Abstract:
Objective: To describe the changes in plasma glucose concentration in severely injured, canine to canine bite wound cases admitted for veterinary treatment. The changes were measured over a period of 72 hours from the initiation of the trauma. Historical, signalment, clinical and haematological factors were investigated to determine their possible relationship to blood glucose concentration. Hypo- and hyperglycaemia have been associated with death from sepsis and acute injury. Method: Twenty dogs admitted to the Intensive Care Unit at Onderstepoort Veterinary Academic Hospital (OVAH) with severe bite wounds were evaluated. The time of injury was established by questioning the dogs’ owners. Blood was taken on admission for haematology and plasma glucose concentration. Haematology was repeated every 24 hours and glucose every 8 hours, measured from the time the dogs were first bitten. Results: On admission, 5% (1/20) of the dogs were hypoglycaemic, 40% (8/20) were normoglycaemic and 55% (11/20) were hyperglycaemic. No other dogs showed hypoglycaemia during the study period. The median glucose at each of the ten collection points, prior to the 56-hour collection point and at the 72 hour collection point, was in the hyperglycaemic range (5.8mmol/l to 6.2mmol/l). Puppies and thin dogs had considerably higher median plasma glucose concentrations than adult and fat dogs at 0 and 16 hours respectively (P < 0.05 for both). A high incidence of SIRS was encountered (65% to 80%). Fifteen dogs were alive at 72-hours. Thirteen dogs (81.3%) eventually made a full recovery. Three out of four dogs (75%) that were recumbent on admission, died, whereas all dogs (12/12) admitted with either an alert or depressed mental status survived (P = 0. 004). Clinical significance: The high incidence of hyperglycaemia may be explained by the ‘diabetes of injury’ phenomenon. The role of insulin therapy in the treatment of severe injuries should be explored in future studies, as its use in the treatment of human ICU cases, has resulted in a substantial reduction of fatalities resulting from acute injury. The high incidence of death and initial hyperglycemia in the collapsed group and the higher plasma glucose concentrations found in puppies and thin dogs warrants further investigation with a larger group of animals.
