1
|
Heilmann RM, Grützner N, Kook PH, Schellenberg S, Suchodolski JS, Steiner JM. High-Dose Hydrocortisone Treatment Does Not Affect Serum C-Reactive Protein (CRP) Concentrations in Healthy Dogs. Vet Sci 2023; 10:620. [PMID: 37888572 PMCID: PMC10610719 DOI: 10.3390/vetsci10100620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Measuring C-reactive protein (CRP) in serum is a useful surrogate marker for assessing disease progression and treatment response in dogs with autoinflammatory diseases. Affected dogs often receive high-dose glucocorticoid treatment, but the effect of such treatment alone on serum CRP concentrations is unknown. We evaluated serum CRP concentrations via immunoassay (sandwich enzyme-linked immunosorbent assay and particle-enhanced turbidimetric immunoassay) in 12 healthy beagle dogs administered high-dose hydrocortisone (8 mg/kg q12 h) per os vs. placebo over 28 days (days 0, 1, 5, and 28) in a randomized parallel study design. Serum CRP concentrations slightly decreased during treatment or placebo but without a significant association with hydrocortisone administration (p = 0.761). Compared to baseline, serum CRP concentrations were decreased by >2.7-fold (minimum critical difference) in three hydrocortisone-treated dogs and two dogs in the placebo group on day 28, whereas an increase to >2.7-fold was seen in one dog receiving placebo. These results suggest a lack of confounding effects of high-dose hydrocortisone administration on serum CRP concentrations in healthy dogs. This might also hold in dogs with autoinflammatory conditions and/or administration of other high-dose corticosteroids, suggesting that CRP presents a suitable biomarker to monitor inflammatory disease processes. However, this needs confirmation by further studies evaluating corticosteroid-induced cellular (e.g., hepatic) transcriptome and proteome changes.
Collapse
Affiliation(s)
- Romy M. Heilmann
- Department for Small Animals, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Leipzig University, An den Tierkliniken 23, DE-04103 Leipzig, Germany
| | - Niels Grützner
- Ruminant and Swine Clinic, Free University of Berlin, Königsweg 65, DE-14163 Berlin, Germany;
| | - Peter H. Kook
- Small Animal Clinic, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland;
| | - Stefan Schellenberg
- Small Animal Specialty Center Aarau West, Muhenstrasse 56, CH-5036 Oberentfelden, Switzerland;
| | - Jan S. Suchodolski
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TAMU 4474, College Station, TX 77845, USA; (J.S.S.); (J.M.S.)
| | - Joerg M. Steiner
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TAMU 4474, College Station, TX 77845, USA; (J.S.S.); (J.M.S.)
| |
Collapse
|
2
|
Jandel AN, Heilmann RM, Sander H, Steiner JM, Grützner N, Xenoulis PG. Serum α 1-Proteinase Inhibitor, Calprotectin, and S100A12 Concentrations in the Characterization of Pancreatitis in Dogs. Vet Sci 2023; 10:428. [PMID: 37505833 PMCID: PMC10385135 DOI: 10.3390/vetsci10070428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023] Open
Abstract
Miniature Schnauzers are predisposed to develop pancreatitis, with familial hypertriglyceridemia (HTG) described as a potential risk factor. Diagnosing pancreatitis in dogs is based on the integration of serum canine-specific pancreatic lipase (cPLI) concentration, clinical presentation, and diagnostic imaging findings. However, markers of systemic inflammation and antiprotease activity have not been extensively investigated in the characterization and prognostication of pancreatitis in dogs. Serum concentrations of alpha1-proteinase inhibitor (α1PI; as a marker of systemic antiprotease response) and calprotectin and S100A12 (as markers of systemic inflammation) were measured in serum samples from 35 Miniature Schnauzers diagnosed with pancreatitis (serum cPLI concentration >400 μg/L, clinical signs, abdominal imaging findings). These markers were evaluated for possible associations with patient characteristics, clinical presentation, risk factors for pancreatitis, and outcome. The study showed that biomarkers of systemic inflammation and antiprotease activity are commonly increased in Miniature Schnauzers with pancreatitis. Whereas serum calprotectin and S100A12 concentrations were found to have limited utility in differentiating pancreatitis presentations, serum α1PI concentrations and potentially also the serum calprotectin-to-S100A12 ratio might be non-invasive surrogate markers of disease severity in dogs with pancreatitis.
