Progress 01/20/14 to 09/30/14
Outputs
Target Audience: An abstract of the results of this study was published in the Journal of Veterinary Emergency and Critical Care in association with presentation of the results in an oral abstract presentation at the International Veterinary Emergency and Critical Care Society meeting in Indianapolis, Indianain September of 2014. Changes/Problems: Although we gathered sufficient data to check agreement between the analyzers the tabletop analyzer broke beyond repair to be of further use, so we have continued the study using only the handheld monitor. Most horses enrolled in the study have survived, limiting our ability to evaluate the test as a prognositic indicator. Instead, we have moved to using a simpler test that we are evaluating in a separate study. The study of clearance remains a very valuable study in that it is allowing us to query the underlying causes of persistent hyperlactatemia in horses with acute GI disease. What opportunities for training and professional development has the project provided? This project has provided research training opportunities for 1 resident in Emergency and Critical Care and 1 resident/graduate student in Equine Internal Medicine. Veterinary students have participated in the project if a study was ongoing while they were on the equine medicine service. How have the results been disseminated to communities of interest? Results were disseminated asresearch abstract presentations and will also be disseminsted as a research manuscript in a peer-reviewed journal once all data are fully analyzed. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
Thirty adult horses presenting for acute gastrointestinal disease and requiring fluid resuscitation had been planned for study. To date, eight horses have been enrolled. Horses were fluid resuscitated prior to entering the study. Sodium L-lactate solution (1.0 mmol/kg IV) was administered over 15 minutes and L-lactate concentration [LAC] measured immediately prior to, during, and post infusion. Disposition modeling will beperformed using proprietary software once data from all horses has beencollected.All eight horses survived. Four horses were explored surgically and lesions corrected while four horses were treated medically. Four horses were mildly hyperlactemic ([LAC]>1.2 mmol/L) at the time of study; mean [LAC] immediately prior to infusion was 1.2 mmol/L (range 0.7–1.8). [LAC] at end-infusion was 2.55 mmol/L (range 1.6–3.7) with a mean increase of 1.3 mmol/L (range 0.9–2.1). Time to return to baseline was 251 min (range 45–555) and may be prolonged in medical (345 min) vs. surgical (158 min) disease (P = 0.087). Conclusion: Infusion of exogenous L-lactate 1.0 mmol/kg BW provides sufficient increase in [LAC] for future disposition modeling. We have completed analysis on 20 of the 30 horses to date, medically treated horses (horses with medically amenable problems) show slower clearance than do horses treated surgically. There has been insufficient number of horses that did not survive to evaluate any association with prognosis. The tabletop and handheld measuring devices provide concordant but predictablydifferent results
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2014
Citation:
Vander Werf, K., Wilkins, P.A., Sheahan, B. and Boston, R.C. Exogenous L-lactate clearance in horses with gastrointestinal disease. Journal of Veterinary Emergency and Critical Care 2014;24(S1):S2.
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