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

## TL;DR

The study shows that the erythrocyte sedimentation rate (ESR) can predict dog mortality in the ICU and track sepsis, making it a useful monitoring tool.

## Contribution

This study is the first to demonstrate ESR as a prognostic and sepsis marker in critically ill dogs.

## Key findings

- ESR at admission was significantly higher in nonsurvivors compared to survivors.
- ESR increased over time in nonsurvivors but decreased in survivors during hospitalization.
- A cutoff of 22 mm/h ESR effectively differentiates septic from nonseptic dogs with high sensitivity and specificity.

## Abstract

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.

Prospective study using residual K3‐EDTA blood samples of hospitalized dogs.

ICU of a university teaching hospital.

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.

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).

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.