Collapse
Affiliation(s)
- Annina N Jandel
- Department for Small Animals, College of Veterinary Medicine, University of Leipzig, DE-04103 Leipzig, Germany
| | - Romy M Heilmann
- Department for Small Animals, College of Veterinary Medicine, University of Leipzig, DE-04103 Leipzig, Germany
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Henri Sander
- Department for Small Animals, College of Veterinary Medicine, University of Leipzig, DE-04103 Leipzig, Germany
| | - Jörg M Steiner
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Niels Grützner
- Ruminant and Swine Clinic, Free University of Berlin, DE-14165 Berlin, Germany
- VetaRegio GmbH, DE-06366 Köthen, Germany
| | - Panagiotis G Xenoulis
- Gastrointestinal Laboratory, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, 43100 Karditsa, Greece
| |
Collapse
|
3
|
Dröes FC, Suchodolski JS, Steiner JM, Lidbury JA. Prevalence of portal vein and splanchnic venous thrombosis in dogs with chronic hepatitis. J Small Anim Pract 2023; 64:375-383. [PMID: 36973881 DOI: 10.1111/jsap.13597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 11/24/2022] [Accepted: 01/24/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVES Alterations in haemostasis have been described in dogs and humans with chronic hepatitis. Portal vein thrombosis is a recognised complication of chronic hepatitis in humans; however, its prevalence in dogs with chronic hepatitis has not been reported. We aimed to estimate the prevalence of, and describe clinical and laboratory data of dogs with chronic hepatitis and portal vein thrombosis and splanchnic venous thrombosis. MATERIALS AND METHODS Retrospective cross-sectional study. Medical records of dogs admitted to a veterinary teaching hospital between 2009 and 2019 were reviewed. Dogs were included if chronic hepatitis was histopathologically confirmed, and if diagnostic imaging or necropsy indicated the presence of thrombosis. Clinical and laboratory data (i.e. haematology, biochemistry, coagulation panels) were recorded. Descriptive statistics were used to characterise dogs with and without thrombosis. RESULTS Records from 136 dogs with chronic hepatitis were identified. Three of these dogs, 2.2% (95% confidence interval: 0.8 to 6.3%) all females, were diagnosed with portal vein thrombosis. Five dogs in total, (3.7%; 95% confidence interval: 1.6 to 8.3%), including three with portal vein thrombosis, all females, were diagnosed with splanchnic venous thrombosis. Dogs with portal vein and splanchnic venous thrombosis often had hyperbilirubinaemia, increased serum gamma-glutamyl transferase activity, and decreased plasma antithrombin 3 activity. They also had relatively high alternative Child-Pugh scores for dogs (median 6 out of 13). CLINICAL SIGNIFICANCE Portal vein and splanchnic venous thrombosis are potentially serious complications that were identified in a relatively low proportion of dogs with chronic hepatitis.
