6 electrolytes unmeasured strong ions (USI) and the total nonvolatile buffer ion concentration in plasma (Atot). The relationship between measured blood pH and HCO3−, and the sSID variables was examined using forward stepwise linear regression. Cox proportional hazard models were constructed to assess associations between potential predictor variables and mortality of goats during hospitalization. Results Hypocapnia, hypokalemia, hyperchloremia, hyperlactatemia, and hyperproteinemia were common abnormalities identified in sick goats. Respiratory alkalosis, strong ion acidosis, and Atot acidosis were acid‐base disorders frequently encountered in sick goats. In sick goats, the sSID variables explained 97% and 100% of the changes in blood pH and HCO3−, respectively. The results indicated that changes in the respiratory rate (<16 respirations per minute), USI, and pH at admission were associated with increased hazard of hospital mortality in sick goats. Conclusions and Clinical Importance The sSID approach is a useful methodology to quantify acid‐base disorders in goats and to determine the mechanisms of their development. Clinicians should consider calculation of USI in sick goats as part of the battery of information required to establish prognosis.
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Affiliation(s)
- Diego E Gomez
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.,Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Sofia Bedford
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Shannon Darby
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Megan Palmisano
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Robert J MacKay
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - David L Renaud
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Giertzuch S, Lorch A, Lausch CK, Knubben-Schweizer G, Trefz FM. Prognostic utility of pre- and postoperative plasma l-lactate measurements in hospitalized cows with acute abdominal emergencies. J Dairy Sci 2020; 103:11769-11781. [PMID: 32981725 DOI: 10.3168/jds.2020-19102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/02/2020] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- S Giertzuch
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleißheim, Germany
| | - A Lorch
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleißheim, Germany
| | - C K Lausch
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleißheim, Germany
| | - G Knubben-Schweizer
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleißheim, Germany
| | - F M Trefz
- Clinic for Ruminants with Ambulatory and Herd Health Services at the Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität (LMU) Munich, Sonnenstrasse 16, 85764 Oberschleißheim, Germany; Clinic for Ruminants, Vetsuisse-Faculty, University of Bern, Bremgartenstrasse 109a, 3012 Bern, Switzerland.
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