We do not have a background in veterinary medicine but have asked some teachers at veterinary hospitals why and when lactate should be measured in veterinary medicine. They replied that lactate testing is often used for detection, prognosis and monitoring which is the basis of the visual above. The following articles in the literature were recommended to us.

A very good summary references for the use of lactate testing for veterinarians is an article by Dez Hughes in Kirk's Current Veterinary Therapy XIII Small Animal Practice (1999 pages 112-116) which is edited by John Bonagura and published by W. B. Saunders. In this article is a chart which lists the major causes of hyperlactatemia that are relevant to veterinary medicine. A short summary of these causes is:

  • Issues of absolute or relative tissue hypoxia such as shock, local hypoperfusion, severe hypoxemia, severe anemia, carbon monoxide toxicity and excessive muscular activity.
  • Issues where there is no clinical evidence of tissue hypoxia. For example,

    • in association with underlying diseases such as diabetes mellitus, severe liver disease, malignancy, sepsis, and others.
    • due to drugs or toxins such as acetaminophen, cyanide, epinephrine and others.
    • due to inborn metabolic defects such as mitochondrial myopathy.

See the article for a more complete discussion.

Another very detailed article appeared in the April 2006 issue of Compendium. The article titled, "Lactate Measurement as an Indicator of Perfusion" is by Michael H. Karagiannis, Marie E. Kerl, F. A. Mann and Alisa N. Reniker. It is available online if you have a subscription at

http://www.vetlearn.com/ArticleDetails/tabid/106/ArticleID/301/Default.aspx

An abstract of the article is

With the advent of accurate, affordable, point-of-care lactate monitors, use of plasma or blood lactate measurements can provide valuable diagnostic information in treating critically ill patients. Tissue hypoxia causes anaerobic metabolism, which increases lactate production. Decreased perfusion is the most common cause of hyperlactatemia in critically ill patients; however, there are other causes of hyperlactatemia besides tissue hypoxia (i.e., mitochondrial dysfunction, hypermetabolic states), and collection techniques and sample handling can also affect results. Serial blood lactate measurements can guide treatment by allowing clinicians to assess improvements in tissue oxygenation and provide prognostic information to clients.

 

Some other references in the literature on how lactate testing is used for veterinary uses are:

  • Plasma Lactate Concentration as a Predictor of Gastric Necrosis and Survival Among Dogs with Gastric Dilatation-Volvulus: 102 Cases (1995-1998) - J Am Vet Med Assoc 215[1]:49-52 Jul 1'99 Retrospective Study 28 Refs) Author(s): Erika de Papp, DVM; Kenneth J. Drobatz, DVM, DACVIM, DACVECC; Dez Hughes, BVSC, DACVECC; Sections of Medicine and Critical Care, Dept. of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104
  • Lactate Kinetics in Veterinary Critical Care: A Review - J Vet Emerg Crit Care 6[2]:81-95 Jul-Dec'96 Review Article 129 Refs) Author(s): Michael S. Lagutchik, DVM; Gregory K. Ogilvie, DVM; Wayne E. Wingfield, MS, DVM*; Timothy B. Hackett, DVM, MS; College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523
  • Increased Lactate Concentrations in Ill and Injured Dogs - J Vet Emerg Crit Care 8[2]:117-127 May/Aug'98 Clinical Study 99 Refs Auhor(s) Michael S. Lagutchik, DVM; Gregory K. Ogilvie, DVM; Timothy B. Hackett, DVM, MS; Wayne E. Wingfield, MS, DVM Veterinary Teaching Hospital 300 W. Drake, Fort Collins, CO 80523
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