Collapse
Affiliation(s)
- F C Dröes
- Gastrointestinal Laboratory, Texas A&M University - College of Veterinary Medicine & Biomedical Sciences, 4474 TAMU, College Station, TX, 77843, USA
| | - J S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University - College of Veterinary Medicine & Biomedical Sciences, 4474 TAMU, College Station, TX, 77843, USA
| | - J M Steiner
- Gastrointestinal Laboratory, Texas A&M University - College of Veterinary Medicine & Biomedical Sciences, 4474 TAMU, College Station, TX, 77843, USA
| | - J A Lidbury
- Gastrointestinal Laboratory, Texas A&M University - College of Veterinary Medicine & Biomedical Sciences, 4474 TAMU, College Station, TX, 77843, USA
| |
Collapse
|
4
|
Kuzi S, Adlersberg D, Aroch I, Segev G. Utility of 1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin)-ester-lipase for monitoring dogs with chronic pancreatitis. J Vet Intern Med 2023; 37:437-445. [PMID: 36785918 DOI: 10.1111/jvim.16638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 01/19/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The utility of 1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin)-ester-(DGGR)-lipase activity (DLA) in monitoring clinical progression of chronic pancreatitis (CP) in dogs is unknown. OBJECTIVE To examine the association of DLA with clinical signs of CP, as assessed by a CP clinical severity score (CPCSS). ANIMALS Twenty-four dogs. METHODS This is a retrospective study. Chronic pancreatitis was diagnosed based on clinical signs and DLA > 250 U/L and monitored using CPCSS and DLA. RESULTS The study included 134 visits (median, 10 visits/dog; range, 2-11). Mild-moderate (CPCSS, 0-3) and severe (CPCSS, ≥4) disease were documented in 94 (70%) and 40 (30%) visits, respectively. In emergency visits (n = 44; 33%) CPCSS (median, 5; range, 0-15) and DLA (median, 534 U/L; range, 63-7133) were higher (P < .001 and P = .003, respectively) than in scheduled ones (n = 90; 67%; median, 1; range, 0-6 and median, 384 U/L; range, 49-3747, respectively). DGGR-lipase activity was associated (P = .009) with the CPCSS, with a lower activity documented in mild-moderate CPCSS (median 391 U/L; range, 49-3747), compared to severe score (median, 558 U/L; range, 63-7133). DGGR-lipase activity was significantly, but weakly, correlated with CPSS (r = 0.233, P = .007). DGGR-lipase activity inefficiently discriminated mild-moderate vs severe CP (area under the receiver operator characteristics curve, 0.64; 95% confidence interval, 0.53-0.75; P = .012), with DLA cutoff of 428 U/L corresponding to sensitivity of 65% and specificity of 63%. CONCLUSIONS AND CLINICAL IMPORTANCE Increased DLA is associated with emergency revisits in dogs with CP, possibly reflecting acute flare-ups. DGGR-lipase activity was associated with the CPCSS over the follow-ups but could not differentiate disease severity.
Collapse
Affiliation(s)
- Sharon Kuzi
- Department of Small Animals Internal Medicine, Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel
| | - Dana Adlersberg
- Department of Small Animals Internal Medicine, Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel
| | - Itamar Aroch
- Department of Small Animals Internal Medicine, Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel
| | - Gilad Segev
- Department of Small Animals Internal Medicine, Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot 761001, Israel
| |
Collapse
|
5
|
Rudinsky AJ. Laboratory Diagnosis of Pancreatitis. Vet Clin North Am Small Anim Pract 2023; 53:225-240. [DOI: 10.1016/j.cvsm.2022.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
6
|
Prognostic Role of Red Cell Distribution Width and Other Routine Clinico-Pathological Parameters in Dogs with Acute Pancreatitis. Animals (Basel) 2022; 12:ani12243483. [PMID: 36552403 PMCID: PMC9774429 DOI: 10.3390/ani12243483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
This study aimed to assess the prognostic value of red cell distribution width (RDW) RDW-to-calcium ratio (RDW/Ca), neutrophils-to-lymphocytes ratio (N/L), platelets-to-lymphocytes ratio (P/L) and other easy to obtain and inexpensive hematological and biochemical parameters in dogs with acute pancreatitis. This is a multicenter, retrospective cohort study including 70 client-owned dogs. The accuracy of clinical and laboratory variables to predict short-term death (i.e., dead by 14 days) was tested by calculating the area under the receiver-operating characteristic curve (AUC). Independent predictors of death were identified using the multivariable Cox proportional hazards regression model. The survival rate was 72.9% (51 dogs) and 19 dogs died within 14 days of admission from AP. RDW and blood urea nitrogen (BUN) had good accuracy to predict short-term dead with AUC of 0.74 and 0.70 at the cut-off of >12.7% and >42 mg/dL, respectively. According to the multivariable model, RDW (hazard ratio and 95% confidence interval [HR, 95% CI] = 5.08, 95% CI = 1.14−22.67; p = 0.03), BUN (HR = 1.00, 95% CI = 1.00−1.01; p < 0.01) and bilirubin (HR = 2.46, 95% CI = 1.38−4.39; p < 0.01) were independent predictors of death. The results indicate that RDW, BUN and bilirubin are useful predictors of short-term death in dogs with acute pancreatitis.
