Sepsis is a leading cause of death in veterinary patients.1,2 It is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.3,4 Untreated patients progress to septic shock, a subset of sepsis in which underlying circulatory, cellular, and metabolic functions are severely compromised, leading to high mortality rates.1,2,5 Persistent hypotension and hyperlactatemia are the hallmarks of septic shock.6,7
In dogs and cats, sepsis is diagnosed by using the SIRS (systemic inflammatory response syndrome) criteria in a patient that has a diagnosed or suspected underlying infection.4,8-10 However, the specificity of this diagnostic approach is low, favoring delayed diagnosis and treatment and therefore resulting in poorer outcomes.8-11 Other scoring systems have been proved to be more accurate in diagnosing sepsis in humans, but similar findings are lacking in dogs and cats.12,13 The elevated costs of treatment, the necessity for well-trained healthcare personnel, and the emergence of multidrug-resistant bacteria also contribute to the observed high mortality rates of sepsis in small animals.
Despite extensive research efforts, sepsis treatment remains primarily supportive.3,14 It is well established, particularly in humans, that early and optimal treatment including antimicrobial and fluid therapy, coupled with close patient monitoring, significantly improves survival.15-19 While fluid therapy and antimicrobials serve as cornerstones in sepsis treatment, myriad other drugs and approaches are often required.3
This algorithm for the treatment of sepsis in dogs and cats is aimed at management. It is important to note that the management of sepsis may vary based on individual patient factors and the specific clinical scenario. A companion checklist to be used alongside this algorithm has also been provided.
