Sepsis: New Strategies/biomarkers

Sepsis, defined as the systemic response to infection, occurs commonly in dogs and cats; it can be a challenge to diagnose, expensive to treat, and it is associated with significant morbidity and mortality. Despite advances in critical care, morbidity and mortality from sepsis remains high. 

It has been determined in people that delay in the treatment of sepsis is associated with a worse outcome. Early identification of sepsis can be difficult as clinical signs associated with sepsis often mimic those of other disease processes making sepsis difficult to diagnose in its early stages. Clinical signs of systemic inflammation including tachycardia, tachypnea, fever or hypothermia, leukocytosis or leukopenia, are also common findings in animals with non-infectious causes of systemic inflammation such as immune-mediated diseases or pancreatitis. Documentation of a septic, suppurative exudate (a highly neutrophilic effusion containing intracellular bacteria) in some animals can be straightforward, however in practice this documentation may be difficult to obtain in dogs experiencing severe hypoperfusion. In some dogs the index of suspicion for sepsis results from sampling of a highly neutrophilic effusion with clinical signs supporting infection, but clear indication of a septic process (intracellular bacteria) may not be visible. Techniques such as comparing the glucose or lactate of the effusion to the peripheral glucose or lactate concentrations have been found to be highly sensitive and specific for the diagnosis of a septic effusion. However, how these can be applied to those animals developing sepsis postoperatively has not been determined.  [...]