Clinical use of plasma lactate concentration. Part 2: Prognostic and diagnostic utility and the clinical management of hyperlactatemia.

This research paper reviews existing literature on the usage of lactate, especially plasma lactate concentration, as a prognostic tool, therapeutic guide, and diagnostic measure for hyperlactatemia in animals including dogs, cats, and horses. It reveals that higher plasma lactate levels are related to increased disease severity and mortality, and that stable lactate levels are better survival predictors than high levels are predictors of death.

Plasma Lactate as a Prognostic Indicator

• The paper posits that lactic acid is a valuable tool in assessing the health of animals and can be utilized to sort animals into categories based on risk levels. It points out that increased plasma lactate concentrations coincide with increased morbidity and mortality in animals.
• The research suggests that, in animal populations with a high rate of mortality, hyperlactatemia (an abnormally high level of lactate in the blood) is moderately indicative of identifying non-survivors. More importantly, eulactatemia (normal levels of lactate) is considered a better predictor of survival than hyperlactatemia is of death.

Measuring Lactate Concentrations

• The study finds that consecutive lactate measurements and calculated relative measures provide more insightful information compared to single measurements.
• It also indicates that increased lactate concentrations in body fluids other than blood should alert healthcare providers to the possibility of septic or malignant processes.

Lactate as a Therapeutic Guide

• The use of lactate as a therapeutic guide in humans has demonstrated promising potential. However, this is yet to be thoroughly researched within veterinary science.

Clinical Management of Hyperlactatemia

• The paper suggests that the management of hyperlactatemia should primarily focus on the root cause of the condition. In other words, rather than just trying to reduce the level of lactic acid in the blood, the underlying issues causing the high lactate levels should be addressed.

Conclusion

• Overall, the study concluded that lactate concentration holds significant promise as a measure for triaging and risk stratification in veterinary practice. It emphasized that additional research is required to substantiate the use of lactate concentration as a therapeutic target and for measuring lactate in body fluids.