Erythrocyte Sedimentation Rate as a Monitoring Marker in the Canine Intensive Care Unit

OBJECTIVE: To (1) establish whether the erythrocyte sedimentation rate (ESR) at admission is related to mortality in dogs hospitalized in the ICU; (2) observe and evaluate the ESR trend during 48-72 h of hospitalization and determine how it relates to mortality; and (3) test whether ESR is a marker of sepsis. DESIGN: Prospective study using residual K3-EDTA blood samples of hospitalized dogs. SETTING: ICU of a university teaching hospital. ANIMALS: A total of 124 hospitalized dogs were included in the study. Sixty of the 124 dogs were used to test whether ESR is a marker of sepsis. MEASUREMENTS AND MAIN RESULTS: The ESR was measured on residual EDTA blood samples collected from hospitalized dogs as part of clinical evaluation. A total of 32 dogs died during hospitalization, while 92 were discharged. The ESR at admission (T0) was significantly higher in nonsurvivors (28 mm/h) compared with survivors (11 mm/h) (p = 0.03). Forty-one dogs had ESR monitored at T1 (24 h postadmission) and T2 (48-72 h postadmission). An increase in the ESR from T0 to T2 was seen in nonsurvivors (p < 0.01; medians: T0, 22 mm/h, T1, 37 mm/h, T2, 42 mm/h). Survivors showed a decrease in the ESR from T0 to T2 (p < 0.01; medians: T0, 12 mm/h, T1, 14 mm/h, T2, 5 mm/h). Twenty-eight dogs were diagnosed with sepsis and had a higher ESR than nonseptic dogs (35 vs. 10 mm/h; p < 0.0001). A cutoff of 22 mm/h may differentiate septic dogs from nonseptic dogs, with a sensitivity of 76% and a specificity of 81% (area under the curve = 0.8; p < 0.0001). CONCLUSIONS: The ESR at admission can predict the mortality of hospitalized dogs. Its monitoring during hospitalization may add prognostic information. Given the challenges involved in screening septic patients, point-of-care testing may easily evaluate the ESR when used alongside other indicators.