Erythrocyte Sedimentation Rate as a Monitoring Marker in the Canine Intensive Care Unit.

Abstract

OBJECTIVE: To (1) establish whether the erythrocyte sedimentation rate (ESR) at admission is related to mortality in dogs hospitalized in the ICU; (2) observe and evaluate the ESR trend during 48-72&#xa0;h of hospitalization and determine how it relates to mortality; and (3) test whether ESR is a marker of sepsis. DESIGN: Prospective study using residual K3-EDTA blood samples of hospitalized dogs. SETTING: ICU of a university teaching hospital. ANIMALS: A total of 124 hospitalized dogs were included in the study. Sixty of the 124 dogs were used to test whether ESR is a marker of sepsis. MEASUREMENTS AND MAIN RESULTS: The ESR was measured on residual EDTA blood samples collected from hospitalized dogs as part of clinical evaluation. A total of 32 dogs died during hospitalization, while 92 were discharged. The ESR at admission (T0) was significantly higher in nonsurvivors (28&#xa0;mm/h) compared with survivors (11&#xa0;mm/h) (p&#xa0;=&#xa0;0.03). Forty-one dogs had ESR monitored at T1 (24&#xa0;h postadmission) and T2 (48-72&#xa0;h postadmission). An increase in the ESR from T0 to T2 was seen in nonsurvivors (p&#xa0;<&#xa0;0.01; medians: T0, 22&#xa0;mm/h, T1, 37&#xa0;mm/h, T2, 42&#xa0;mm/h). Survivors showed a decrease in the ESR from T0 to T2 (p&#xa0;<&#xa0;0.01; medians: T0, 12&#xa0;mm/h, T1, 14&#xa0;mm/h, T2, 5&#xa0;mm/h). Twenty-eight dogs were diagnosed with sepsis and had a higher ESR than nonseptic dogs (35 vs. 10&#xa0;mm/h; p&#xa0;<&#xa0;0.0001). A cutoff of 22&#xa0;mm/h may differentiate septic dogs from nonseptic dogs, with a sensitivity of 76% and a specificity of 81% (area under the curve&#xa0;=&#xa0;0.8; p&#xa0;<&#xa0;0.0001). CONCLUSIONS: The ESR at admission can predict the mortality of hospitalized dogs. Its monitoring during hospitalization may add prognostic information. Given the challenges involved in screening septic patients, point-of-care testing may easily evaluate the ESR when used alongside other indicators.