ABSTRACT
Objective
To describe a population of dogs and cats with cancer admitted to the ICU and identify risk factors affecting survival.
Design
Prospective, observational cohort study between December 2022 and September 2023.
Setting
Veterinary referral teaching hospital.
Animals
Thirty-eight cats and 114 dogs.
Interventions
All ICU admissions were recorded. For patients with a confirmed or presumed cancer diagnosis, reason for ICU admission, clinicopathologic data, diagnostic imaging results, treatments, survival to discharge and at 90 days postdischarge, and date of death, if applicable, were recorded.
Measurements and Main Results
The prevalence of ICU patients with cancer was 13.6% (165/1214 [95% confidence interval {CI}: 11.7–15.7]). A definitive diagnosis was obtained in 106 patients (73.7% [28/38] cats, 68.4% [78/114] dogs). Hematologic neoplasia was the most frequent cancer in cats (64.3% [18/28]), while carcinoma was the most frequent in dogs (37.2% [29/78]). The most frequent reasons for ICU admission were respiratory distress (31.6% [12/38] cats, 20.2% [24/114] dogs) and cardiovascular instability (21.1% [8/38] cats, 20.2% [23/114] dogs). Survival to discharge was 56.6% (44.7% [17/38] cats, 60.5% [69/114] dogs) and at 90 days was 30.6% (21.1% [8/38] cats, 33.9% [37/109] dogs). In the multivariable Cox regression model, oncologic ICU admission was associated with increased hazard of death compared with nononcologic admission (hazard ratio [HR]: 6.06, 95% CI: 2.39–15.36; p < 0.001); surgical treatment was associated with reduced hazard compared with medical treatment (HR: 0.21, 95% CI: 0.11–0.38; p < 0.001); chemotherapy was associated with reduced hazard compared with no chemotherapy (HR: 0.40, 95% CI: 0.22–0.73; p = 0.003); and normal albumin concentration in dogs was associated with reduced hazard compared with hypoalbuminemia (HR: 0.44, 95% CI: 0.26–0.72; p = 0.004).
Conclusions
Cancer was common in this ICU population (prevalence 13.6%). Mortality was high (69.4% 3 months postdischarge), with 88% of deaths resulting from euthanasia.
Journal of Veterinary Emergency and Critical Care, EarlyView.Wiley: Journal of Veterinary Emergency and Critical Care: Table of Contents