What is Multiple Organ Dysfunction (MODS)?
Multiple organ dysfunction syndrome is often caused by an injury or illness that then leads to either sepsis or a systemic inflammatory response (SIRS). Sepsis and SIRS may present in the same way, but in the case of SIRS, no actual infection is causing the response. MODS usually sets in 3-5 days after the initial trauma or illness, usually with no previous injury to those specific organs. Inflammation occurs throughout the body and causes organs like the heart, liver, and kidneys to start shutting down.
Multiple organ dysfunction syndrome is the simultaneous dysfunction of two or more organ systems in acutely ill canines.
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Symptoms of Multiple Organ Dysfunction (MODS) in Dogs
This disorder occurs shortly after traumatic injury or illness has already attacked the body. The symptoms that occur will depend entirely on which systems are being attacked by this disease.
For instance, if the respiratory system is experiencing inflammation or overall failure, you would see difficulty breathing, coughing, and pulmonary crackles. If, however, the heart is one of the failing organs you would see heart arrhythmias, hypotension, and pale mucous membranes.
Systemic inflammatory response syndrome (SIRS)- To reach a diagnosis of SIRS, your dog must fulfill at least two of the criteria including:
- High heart rate
- Increased core temperature
- Increased white blood cells
- Rapid breathing
- Reduced core temperature
- Reduced white blood cells
Causes of Multiple Organ Dysfunction (MODS) in Dogs
The causes of MODS are still a bit of a mystery to the medical community, in approximately one-third of the patients, the primary focus is never found. This disorder usually occurs three to five days after the initial infection or injury, which seems to correspond to an increase in levels of free-floating mitochondrial DNA in the blood. This indicates that there is cell death occurring on a massive scale, but doesn’t fully explain why the organs start failing.
Diagnosis of Multiple Organ Dysfunction (MODS) in Dogs
Several tests will be completed for any critically ill patient to determine the cause of their decline. Your veterinarian will re-examine your dog, checking his blood pressure and overall condition, as well as ordering a urinalysis and blood tests to determine the functionality of his internal organs. The blood tests that are likely to be done may include:
- Blood gas analysis
- Coagulation profile
- Complete blood count (CBC)
- Serum biochemical profile
- X-ray or ultrasound imaging
The technician assessing the samples may see a substantial increase in the amount of free-floating mitochondrial DNA in the tested blood. A diagnosis of either sepsis or SIRS will generally precede the MODS diagnosis, as these distressing disorders can often develop into a multiple organ dysfunction. Technicians looking at the samples will also be searching for a source of the infection as well if sepsis preceded the development of MODS.
Treatment of Multiple Organ Dysfunction (MODS) in Dogs
As there is no current way to reverse the damage to the organs themselves, the treatment of MODS will generally be symptomatic and somewhat dependant on what preceded the disorder. If the initial cause of the organ dysfunction is caused by sepsis, then antibiotics will be required to clear up the infection. Many doctors and veterinarians will put the patient on a tube feeding system right away until the organs are again functioning properly to prevent further infection. One of the primary concerns when treating MODS is ensuring that enough oxygen is getting to the internal organs and the patient remains fully hydrated. The functionality of all of the organs needs to be carefully monitored so that treatment for new symptoms can be instigated as soon as possible. This is of particular importance in this disorder, particularly because once one system starts having trouble, other systems will often begin failing as well, making successful treatment even more challenging.
Recovery of Multiple Organ Dysfunction (MODS) in Dogs
The prognosis for dogs who have developed multiple organ dysfunction is guarded. Most of our statistics for MODS is from human information and mortality statistics for humans with this disorder has not changed in several decades. Despite several advancements in our comprehension of this disorder, our understanding of the cause of this disorder is still incomplete. We don’t really know why this happens in one individual versus another, but an unbalance of the bleeding and clotting behaviors during healing may have an effect. The speed in which the disorder is caught, and the number and type of organs affected will have the most impact on the chances of survival.
