Peer-reviewed veterinary case report
Septic shock types in cats based on blood pressure and lactate
By Troia, Roberta et al.·Published in Frontiers in veterinary science·2021·Department of Veterinary Medical Sciences, Italy·View original on PubMed →
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Original publication title: Classification of Septic Shock Phenotypes Based on the Presence of Hypotension and Hyperlactatemia in Cats.
- Species:
- cat
Plain-English summary
A group of cats with septic shock, which is a severe infection leading to dangerously low blood pressure and high lactate levels, were studied to understand different types of this condition. The researchers found three types of septic shock in the cats: dysoxic shock, vasoplegic shock, and cryptic shock, with dysoxic shock being the most severe. While the overall death rates were similar across the types, cats with dysoxic and vasoplegic shock had a higher chance of suffering from multiple organ failure compared to those with cryptic shock. This study helps veterinarians identify which cats are at greater risk during treatment for septic shock.
People also search for: cat septic shock symptoms · cat low blood pressure treatment · cat infection multi-organ failure
Abstract
Three different phenotypes of septic shock based on changes in blood pressure and lactate are recognized in people. Dysoxic shock, representing the combination of fluid-refractory hypotension and hyperlactatemia, is characterized by greater disease severity and mortality compared to cryptic shock (hyperlactatemia alone) and vasoplegic shock (hypotension with normal blood lactate). Little is known about septic shock and specifically its phenotypes in cats.To analyze the characteristics and prognostic implications of three septic shock phenotypes in cats with sepsis.Cats with septic shock were prospectively included. Septic shock was defined by the presence of hypotension (mean blood pressure <60 mmHg) requiring vasopressor support and/or persistent hyperlactatemia (>4 mmol/L) and classified in three subgroups:and. Clinical and clinicopathological variables including APPLEand APPLEscores, occurrence of multi-organ dysfunction syndrome (MODS; presence of at least two dysfunctional organs simultaneously) and outcome were compared among subgroups. Cats with sepsis showing normal blood pressure and lactate concentrations hospitalized during the study period were included as, and compared to cats with septic shock for selected variables. Length of hospital stay and mortality were evaluated in the whole study population. Odds ratios for mortality were calculated using logistic regression analysis. Significance was set at< 0.05.The study enrolled 48 cats with uncomplicated sepsis and 37 cats with septic shock (dysoxic shock= 17; vasoplegic shock= 11; cryptic shock= 7). Cats with dysoxic shock had significantly higher APPLEand APPLEscores compared to vasoplegic and cryptic shock. Mortality rates were not significantly different among cryptic (57%), dysoxic (65%) and vasoplegic shock (91%), while MODS occurrence was significantly lower in cats with cryptic shock (57%) compared to patients affected by dysoxic (94%) and vasoplegic (100%) shock. Cats with septic shock had higher frequency of MODS and greater mortality rate than cats with uncomplicated sepsis.Despite similar in-hospital mortality, cats with dysoxic and vasoplegic shock are characterized by having higher occurrence of multi- organ dysfunction compared to cats affected by cryptic shock. Results from this study suggest novel means of identifying high-risk subgroups of septic cats.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/34595228/