Lactate in gastric dilatation-volvulus: how to use it
8-year-old German Shepherd with GDV. On admission, lactate is 7.8 mmol/L. After decompression and fluid therapy, at 3 hours lactate is 3.1 mmol/L and the patient is more stable. The owners ask whether the initial value means the stomach is necrotic.
Which statement is correct?
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A. A marked fall in lactate with resuscitation is associated with better survival; a single high initial value is not enough to predict necrosis or to justify euthanasia
Correct. A high initial lactate is associated with greater risk of gastric necrosis and complications, but with overlap between groups. Its trend (clearance) with resuscitation is more informative about perfusion and prognosis.
B. An initial lactate above 6 mmol/L confirms gastric necrosis and euthanasia should be recommended
It does not confirm necrosis: many dogs with high initial lactate do not have it and survive with surgery. Deciding on euthanasia based on a single value is a mistake.
C. Since lactate has fallen, surgery can be postponed and treated with repeated decompression
The fall in lactate indicates better perfusion, not that the volvulus has resolved. GDV requires surgery as soon as the patient is stabilised.
D. Lactate is of no use in GDV because it is always high due to shock
It is not always high, and both its initial value and, especially, its response to resuscitation provide useful information for prognosis and monitoring.
lightbulb Key takeaway
Measure lactate on admission and after resuscitation: rapid clearance is a good sign, and failure to fall calls for reassessment of perfusion. Gastric viability is decided in theatre, not by a number.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.