Lactic acidosis is caused by the way bodies manage metabolism. A progressive medical condition, lactic acidosis is characterized by lactic acid accumulation in the body and a decrease in blood pH, or acidosis.
Lactic acidosis happens when the body accumulates lactic acid in the bloodstream. The acid is a byproduct of anaerobic metabolism, or the way bodies create energy without oxygen.
While muscles naturally produce lactic acid during strenuous activity, excess can tip the metabolic balance and cause health problems During high exertion of muscles, lactic acid levels spike.
This is meant to be temporary. However, if lactic acid levels rise above 4 mmol/L, it can cause unwanted and dangerous physical and mental health effects.
Animals besides humans produce lactic acid. In dogs, it's regulated by the liver and kidneys. A cow's rumen has abundant Lactobacillus microbes.
These rod-shaped, gram-positive bacteria produce lactic acid in nature. Muscles of fish and lobsters also create lactic acid.
Symptoms of lactic acidosis in dogs and other animals may include:
Vomiting
Nausea
Pain & Limping
Weakness
Intolerance to exercise and other activity
Muscle stiffness or soreness
Heavy or difficult breathing
Causes of Lactic Acidosis
Lactic acidosis can arise from various underlying conditions, often categorized into two main types: Type A and Type B lactic acidosis.
Type A Lactic Acidosis
This form is the most common and is primarily due to tissue hypoxia, an insufficient supply of oxygen to the tissues. Causes include:
Severe Infections (Sepsis): Bacterial infections can overwhelm the body's systems and restrict oxygen delivery to organs. Sepsis is a body-wide infection. It increases lactic acid production due to low blood flow.
Severe Anemia: Low red blood cell counts can impair oxygen transport, resulting in an increased lactic acid level.
Shock: Conditions like cardiogenic shock, hypovolemic shock, or distributive shock significantly affect blood flow and oxygen delivery. Conditions such as cardiogenic shock, which occurs when the heart cannot pump enough blood, can also lead to elevated lactic acid levels.
Respiratory Failure: Poor respiratory function can cause reduced oxygen availability, increasing lactic acid production.
Type B Lactic Acidosis
This type is not primarily linked to oxygen deprivation and can result from metabolic and other systemic issues, such as:
Diabetes and Diabetic Ketoacidosis: High blood sugar levels can lead to the production of excessive lactic acid.
Alcoholism: Alcohol metabolism can disrupt normal lactic acid clearance in the liver.
Liver Disease: The liver plays an essential role in metabolizing lactic acid. Conditions like cirrhosis can impair this function, causing lactic acid to accumulate
Medications: Several drugs, including metformin (especially in renal impairment), can precipitate lactic acidosis. HIV drugs lamivudine (3TC) and emtricitabine (FTC) may raise lactic acid levels.
Inherited Metabolic Disorders: Conditions affecting lactic acid metabolism may lead to an accumulation of lactic acid.
Symptoms of Lactic Acidosis
Symptoms of lactic acidosis can range from mild to severe, depending on cause, and degree of acidosis. Symptoms include:
Rapid Breathing: The body tries to compensate for the acidity by increasing respiration.
Weakness or Fatigue: Due to impaired oxygen delivery and energy production.
Nausea and Vomiting: Often a response to metabolic disturbances like excess acid.
Confusion or Dizziness: Due to reduced oxygen in the brain.
Abdominal Pain or Distress: indicates increasing severity.
Untreated lactic acidosis can lead to shock, organ failure and coma.
Diagnosis
Diagnosis is by clinical assessment and laboratory testing.
Blood Tests: Measuring blood pH and lactate levels, with lactic acid levels above 4 millimoles per liter often indicating lactic acidosis.
Assessment of Underlying Causes: Additional tests may include imaging studies or specific tests for infection, kidney function, or metabolic states.
Treatment of Lactic Acidosis
Oxygen Therapy: Improves oxygen delivery to tissues, especially in cases of respiratory failure.
Intravenous Fluids: Restore blood volume, improve kidney function and circulation.
Medications: Depending on cause, medications may be used to treat infections or metabolic imbalances.
Dialysis: In severe cases, dialysis may be needed to get rid of excess lactic acid and restore acid-base balance.
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