Prognostic value of preoperative plasma l-lactate concentrations in calves with acute abdominal emergencies

• Published in: Journal of dairy science 2019-11, Vol.102 (11), p.10202-10212
• Main Authors: Lausch, C.K., Lorch, A., Knubben-Schweizer, G., Rieger, A., Trefz, F.M.
• Format: Article
• Language: English
• Subjects: Abomasum - surgery; Animals; calf; Cattle; Cattle Diseases - blood; Cattle Diseases - diagnosis; Cattle Diseases - mortality; Cattle Diseases - surgery; Emergencies - veterinary; Female; gastrointestinal ileus; hyper-l-lactatemia; Lactic Acid - blood; Male; mortality; peritonitis; Peritonitis - diagnosis; Peritonitis - mortality; Peritonitis - surgery; Peritonitis - veterinary; Prognosis; Retrospective Studies; ROC Curve; Sensitivity and Specificity
• ISSN: 0022-0302; 1525-3198
• DOI: 10.3168/jds.2019-16871

Acute abdominal emergencies in calves due to abomasal disorders, gastrointestinal ileus, or peritonitis are characterized by a rapid disease progression and usually require immediate surgical intervention. Those conditions are associated with a guarded prognosis, and the aim of the present study was to assess the prognostic relevance of preoperatively measured plasma l-lactate concentrations (l-LAC) in a large study population of calves with a broad spectrum of acute abdominal emergencies. For the purpose of this study, the medical records of 587 calves admitted to a veterinary teaching hospital over a 10-yr period were analyzed retrospectively. Plasma l-LAC was measured as part of a routinely performed biochemistry panel before initiation of surgical intervention. Hyper-l-lactatemia (plasma l-LAC >2.2 mmol/L) was evident in 75% of calves, and the overall survival rate until hospital discharge was 31%. Calves with a negative outcome were younger (median: 3.4 vs. 6 wk) and had higher plasma l-LAC (median: 4.96 vs. 3.09 mmol/L) than calves with a positive outcome. At the individual diagnosis level, l-LAC was associated with mortality in calves with a diagnosis of mesenteric torsion, right-sided dilated abomasum, small intestinal volvulus, or paralytic ileus, but not in calves suffering from peritonitis, malformations, abomasal volvulus, bloat, or small intestinal intussusceptions. Considering the whole study population, the area under the receiver operating characteristic (ROC) curve for plasma l-LAC was 0.66 [95% confidence interval (CI): 0.61–0.70]. A classification tree analysis indicated that l-LAC >8.84 mmol/L and age categories of