Prevalence and risk factors for development of hemorrhagic gastro-intestinal disease in veterinary intensive care units in the United Kingdom.
Swann JW., Maunder CL., Roberts E., McLauchlan G., Adamantos S.
OBJECTIVE: To determine the prevalence of hemorrhagic gastro-intestinal (GI) disease developing in dogs and cats admitted for management of non-GI disease in veterinary intensive care units (ICUs). DESIGN: Retrospective study of animals presented between October 2012 and July 2013. SETTING: Three ICUs located in veterinary teaching hospitals in the United Kingdom. ANIMALS: Dogs (n = 272) and cats (n = 94) were consecutively enrolled from 3 ICUs if they were hospitalized in the unit for at least 24 hours. Cases were excluded if they had hemorrhagic GI disease in the 48-hour period before presentation or in the 24-hour period after admission. Cases were also excluded if they suffered skull fracture, epistaxis, or hemoptysis, if they underwent surgical procedures of the GI or upper respiratory tracts, or if they were presented for management of GI disease. MEASUREMENTS AND MAIN RESULTS: Hemorrhagic GI disease was observed in dogs at all 3 units, but at different rates (Center 1: 10.3%, Center 2: 4.8%, Center 3: 2.2%). Hemorrhagic GI disease was not observed in cats at any of the participating centers. Construction of a multivariable logistic regression model revealed that serum albumin concentration, administration of prophylactic gastro-protectant drugs, and institution were significantly associated with the development of hemorrhagic GI disease in dogs. Development of hemorrhagic GI disease and placement of a feeding tube were significantly associated with mortality during the period of hospitalization in dogs. Thirty-seven (13.6%) dogs and 12 (12.8%) cats died or were euthanized while hospitalized, with a higher mortality rate (42.1%) in dogs with hemorrhagic GI disease. CONCLUSIONS: Hemorrhagic GI disease does develop in dogs hospitalized for management of non-GI disease, but this phenomenon was not observed in cats. Development of hemorrhagic GI disease appeared to have a significant impact on survival in veterinary ICUs.