Collapse
|
7
|
Tusa NV, Abuelo A, Levy NA, Gandy JC, Langlois DK, Cridge H. Peripheral biomarkers of oxidative stress in dogs with acute pancreatitis. J Vet Intern Med 2022; 36:1958-1965. [PMID: 36086902 DOI: 10.1111/jvim.16535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/22/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Oxidative stress is considered a pathomechanism of acute pancreatitis (AP), but no studies have extensively characterized oxidant status in dogs with naturally-occurring AP. HYPOTHESIS OR OBJECTIVES Evaluate measures of oxidant status in dogs with AP and explore whether these measures correlate with AP severity. ANIMALS Fifteen dogs with AP and 9 control dogs. METHODS Prospective, controlled observational study. Plasma reactive metabolite (RM) concentrations, antioxidant potential (AOP), and urinary F2 isoprostane concentrations were measured in AP dogs and healthy controls. Severity of AP was assessed by length of hospitalization and 3 disease severity indices: canine acute pancreatitis severity (CAPS), modified canine activity index (M-CAI), and the acute patient physiologic and laboratory evaluation score (APPLEfull ). RESULTS Reactive metabolite (RM) concentrations (median, 65 relative fluorescent units [RFU]/μL; range, 20-331 RFU/μL) and RM:AOP (median, 7; range, 4-109) were higher in AP dogs than healthy controls (median RM, 25 RFU/μL; range, 16-41 RFU/μL; median RM:AOP, 4; range, 2-7; P < .001 for both comparisons). Reactive metabolite (rS = 0.603, P = .08) and RM:AOP (rS = 0.491, P = .06) were not correlated with the duration of hospitalization or disease severity indices evaluated. However, disease severity indices did not predict mortality in our study. Normalized urine 2,3-dinor-8-iso-prostaglandin F2α concentrations were correlated with C-reactive protein (CRP; rS = 0.491, P = .03), canine specific pancreatic lipase (Spec cPL; rS = 0.746, P = .002), and CAPS (rS = 0.603, P = .02). CONCLUSIONS AND CLINICAL IMPORTANCE Oxidant status is altered in dogs with naturally occurring AP, but the clinical relevance of this finding is unknown.
Collapse
Affiliation(s)
- Nicole V Tusa
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Angel Abuelo
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Nyssa A Levy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Jeffery C Gandy
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Daniel K Langlois
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Harry Cridge
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| |
Collapse
|
8
|
Hardwick JJ, Reeve EJ, Hezzell MJ, Reeve JA. Prevalence of ultrasonographic gastrointestinal wall changes in dogs with acute pancreatitis: A retrospective study (2012-2020). J Vet Intern Med 2022; 36:947-956. [PMID: 35318742 PMCID: PMC9151481 DOI: 10.1111/jvim.16414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background Ultrasonographic gastrointestinal wall changes in dogs with acute pancreatitis (AP) are not well characterized in the literature. No detailed studies have described their prevalence, characteristics, distribution, or clinical relevance. Hypothesis/Objectives Describe the prevalence of ultrasonographic gastrointestinal wall changes in a population of dogs with AP and evaluate for associations between the presence of gastrointestinal wall changes and clinical or clinicopathological variables. Animals Referral population of 66 client‐owned dogs with AP. Methods Retrospective search of clinical records to identify dogs with AP. Clinical variables, clinicopathological variables and ultrasonographic findings were reported using descriptive statistics. A binary logistic regression model was used to evaluate for associations between the presence of gastrointestinal wall changes and clinical or clinicopathological variables. Results Sixty‐six dogs were included. Forty‐seven percent of dogs (95% confidence interval [CI], 35.0%‐59.0%; n = 31) with AP had ultrasonographic gastrointestinal wall changes. Gastrointestinal wall changes were most common in the duodenum and identified in 71% (n = 22) of affected dogs. Of dogs with gastrointestinal wall changes, 74.2% (n = 23) had wall thickening, 61.3% (n = 19) had abnormal wall layering, and 35.5% (n = 11) had wall corrugation. In the multivariable model, only heart rate remained an independent predictor of ultrasonographic gastrointestinal wall changes (P = .02). Conclusions and Clinical Importance Ultrasonographic gastrointestinal wall changes in this population of dogs with AP were common. Increased heart rate was the only independent predictor of gastrointestinal wall changes, which might imply more severe disease. Additional studies are required to elucidate whether ultrasonographic gastrointestinal wall changes reflect disease severity in AP.
