Professor Universidade Federal do Rio Grande do Sul Porto Alegre, Rio Grande do Sul, Brazil
Abstract: Background – Hyperlactatemia in humans with Cushing´s syndrome and dogs under glucocorticoid therapy are well described. The relevance of plasma lactate in dogs with naturally occurring hypercortisolism (NOHC) is unknown.
Hypothesis/Objectives – Assess plasma lactate as a prognostic tool in canine NOHC.
Animals – Twenty-two dogs newly diagnosed with NOHC from a veterinary teaching hospital. Dogs were classified accordingly with plasma lactate at diagnosis: CG (control group, lactatemia ≤ 2.5 mmol/L, n=7) and HLG (hyperlactatemia group, lactatemia > 2.51 mmol/L, n=15).
Methods – Cohort study. Age, weight, BCS, serum LDH activity, perfusion index, SBP, and echocardiographic measurements (LA/Ao, LVIDd, LVDWd, IVSd) were compared between groups and correlations with lactatemia studied by Pearson´s correlation. Survival, ALIVE Cushing´s Clinical Score (ACCS), trilostane doses prescribed, and complications/comorbidities occurrence were set as outcomes and compared between groups. Lactatemia after reaching satisfactory NOHC control was compared with initial results.
Results – Differences were found in plasma lactate (HLG = 4.37±1.77, CG = 1.81±0.49, p< 0.0001), ACCS at diagnosis (HLG = 10/15, range 9-13, CG = 9/15, range 3-9, p=0.0013), and complications/comorbidities (p=0.0085) between groups. There were five deaths in the HLG and none in the CG (p=0.0956, Figure 1). There were no differences between the other parameters compared between groups, as well as lactatemia showed no significant correlation with the studied variables. Lactatemia significantly reduced after disease satisfactory control (p=0.037, Figure 2).
Conclusions and clinical importance – Hyperlactatemia suggests a poorer short-term prognosis in canine NOHC and was associated with a worsened clinical initial presentation.
