Clinical features and outcome of septic shock in dogs: 37 Cases (2008-2015).

Abstract

OBJECTIVES: To describe patient characteristics of dogs with septic shock, investigate markers of disease severity, and assess treatment impact on outcome. DESIGN: Retrospective study. SETTING: Single center, university veterinary teaching intensive care unit. ANIMALS: Thirty-seven dogs with septic shock. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Mean number of organ dysfunction was 3.24&#xa0;&#xb1;&#xa0;1.0, and included cardiovascular (100%), respiratory (73%), hematologic (68%), renal (49%), and hepatic (32%) dysfunction. The gastrointestinal tract was the most common source of sepsis. Mean blood pressure prior to resuscitation was 50&#xa0;&#xb1;&#xa0;8&#xa0;mm Hg. All dogs were given IV fluids before vasopressor therapy with a mean rate of 12.1&#xa0;&#xb1;&#xa0;11.0&#xa0;mL/kg/h. All dogs were given antimicrobials, administered within a mean of 4.3&#xa0;&#xb1;&#xa0;5.7&#xa0;hours after diagnosis. Dopamine or norepinephrine was administered IV, respectively in 51.3% and 37.8% of dogs, with a mean duration of hypotension of 2.6&#xa0;&#xb1;&#xa0;3.0&#xa0;hours. Mortality rate was 81.1%. Survivors were more likely to have a feeding tube (P&#xa0;=&#xa0;0.007) and to have gastrointestinal sepsis (P&#xa0;=&#xa0;0.012), and less likely to have respiratory dysfunction (P&#xa0;<&#xa0;0.001). APPLEscores (P&#xa0;=&#xa0;0.014) and time to antimicrobial therapy (P&#xa0;=&#xa0;0.047) were identified as predictors of mortality. Treatment bundles consisting of 7 interventions that may improve outcomes in people with septic shock were evaluated. Survivors received 4.1&#xa0;&#xb1;&#xa0;1.3 interventions, whereas nonsurvivors received 2.4&#xa0;&#xb1;&#xa0;1.4 (P&#xa0;=&#xa0;0.003). CONCLUSIONS: Septic shock in dogs confers a guarded prognosis. Early antimicrobial therapy and the utilization of treatment bundles may increase survivability in dogs with septic shock. More research is warranted to investigate the impact of specific interventions on survival.