Multiple Organ Dysfunction (MODS) Questions and Advice from Veterinary Professionals
My 16 yr old 12lb rat terrier was diagnosed with congestive heart failure at the beginning of December. We had been managing it well with lasix, vetmedin, and a variety of homeopathic supplements. Everyone was actually super impressed that she had never slowed down or lost muscle mass. She had blood work then, and again at the beginning of April. Both times her BUN were slightly elevated but everything else was fine including the SDMA? (Kidney test.)
Tuesday morning she woke up limping on what appeared to be her entire left side. Other than that she seemed fine. She ate breakfast and then started doing the im upset pacing, digging etc and eventually threw up and then almost immediately passed out. This scared me but she bounced back, was begging for food .. still limping a little but it seemed to improve the more she walked. Started with a spoon full of rice, a few hrs later spoon of chicken... by dinner she had kept everything down was drinking using the rest room and totally acting like herself so I fed her dinner. That was fine. She slept like a baby. Woke me up in the morning because she wanted breakfast. She was still limping fed her and the same thing happened about 20 min later she vomited and collapsed. She never fully recovered this time. She was lethargic, continued vomiting etc so at noon she was at the vet .. checked her out, took blood, her lungs and heart sounded great and clear , gave her anti nausea meds. Vet agreed she was most likely super upset about the puking and it blocked her airway causing the collapse.. if it didn’t improve or got worse call him to run more tests and have the er vet # ready. Their machine was down so he had to send out the blood work. She came home drank a bunch of water but was still lethargic wobbly. After that she wouldn’t drink anymore but kept standing over the water dish. Couldn’t get comfortable, pacing .. etc I was giving her about a tsp-2 of broth every hour or 2 as advised.. she was swallowing it. Around midnight she seemed to get worse ... more lethargic more uncomfortable, kept wanting to get up but she’d fall after jumping. Pacing standing over the water dishes. She did urinate normally and have a solid poop outside. she seemed to get super exhausted she wasn’t flopping anymore but you could tell she was uncomfortable, she kept kicking her legs she refused to close her eyes. Anytime she started to fall asleep she’d jerk herself awake. We stayed up with her all night and called the vet as soon as they opened. My vet wasn’t in but his partner was. She said her blood work had completely changed. All 3 of her kidney levels were high. Her liver levels were high. She recommended we go to the emergency vet for an ultrasound, fluids etc .. my mom ran to my grandpas to get his credit card (I was out of money and it costs $500 just to walk in the door) and we went. By the time we got there she was still pink, her refill time was great but she was shallow breathing. They put her in oxygen and then the vet came in and started talking euthanasia or keeping her there for days trying to save her her but what quality of life? lungs sounded fluid filled. They didn’t think an ultra sound and fluids was the right thing.. because her lungs had fluid (which I thought that’s what we were doing) . I called my vet back and discussed things with them. They had given her a large dose of IV lasix. She called and talked to the er vet called me back and. explained things to me (i was kind of losing it) said I should wait an hr and see how she does with lasix and oxygen. So that’s what we decided to do. I wasn’t mentally or emotionally in a place to make a decision this was all a shock to me she was just FINE.. we had been camping and going on adventures just days before. When they brought her back to me she was struggling to breathe .. twitching, she had and continued to have liquid bloody stool leaking out of her, out of it and in obvious pain she whined when I picked her up. She was gone. I decided to let her go. She left while in my arms snuggled up against me and not alone with strangers being poked at. She came too enough to look at me one more time and snuggled into my chest. I talked to her softly and let her know it was fine and then the vet came in. Her heart took a very long time to stop. The vet was surprised and kept checking .. although I told her I could feel it against my hand. I’ve had dogs put down and she was so sick and her heart was already bad but she kept fighting to be there with me, which broke my heart. What we don’t know is why her organs suddenly failed. All of them. (Except apparently her bad heart) she had blood work less than 2 months earlier all was good. Her gums were pink and her temp was on the low side of normal (99.8) she wasn’t in shock.
Why would her organs just suddenly fail like that? (No she didn’t get into any poisons, Meds etc)
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At this point she is diagnosed with kidney failure & possible leptospirosis infection. However, exact reason for organ failure is yet to be known. Can it be mods & if so what are the chances of survival ??
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