Time course of clinical signs and mortality in dogs with severe perioperative acute kidney injury: A scoping review.

Abstract

Perioperative acute kidney injury (AKI) is a potential cause of anaesthetic mortality in dogs. The time delay between anaesthetic recovery, onset of clinical signs and any subsequent mortality may result in under-recognition of this complication. This review aimed to explore the literature reporting dogs with severe AKI after general anaesthesia and surgery. Firstly, to determine the time course between anaesthesia recovery and onset of clinical signs, and between recovery and any mortality. Secondly, to identify the common clinical signs and signalment of dogs with perioperative AKI. PubMed and CAB abstracts data bases using the terms "(acute kidney injury OR acute renal failure) AND dog AND (anaesthesia OR surgery)"; and ResearchRabbit were searched. Peer reviewed publications in English describing dogs that developed AKI with overt clinical signs after anaesthesia were included. Number of postoperative days until onset of clinical signs and death; along with signalment and the reported clinical signs leading to AKI diagnosis were extracted. Nine publications describing a total of 31 dogs were included in the review. Clinical signs were typically first seen 2-4 days postoperatively (range 1-14). Death/euthanasia occurred in 5 dogs; between 3 and 60 days postoperatively. Persistent renal dysfunction occurred in 4 survivors. The most common clinical signs were anorexia, lethargy, polyuria/polydipsia and vomiting. Female and larger breed dogs especially Labradors and Golden Retrievers were overrepresented. Knowledge of this time course may improve postoperative monitoring and recognition of perioperative AKI in dogs.