How delays affect lactate test results in dogs with shock

Abstract

INTRODUCTION: Lactate concentrations can increase with hypoperfusion in dogs and could be used as a prognostic indicator in sick dogs. In a busy emergency service, sample evaluation could be delayed. However, sample evaluation delays have been shown to cause lactate concentration increases in healthy dogs. In sick dogs, the magnitude of increased lactate is unknown. The goal of this study was to prospectively evaluate the effect of room temperature storage times on lactate measurements in dogs presenting to an emergency service. METHODS: We evaluated the precision and accuracy of the NOVA Lactate Plus, using standard procedures. To assess the impact of time on lactate concentrations in sick dogs, we prospectively enrolled dogs presenting to an emergency service. Lactate concentrations were measured at six time points using samples stored at room temperature. A Friedman test, followed by a Wilcoxon rank test with a Bonferroni correction was used to evaluate time points. RESULTS: Forty-five dogs were enrolled in this prospective observational study. The Lactate Plus and table-top analyzer compared favorably, with an Rof .98, and a mean bias of 0.26 in 50 canine samples. Precision was acceptable, with a percent coefficient of variation of 5.39. Statistically significant increases in lactate concentrations were found at all time points over baseline (P = .008). CONCLUSIONS: In as little as 7.5 minutes, lactate concentrations increased significantly in samples stored at room temperature. Dogs with lower initial lactate concentrations had had higher increases in lactate concentration percentages over 90 minutes.