Graduate Thesis Or Dissertation
 

Clinical Applications of Lactate Measurements in Equine Veterinary Medicine

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https://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/9z903427x

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  • Lactate is an end-product of both aerobic and anaerobic glycolysis and it can be used as an energy source for tissues. It is produced by all cells in the mammalian body that can metabolize glucose. Increased production of lactate can be seen with there is an increase in cellular metabolism or a decrease in available oxygen to tissues. Therefore, it is a valuable marker in both human and veterinary medicine for many patients with critical illness and/or sepsis for monitoring response to treatment, severity of disease, and likelihood of survival or development of complications. In equine medicine, lactate production has been shown to vary between different regions of the body, however there is little information regarding production in the limbs of the horse and in its development secondary to tissue perfusion altering medications. In the first study detailed here, we evaluated the differences between jugular and cephalic vein venous blood gas variables in both healthy and clinically ill horses, with a focus on lactate. We took simultaneous samples from both the jugular and cephalic veins in 10 healthy horses and compared these two sites to each other. We found that the cephalic vein lactate was significantly higher than the jugular vein lactate in these horses (p<0.05). Additionally, we took simultaneous jugular and cephalic vein samples from horses that presented to the Oregon State University, College of Veterinary Medicine for potential colitis. With these horses, additional samples were obtained during the first 24-hours of hospitalization to monitor how these variables change with treatment. For all sick horses, the cephalic vein lactate was significantly higher than the jugular vein lactate at presentation and during all time points sampled after (p<0.05). When the sick horses were investigated for specific outcomes (survivors vs. non-survivors and laminitis vs. non-laminitis) the cephalic vein was significantly higher in survivors and horses that did not develop laminitis (p<0.05) however no significant difference was found in non-survivors or horses that developed laminitis. Additionally, no significant difference was seen in the rate of change in lactate over time when survivors were compared to non-survivors and when horses who developed laminitis were compared to those that did not. In the second study, the main objective was to establish how perfusion parameters change in horses that undergo prolonged sedation with the α-2 agonist, detomidine. The primary variable examined was lactate, however attention was also given to venous oxygen and carbon dioxide content as well as to blood glucose. Statistically significant differences (p<0.05) were seen in all variables examined, however the only variable that changed in a manner that would be considered clinically significant was glucose, with a mean increase in circulating blood glucose of 156 mg/dL. This represents an almost 3-fold increase in circulating blood glucose measurements, which remained elevated throughout the course of the four-hour infusion. While lactate did not elevate above the normal threshold value (>2.0 mmol/L), these horses also did not achieve a clinically relevant plane of sedation for standing surgical procedures. Therefore, further study is warranted to assess how lactate may change in a more clinically relevant setting.
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  • Existing Confidentiality Agreement
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  • 2017-10-21 to 2018-06-21

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