Lactate analysers

Re: Lactate analysers

Bob Russell — Thu, 09 Feb 2012 12:04:50 GMT

[quote user="robloxley"]

[quote user="Clive Ansell"]Actually, I am only interested for human use for running lactate threshold tests for endurance training[/quote]

Lugging a VetTest round to check your lactate would certainly be endurance training

[/quote]

Also dropping and breaking an istat would bring on an instant coronary!!

Re: Lactate analysers

Graham Bilbrough — Thu, 09 Feb 2012 11:56:45 GMT

Yes, and don't forget the centrifuge.

Re: Lactate analysers

Rob Loxley — Thu, 09 Feb 2012 08:45:36 GMT

[quote user="Clive Ansell"]Actually, I am only interested for human use for running lactate threshold tests for endurance training[/quote]

Lugging a VetTest round to check your lactate would certainly be endurance training

Re: Lactate analysers

Clive Ansell — Thu, 09 Feb 2012 07:39:51 GMT

[quote user="Jane Dunnett"]

Clive - I had a funny feeling as I wrote my tome you were only wanting info for human use. Oh well....

[/quote]

Vets-Now have been using iStats for ages which I think can measure Lactate?

If I were to buy one, would use it both for human and veterinary - - - perhaps .

Re: Lactate analysers

jd2008 — Thu, 09 Feb 2012 06:35:20 GMT

[quote user="Neil Wheadon"]

Dear Jane

Where did you get this information from and what's the best reference? Vets Now have recently rolled these out across the clinics and I'd be interested to learn more

Thanks

Neil

[/quote]

Hi Neil,

I'm really surprised Vets Now haven't been using lactate before now.

The two articles below are the relevant recent retrospective studies.

Evaluation of initial plasma lactate values as a predictor of gastric necrosis and initial and subsequent plasma lactate values as a predictor of survival in dogs with gastric dilatation-volvulus: 84 dogs (2003-2007)

Images

Authors:

Green, TI

Tonozzi, CC

Kirby, R

Rudloff, E

Source:

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE; FEB, 2011, 21 1, p36-p44, 9p.

Publisher Copyright:

WILEY-BLACKWELL PUBLISHING, INC

ISSN:

14793261

Association between outcome and changes in plasma lactate concentration during presurgical treatment in dogs with gastric dilatation-volvulus: 64 cases (2002-2008)

Authors:

Zacher, LA

Berg, J

Shaw, SP

Kudej, RK

Source:

JAVMA-JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION; APR 15, 2010, 236 8, p892-p897, 6p.

Publisher Copyright:

AMER VETERINARY MEDICAL ASSOC

ISSN:

00031488

Clive - I had a funny feeling as I wrote my tome you were only wanting info for human use. Oh well....

Re: Lactate analysers

sam aldridge — Wed, 08 Feb 2012 21:35:09 GMT

Vets now are using the edge lactate. No idea on human use though :D

Re: Lactate analysers

Clive Ansell — Wed, 08 Feb 2012 13:49:41 GMT

I like to stop for coffee and cakes anyway, whether it hurts or not

Re: Lactate analysers

Neil Wheadon — Wed, 08 Feb 2012 13:42:51 GMT

Hi Clive

I'll post the answer on Friday/Saturday when I can tell you exactly

One of the head vets I know quite well does triathlons and uses this on himself so i'll try to find this out too

I'm not quite into this, if cycling hurts too much, I stop for a pot of tea and a big piece of carrot cake

Re: Lactate analysers

Clive Ansell — Wed, 08 Feb 2012 13:23:00 GMT

[quote user="Neil Wheadon"]

Vets Now have recently rolled these out across the clinics and I'd be interested to learn more

[/quote]

Which model are Vets-Now using now?

Actually, I am only interested for human use for running lactate threshold tests for endurance training

Re: Lactate analysers

Neil Wheadon — Wed, 08 Feb 2012 12:28:15 GMT

[quote user="Jane Dunnett"]

The most useful, recent reotrospective study in dogs showed: Within a group of dogs with an initial lactate of >9.0mmol/l dogs with a final lactate of >6.4mmol/l had a significantly lower survival (23%) than those with a final lactate less than or equal to 6.4mmol/l. Survival in dogs with an absolute change in lactate of less than or equal to 4mmol/l was 10% compared tp 86% when lactate fell >4mmol/l. When change in lactate concentration was less than or equal to 42.5% survival was 15% compared to 100% when the change was >42.5%

[/quote]

Dear Jane

Where did you get this information from and what's the best reference? Vets Now have recently rolled these out across the clinics and I'd be interested to learn more

Thanks

Neil

Re: Lactate analysers

Graham Bilbrough — Wed, 08 Feb 2012 08:01:21 GMT

You can also measure lactate concentration on a VetTest or Catalyst Dx. No special equipment needed, just lactate slides. Before the red stars appear: some other chemistry analysers have this analyte too and it is well worth checking before buying new equipment for this specific task.

I would recommend the use of fluoride oxalate tubes and consistent handly technique.

Re: Lactate analysers

jd2008 — Wed, 08 Feb 2012 02:03:52 GMT

[quote user="Clive Ansell"]

Does anyone have experience of using The Edge handheld lactate analyser, or any other similar product, either for veterinary or sports use?

[/quote]

Not come across this one before to be honest. However, from the horse's mouth (Dez Hughes ex RVC now Melb Uni and the person who has arguably done the most work with lactate in the veterinary field) the Lactate Pro and Lactate Scout, in that order, are the best of the handhelds.

Worth noting that all handhelds are quite inaccurate compared to the whizzbang mega expensive Nova Biomedical and Radiometer benchtop analysers. The iStat is a reasonable middle ground but still relatively pricey if you just want lactate measured.

Inaccuracy of even 0.5mmol does matter, especially in cats who do not display a linear relationship between blood lactate and perfusion.

[quote user="Michael Woodhouse"]

Why? Kevin Corley at the RVC loved them, but no one else gave them a second thought. The ones with high lactate and suspected reduced peripheral perfusion were the ones you'd expect to have reduced peripheral perfusion............

[/quote]

Good point but lactate is not meant to be used a a single, stand-alone result. What matters is the trend in lactate measurement. In the human field there are recent studies using lactate to guide therapy in the ICU. Results have been good so far. The results of one study showed mortality was lower in the lactate-guided group. Moreover patients could be weaned off ionotropes and mechanical ventilation and discharged from the ICU sooner.

Failure to reduce lactate should prompt you to do two things.

1) Reassess your treatment. e.g does you patient need pressors? Is your GDV or severe trauma patient also septic? Have you simply not given adequate fluid volume/type? Lacate that remains above normal despite adequate fluid resuscitation can also indicate concurrent disease (lymphoma especially)

2) Have a Serious Talk with the owners.

Cheers,

Jane

Re: Lactate analysers

Michael Woodhouse — Tue, 07 Feb 2012 19:45:32 GMT