What Is Sepsis in Dogs?

 

Treating sepsis in dogs is important as it is a very serious and life-threatening condition that results from the body's response to an infection and causes damage to organs and tissues.

The first stage of sepsis is characterized by suppression of the immune system. The most common symptoms following sepsis include increased body temperature, increased heart rate, increased respiratory rate, and unusual behavior of the animal.

Some dogs may not show any visible symptoms until it is too late. If left untreated, sepsis can lead to septic shock and death.

Sepsis Types and Symptoms in Dogs

Sepsis is a serious condition and is always triggered by an external cause. An infection always triggers the body's inflammatory immune response.

These infections can be:

1. Bacterial (most common)
2. viral
3. Mushrooms
4. protozoan

Most common localized origin of sepsis in dogs:

• skin
• Urethra
• lungs
• Brain
• abdominal organs
• Uterus

Sepsis symptoms will vary depending on the type and severity of the infection and the progression of the condition. The underlying cause of the disease leading to sepsis will play a large role in the progression of symptoms.

Sepsis symptoms are divided into two stages, early stage and late stage.

Early-stage symptoms of sepsis in dogs include:

• Fire
• Too high or missing white blood cells
• Shaking
• Lethargy
• Confusion, confusion
• increased heart rate
• A rapid increase in body temperature
• breathless
• Decreased urine output and anuria
• low glucose levels
• Red mucous membranes

Late symptoms of sepsis in dogs include:

• inconsistent heart rate
• Pale mucous membranes
• cold paws and legs
• low body temperature
• glassy eyes
• trouble breathing
• fluid build-up
• acid
• organ failure

Pathophysiology of Canine Sepsis

What happens when a dog's body goes into sepsis and septic shock? Sepsis never happens on its own. It is always the result of another condition that goes untreated and becomes complicated. Examples of such a condition are an untreated superficial lung infection, urinary tract infection, skin lesion, or burn.

Not all dogs live at home and are with us on the couch every day where we can watch small changes in their behavior and health. Some dogs are hunting dogs, guard dogs, shepherd dogs, etc. For example, if there is a urinary tract infection, it may go unnoticed for a while.

Or imagine a Malamute with his own dog house in his backyard. Beneath all that fur (and we all know how dense an Alaskan malamute's fur can be) there can be a small scratch that, if left unnoticed, can lead to a large wound to the skin. The skin will begin to flake off.

Such situations and conditions can lead to sepsis. A small scratch can invalidate the blood circulation with bacteria and lead to sepsis. And the leading cause of sepsis is cytokines.

Cytokines are substances from the immune system that are produced to fight infection. Cytokines cause blood vessels to dilate, which then leads to a drop in blood pressure.

This will reduce blood flow throughout the entire body, including blood flow to all major organs such as the liver, kidneys, and brain. The dog's body will try to compensate by increasing the heart rate in hopes that more blood will be pumped.

After a while, this will lead to weakening of the heart and further reduction of blood flow.

The most common causes of sepsis and septic shock in dogs are:

• Improper surgery (non-sterile instruments or infected surgical site)
• pre-existing infections
• skin infections
• urinary tract infections
• pyometra and other uterine infections
• Pneumonia
• immune disorders

Clinical Effects of Sepsis in Dogs

The clinical effects of sepsis in dogs can vary from dog to dog. The researchers divided the dogs' response into two categories:

• Hyper-dynamic response during sepsis
• Hypodynamic response during sepsis

The first category, the hyper-dynamic response, is characterized by fever, dark red mucous membranes, limiting pulse, and tachycardia.

The second category, the hypo-dynamic response, is characterized by pale white mucous membranes, hypotension, and hypothermia.

Often times, dogs with sepsis will have gastrointestinal symptoms such as vomiting or diarrhea and pulmonary symptoms such as coughing and difficulty breathing. The biochemistry profile will show hypo- or hyperglycemia, azotemia, hyperbilirubinemia, and elevated ALT, AST, and/or ALP.

Some coagulation abnormalities may be seen, such as decreased anticoagulant proteins (antithrombin and protein C) and a significant reduction in PT, PTT, and D-dimers.

Microcirculation changes that occur during sepsis in dogs can lead to metabolic acidosis and organ failure, the most common renal and respiratory failure.