Collapse
Affiliation(s)
- Joshua J Hardwick
- Bristol Veterinary School, University of Bristol, North Somerset, United Kingdom.,Langford Vets, Small Animal Referral Hospital, Langford, United Kingdom
| | | | - Melanie J Hezzell
- Bristol Veterinary School, University of Bristol, North Somerset, United Kingdom
| | - Jenny A Reeve
- Bristol Veterinary School, University of Bristol, North Somerset, United Kingdom
| |
Collapse
|
9
|
Covin MA, Steiner JM. Measurement and clinical applications of C-reactive protein in gastrointestinal diseases of dogs. Vet Clin Pathol 2022; 50 Suppl 1:29-36. [PMID: 35014071 PMCID: PMC9303876 DOI: 10.1111/vcp.13100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 10/12/2021] [Accepted: 11/14/2021] [Indexed: 12/11/2022]
Abstract
C-reactive protein (CRP) is a positive acute-phase protein, serum concentrations of which increase nonspecifically in response to inflammatory processes of the dog. As such, it can aid in the identification of inflammatory disease and, maybe more importantly, the objective monitoring of disease progression. In dogs, CRP is frequently used to evaluate dogs with gastrointestinal diseases, such as chronic inflammatory enteropathies (also termed idiopathic inflammatory bowel disease), acute pancreatitis, canine parvovirus infection, hepatic disease, acute abdomen, and protein-losing enteropathy. The diversity of the assays available to measure CRP in dogs is nearly as numerous as the diseases in which serum concentrations of this protein are increased. Assay methodologies include laser nephelometric immunoassays, enzyme-linked immunosorbent assays, immunoturbidimetric assays, and time-resolved immunofluorometric assays. While many of these assays are acceptable for clinical use in the dog, the same assay and analyzer should be used to measure a patient's CRP concentration longitudinally. By looking at the uses of CRP in human gastroenterology, including reducing the duration of antibiotic therapy, the veterinary profession can gain insight into novel ways in which serum CRP concentration measurements might be applied in veterinary medicine in the future.
Collapse
Affiliation(s)
- Marshal A Covin
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| |
Collapse
|
10
|
Asakawa M, Fukuzawa M, Asakawa MG, Flanders JA. Preoperative serum C-reactive protein concentration can be used to detect gallbladder rupture in dogs with gallbladder mucocele. Am J Vet Res 2022; 83:23-32. [PMID: 34757924 DOI: 10.2460/ajvr.21.09.0141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine whether serum C-reactive protein (CRP) concentration could be used to detect gallbladder rupture (GBR) prior to surgery in dogs undergoing cholecystectomy for treatment of gallbladder mucocele (GBM). ANIMALS 45 dogs that underwent cholecystectomy because of GBM at a companion animal referral hospital from 2017 to 2020. PROCEDURES Electronic medical records were reviewed, and dogs were included if serum CRP concentration had been measured within 24 hours prior to cholecystectomy. Dogs were grouped as to whether the gallbladder was found to be ruptured or intact during surgery. Accuracy of using preoperative CRP concentration to predict GBR was compared with accuracy of abdominal ultrasonography and other preoperative blood tests. RESULTS GBR was present in 15 dogs at the time of surgery. Median preoperative CRP concentration was significantly higher in dogs with GBR (15.1 mg/dL; interquartile range, 7.4 to 16.8 mg/dL) than in dogs with an intact gallbladder (2.65 mg/dL; interquartile range, 0.97 to 13.4 mg/dL). Sensitivity, specificity, and accuracy of using preoperative CRP concentration to predict GBR were 100%, 67%, and 78%, respectively. CLINICAL RELEVANCE Measurement of preoperative CRP concentration provided excellent sensitivity and moderate specificity for detection of GBR in dogs undergoing cholecystectomy because of GBM. Accuracy of using preoperative CRP concentration for detection of GBR was not superior to the accuracy of preoperative abdominal ultrasonography. However, when CRP concentration was combined with results of ultrasonography, the sensitivity, specificity, and accuracy for detection of GBR were 100%, 93%, and 96%, respectively.
