Retrospective Evaluation of Outcomes in Canine Anaphylaxis Patients Receiving Late Epinephrine or No Epinephrine: 49 Cases (2019-2023).

High survival in canine anaphylaxis despite delayed epinephrine; shock index predicts mortality.

This retrospective study evaluated 49 dogs with severe anaphylaxis that did not receive early epinephrine treatment between 2019-2023 at a university teaching hospital. The study examined presenting vital parameters, point-of-care results, resuscitation fluid volumes within 6 hours of presentation, and clinical outcomes. Overall survival rate was 91.8%, which is notably high despite delayed or absent epinephrine administration. Shock index (SI) on presentation was significantly higher in non-survivors compared to survivors (p = 0.022), suggesting it may be a useful prognostic indicator. Pressor support was needed in 18.4% of cases, and patients requiring vasopressors had significantly lower presenting body temperatures. Median total resuscitation volume was 53.0 mL/kg with median hospital stay of 31 hours for survivors. Blood lactate concentration showed weak positive correlation with both total resuscitation volume and length of hospitalization. The findings suggest aggressive fluid resuscitation may compensate for delayed epinephrine administration in canine anaphylaxis, though shock index remains a valuable mortality predictor.

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