New Therapies Available

The first step in treating sepsis in dogs is to find and eliminate the cause of the infection. This should be done by cytological examination and culture.. It is very important to start antimicrobial therapy while waiting for the results.

For this purpose, broad-spectrum antibiotics, which are usually a combination of a penicillin derivative and a fluoroquinolone, are used. The remainder of therapy will include maintenance of tissue perfusion and very aggressive supportive care.

Each treatment should be tailored to the needs of each individual dog. Intravenous fluid therapy is essential for any dog ​​suspected of sepsis, and cardiovascular support is essential for good tissue perfusion.

Additional nutritional management will be required in dogs showing gastrointestinal symptoms as a result of sepsis. Some dogs may need a feeding tube and some dogs may only need GI-sparing medications such as famotidine and omeprazole.

Newer treatments available for the treatment of sepsis in dogs include some old-school medications such as:

Corticosteroids

Generally, the use of corticosteroids during sepsis is contraindicated, but there is an exception in a particular case. A small or physiological dose of corticosteroid can be used to manage relative adrenal insufficiency during sepsis in dogs.

Insulin

Although not yet evaluated in dogs, clinical studies with sepsis in humans show that administration of insulin to maintain glycemic control reduces mortality by 40%.

Activated protein C

It is an anticoagulant protein with anti-inflammatory, profibrinolytic and anti-apoptotic effects. This is currently only available for humans, but if developed for dogs it would significantly improve veterinary medicine survival rates.

Polymyxin B

It is a cationic polypeptide antibiotic that binds endotoxin released from Gram-bacteria during sepsis. Thus, the endotoxin will not be able to activate the inflammatory cells, thereby preventing a cytokine reaction and systemic inflammation.

Polymyxin B is routinely used in the treatment of Gram-sepsis in horses and there are currently studies for its use in dogs.

Related Medical and Surgical Procedures

When a dog with sepsis comes to the clinic, it is imperative to restore the body's hemodynamics. By aseptically placing an IV catheter, we will be able to provide adequate fluid therapy and perfusion to vital organs. In these cases, the preferred solution is Ringer's lactate or Normosol-R.

Hypertonic saline solution should not be used in resuscitation because often the dog is severely dehydrated. For the next four hours, rehydration should be done at a rate of 3-10 ml/kg per hour and maintained at a rate of 2-3 ml/kg per hour.

If the dog is septic and we are awaiting culture, we should consider giving intravenous antibiotics once the perfusion has improved. These antibiotics should be cephalosporins, metronidazole or aminoglycosides.

If the dog is vomiting, insertion of a nasogastric tube may be necessary. Vomiting can be controlled with chlorpromazine or metoclopramide. It is very important to listen to a bowel movement in case of intussusception.

The dog should always be closely monitored. CRT, blood pressure, CVP, mucous membrane color, pulse rate should be monitored every two to four hours. Vomiting, diarrhea and urine output should be checked every two hours.

Body temperature should be checked rectal every four to six hours. Glucose, BUN, sodium, total plasma solids, potassium levels, and packed cell volume should be monitored every four to six hours.

Experiencing and Managing Canine Sepsis

Even if signs of sepsis and septic shock are recognized in time, the prognosis is poor in dogs. Organ failure may have started when the dog went to the vet.

Long-term effects can result in death, even with aggressive antibiotic and hydration therapy. Recovery from sepsis will largely depend on the severity of the sepsis, the general condition of the dog before sepsis, the organs affected by the sepsis, and the likelihood of complications after treatment.

If the dog recovers from sepsis, over the next few months there will be problems with clotting, fluctuations in sugar levels, kidney problems, urine output, liver enzymes, blood cell counts, etc. Close monitoring is very important.

Summary

Sepsis in dogs is a life-threatening condition most likely caused by a bacterial infection, but can also be caused by viruses, fungi, and protozoans. It is very important that the dog receives a prompt diagnosis and prompt treatment.

Sepsis in dogs presents with many clinical symptoms, including inadequate hydration and organ perfusion, leading to organ failure and death. Intensive care and hydration are the first steps in the treatment of sepsis.

A systemic infection, burns, serious injuries, foreign bodies, etc. It is vital to identify the cause of this inflammatory reaction that can occur. If left untreated, sepsis in dogs has a poor or serious prognosis.