Collapse
Affiliation(s)
- Makoto Asakawa
- 1Veterinary Specialists Emergency Center, Saitama Prefecture, Japan
| | - Mayuko Fukuzawa
- 1Veterinary Specialists Emergency Center, Saitama Prefecture, Japan
| | | | - James A Flanders
- 2Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| |
Collapse
|
11
|
Ludwik TM, Heinrich DA, Rendahl A, Friedenberg SG. Red cell distribution width is a predictor of all-cause mortality in hospitalized dogs. J Vet Emerg Crit Care (San Antonio) 2022; 32:9-17. [PMID: 34432939 PMCID: PMC9272852 DOI: 10.1111/vec.13109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/09/2020] [Accepted: 04/16/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine whether RBC distribution width (RDW) is associated with an increased odds of mortality in hospitalized dogs and cats. DESIGN Retrospective, single-center study; data collected from 2007 to 2017. SETTING University teaching hospital. ANIMALS Six thousand six hundred and sixty-one animals (5183 dogs and 1478 cats). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Medical records were identified from animals presented to the emergency service and admitted to the ICU with a CBC and serum biochemistry performed on admission. Patients were stratified into quintiles based upon presenting RDW, and logistic regression modeling was performed to evaluate the relationship between RDW and in-hospital mortality. Canine patients with a presenting RDW in the upper fourth and fifth quintiles had an increased odds of all-cause in-hospital mortality (p < 0.0001). Specifically, dogs in the upper fifth quintile had a 2.1-fold greater odds of death compared to dogs in the first quintile, and dogs in the upper fourth quintile had a 1.9-fold greater odds of death compared to dogs in the first quintile. This relationship remained significant after adjusting for age, sex, key laboratory values excluding HCT, medical versus surgical disease, and diagnosis category. This relationship was no longer significant with the inclusion of HCT. No significant association was identified between presenting RDW and in-hospital mortality in cats. CONCLUSIONS Hospitalized dogs with higher RDW on presentation to the emergency service have greater odds of all-cause in-hospital mortality compared to dogs with a lower RDW. A similar association between RDW and mortality was not found in cats. Further studies are warranted to assess the usefulness of this biomarker for specific diseases in dogs and to better understand the mechanisms driving the association between increased RDW and mortality in canine patients.
Collapse
Affiliation(s)
- Tasia M Ludwik
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Daniel A Heinrich
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Aaron Rendahl
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Steven G Friedenberg
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| |
Collapse
|
12
|
Cridge H, Twedt DC, Marolf AJ, Sharkey LC, Steiner JM. Advances in the diagnosis of acute pancreatitis in dogs. J Vet Intern Med 2021; 35:2572-2587. [PMID: 34751442 PMCID: PMC8692219 DOI: 10.1111/jvim.16292] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 10/04/2021] [Accepted: 10/12/2021] [Indexed: 12/17/2022] Open
Abstract
In the last 20 years, the diagnosis of pancreatitis has become more frequent as a result of improved diagnostic modalities such as abdominal ultrasound examination, advanced imaging, and immunoassays for the measurement of pancreatic lipase. Our aim is to provide a state‐of‐the‐art overview of the clinical diagnosis of acute pancreatitis (AP) in dogs with a particular focus on pancreatic lipase assay validation and clinical performance, in addition to advanced imaging modalities. We also discuss the potential indications for cytology and histopathology in dogs with suspected AP.
