Veterinary Guide to Canine Lactic Acidosis 2025 🐶💉🩺

By Dr. Duncan Houston BVSc

🧬 What Is Lactic Acidosis?

Lactic acidosis is a serious medical condition resulting from elevated blood lactate (>4–5 mmol/L) combined with metabolic acidemia (pH < 7.35). This occurs when tissue lactic acid production exceeds clearance via the liver and kidneys.

⚠️ Types & Causes

• Type A (Hypoxic): Caused by poor tissue perfusion/oxygenation—shock, anemia, respiratory failure, cardiac arrest.
• Type B (Non‑hypoxic):
  • B1: Disease‑related (sepsis, liver/kidney failure, malignancy).
  • B2: Drug‑/toxin‑induced (e.g., metformin, salicylates, phenformin).
  • B3: Inborn metabolic errors (rare).

👥 Who’s at Risk?

• Puppies/young dogs are prone to trauma or exercise-related hypoxia.
• Sick or hospitalized dogs (sepsis, major surgery).
• Patients on certain drugs (e.g., metformin, NSAIDs, phenformin).
• Dogs with liver or kidney dysfunction affecting lactate clearance.

⚕️ Clinical Signs

• Weakness, collapse, exercise intolerance, reluctance to move.
• Tachypnea or dyspnea as compensation for acidemia.
• Nausea, vomiting, abdominal discomfort.
• Bradycardia or hypotension in severe cases.
• Neurologic signs—confusion, seizures if severe.

🔍 Diagnostic Approach

1. History & Exam: Recent exercise, trauma, toxin/drug exposure, sepsis.
2. Blood Gas & Lactate: Confirm pH < 7.35, HCO₃⁻ < 20 mmol/L, lactate > 4–5 mmol/L.
3. Chemistry Panels: Assess organ function.
4. Urinalysis: May show indicators of sepsis, renal failure.
5. Imaging & Labs: Diagnose underlying cause—ultrasound, blood cultures.
6. Biomarkers: In research via TIMP‑2, KIM‑1 (emerging tools).

🛠 Treatment Strategies

• Immediate Support

• IV Fluids (e.g., LRS) to restore perfusion and wash out excess lactate.
• Supplemental Oxygen or transfusion if hypoxic or anemic.
• Sodium bicarbonate if base deficit >10 mEq/L or pH < 7.2, under careful monitoring.

• Address the Underlying Cause

• Treat shock, sepsis, and organ dysfunction (antibiotics, vasopressors).
• Stop offending drugs/toxins (e.g., metformin, phenformin).
• Support organ systems: dialysis for AKI, etc.

• Adjunctive Treatments

• Dichloroacetate (DCA): In experimental canine models, improved survival, lactate clearance, and cardiac output compared to bicarbonate alone.
• Experimental acid-base treatments (rarely used clinically).

📈 Prognosis

• Mortality remains >60% without prompt correction.
• Prognosis depends on severity, lactate clearance rate, and underlying condition.
• Persistent high lactate levels or poor clearance predict poor outcomes.

🏡 Home & Supportive Care

• Monitor for appetite, energy levels, and breathing rate.
• Ensure oxygen access and hydration post-hospital discharge.
• Adhere to medications and follow-up testing schedules.

📱 Ask A Vet Telehealth Support

• 📸 Share blood gas or lactate results instantly via the app.
• 🔔 Get IV fluid and oxygen therapy reminders.
• 🩺 Video assessments for breathing, CRT, and hydration.

🎓 Case Spotlight: “Bailey” the Boxer

Bailey, a 3‑year‑old Boxer, presented post‑CPR with pH 7.1 and lactate 13 mmol/L. ICU management included high-flow O₂, IV fluids, targeted bicarbonate, and a single dose of experimental DCA. Lactate dropped below 4 mmol/L within 6 h; Bailey recovered and was discharged 4 days later. Ask A Vet supported follow-up assessments and home oxygen delivery. 🐾

🔚 Key Takeaways

1. Lactic acidosis is defined by high lactate and metabolic acidemia, indicating serious systemic issues.
2. Type A is due to hypoxia/perfusion; Type B is from disease and toxins.
3. Rapid diagnosis via blood gas and lactate measurement is critical.
4. Treatment: IV fluids, oxygen, stop toxins, possible bicarbonate, and DCA.
5. Prognosis hinges on prompt treatment and underlying recovery; persistence means higher risk.
6. Ask A Vet telehealth enhances care through remote monitoring, results-sharing, therapy reminders, and care coordination 📲🐾

Dr Duncan Houston BVSc, founder of Ask A Vet. Download the Ask A Vet app to protect your dog from lactic acidosis—from early detection and emergency support to advanced diagnostics, IV/DCA therapy coordination, and telehealth vital sign monitoring 🐶📲