Outcomes for dogs with anaphylaxis treated late or without epinephrine

Abstract

OBJECTIVE: To describe the outcomes of dogs with anaphylaxis (APX) that did not receive epinephrine (EPI) as part of early treatment and to identify associations between these outcomes and selected presenting vital signs and parameters. DESIGN: Retrospective medical record review from January 2019 to December 2023. SETTING: University teaching hospital. ANIMALS: Forty-nine dogs with severe APX. MEASUREMENTS AND MAIN RESULTS: Presenting vital parameters, point-of-care results, resuscitation fluid volumes within 6 h of presentation, and outcomes were recorded. Selected presenting parameters were assessed for correlations to mortality, need for pressor support, total resuscitation volume (TRV), and time in hospital. Associations between outcomes were tested. Overall survival was 91.8%. Shock index (SI) on presentation was higher in patients that died than in those that survived (p = 0.022). Pressor support was required in 18.4% of cases. Presenting body temperature was lower in patients that required pressor support than those that did not (p = 0.021). The median TRV was 53.0 mL/kg, and time in hospital for survivors was 31 h. Presenting blood lactate concentration was weakly correlated with TRV and time in hospital. Between the outcomes, time in hospital and TRV were weakly correlated. CONCLUSIONS: Overall survival rate was 91.8% in canine patients with APX that did not receive EPI as part of early treatment. Higher SI was associated with mortality. Higher blood lactate concentrations correlated with longer hospital stays and higher resuscitation volumes.