Prevalence and Risk Factors for Survival in Dogs and Cats With Cancer Admitted to the ICU.

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.