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Lactate is an essential, versatile metabolic fuel in cellular bioenergetics. In human emergency and critical care, lactate is used as a biomarker and therapeutic endpoint and evidence is growing in veterinary medicine supporting its clinical utility. Lactate production is a protective response providing ongoing cellular energy during tissue hypoperfusion or hypoxia and mitigating acidosis. Hence, hyperlactatemia is closely associated with disease severity but it is an epiphenomenon as the body attempts to protect itself. This article reviews lactate biochemistry, kinetics, pathophysiology, some practical aspects of measuring lactate, as well as its use in diagnosis, prognosis, and monitoring.

Objectives To discuss the advantages and disadvantages of colloidal therapy in veterinary medicine. Databases used MEDLINE (1966-present), Commonwealth Agricultural Bureau Abstracts (1973-present), personal files.

Acquisition of vascular access in the emergent small animal patient is one of the keys to successful management of a population of patients that are often unstable with regard to their major body systems. Venous and intraosseus cannulation allow for the administration of a variety of fluids and potentially life-saving medications. In addition, central venous and arterial access also serve as conduits for atraumatic blood sampling and intravascular pressure monitoring. A thorough knowledge of vascular access theory, the dynamics of fluid flow, vascular anatomy, catheter selection criteria, and placement techniques are critical to the proper and safe use of the vascular access options available today to the small animal clinician.

Peritonitis is a clinical syndrome rather than a definitive diagnosis and, as such, the underlying cause must be identified. Many potential causes exist, and peritonitis may be classified as primary or secondary, local or diffuse, acute or chronic, or according to the causative agent. Peritonitis is one of the most common initiators of the systemic inflammatory response syndrome faced by the small animal practitioner. Because systemic inflammatory response syndrome is such a devastating disease process, aggressive stabilization, rapid definitive diagnosis, and prompt surgical and medical treatment are vital for optimizing outcome.

This article reviews the diagnostic evaluation and critical care management necessary to optimize outcome in cases of potentially reversible, acute liver failure in dogs and cats. A definitive histopathologic diagnosis should always be pursued to allow evaluation of the reversibility of the underlying condition. Treatment of acute liver failure in dogs and cats is largely supportive and requires specific attention to each functional derangement. With the current advances in veterinary critical care, improved medical and technical management of the patient with acute liver should reduce both morbidity and mortality.