Collapse
Affiliation(s)
- Harry Cridge
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - David C Twedt
- Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA
| | - Angela J Marolf
- Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Leslie C Sharkey
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| |
Collapse
|
13
|
Lee JH, Song WJ, An JH, Chae HK, Park SM, Li Q, Youn HY. Role of serum high-motility group box-1 (HMGB1) concentration as a prognostic factor in canine acute pancreatitis: A pilot study. Res Vet Sci 2021; 141:26-32. [PMID: 34649188 DOI: 10.1016/j.rvsc.2021.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/08/2021] [Accepted: 09/26/2021] [Indexed: 11/18/2022]
Abstract
High-mobility group box-1 (HMGB1) is an intranuclear molecule that is released extracellularly in cytotoxic conditions. In acute pancreatitis, extracellular HMGB1 acts as a stimulating factor in the mechanism associated with pancreatic injury. To evaluate the prognostic property of serum HMGB1 levels at the time of diagnosis of pancreatitis, the blood samples collected over 10 months from canine patients in Seoul National University Veterinary Medical Teaching Hospital (n = 29). The HMGB1 levels were measured with ELISA kit and results were analyzed correlation with patient's death, hospitalization cost and period. HMGB1 levels in patients with acute pancreatitis (mean = 76 ng/mL, standard deviation [SD] = 46.99 ng/mL) were higher than that of normal individuals (mean = 31.65 ng/mL, SD = 18.41 ng/mL, p = 0.0082). Similarly, non-survivors demonstrated statistically significant difference than the survivors (p = 0.008). Clinical severity of acute pancreatitis was categorized into three stages: mild, moderate, and severe based on the disease activity index (DAI). The HMGB1 levels and mortality were associated with moderate DAI (p = 0.0236). However, the correlation between serum HMGB1 and patients' hospitalization period and cost were not found to be significant (R2 = 0.01991). The evaluation of serum HMGB1 level at the time of diagnosis was identified as a potential prognostic factor to estimate the prognosis of acute pancreatitis in canines.
Collapse
Affiliation(s)
- Jeong-Hwa Lee
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Woo-Jin Song
- Department of Veterinary Internal Medicine and Research Institute of Veterinary Science, College of Veterinary Medicine, Jeju National University, Jeju 63243, Republic of Korea
| | - Ju-Hyun An
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Hyung-Kyu Chae
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Su-Min Park
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Qiang Li
- Department of Veterinary Medicine, College of Agriculture, YanBian University, YanJi, JiLin 133000, China.
| | - Hwa-Young Youn
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea.
| |
Collapse
|
14
|
Nivy R, Kuzi S, Yochai A, Aroch I, Bruchim Y. Evaluation of serum histone concentrations and their associations with hemostasis, markers of inflammation, and outcome in dogs with naturally occurring acute pancreatitis. Am J Vet Res 2021; 82:701-711. [PMID: 34432516 DOI: 10.2460/ajvr.82.9.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare serum concentrations of histones and inflammatory markers in dogs with acute pancreatitis and healthy control dogs, investigate associations of these variables with coagulation test results and survival (vs nonsurvival) to hospital discharge, and examine the prognostic utility of clinical findings and routine laboratory and coagulation tests in affected dogs. ANIMALS 36 dogs. PROCEDURES Dogs with findings consistent with acute pancreatitis (n = 29) and healthy control dogs (7) were enrolled in a prospective, observational study. Serum concentrations of histones, interleukin (IL)-6, and tumor-necrosis factor-α were assessed for all dogs. Clinical (including ultrasonographic) findings, relevant history, routine laboratory and coagulation test results, and outcomes were recorded for dogs with pancreatitis. Variables were assessed to determine an association with outcome for affected dogs and hospitalization time for survivors; histone concentrations and markers of inflammation were compared among survivors, nonsurvivors, and controls. Correlation between quantitative variables was investigated. RESULTS Serum histone and IL-6 concentrations did not differentiate survivors (n = 23) from nonsurvivors (6); IL-6 concentrations in affected dogs were correlated with 1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin) ester lipase activity (rS = 0.436) and hospitalization time (rS = 0.528). Pancreatitis-associated peritoneal fluid, obtundation, and jaundice were more common, and serum bilirubin concentration, serum alanine aminotransferase and aspartate aminotransferase activities, and prothrombin and activated partial thromboplastin times were greater in nonsurvivors than in survivors. Thromboelastometric changes consistent with hypercoagulability were detected in survivors; hypocoagulability was detected in 2 nonsurvivors. CONCLUSIONS AND CLINICAL RELEVANCE Serum histone concentrations were not associated with presence of acute pancreatitis or outcome for affected dogs. Further research is needed to investigate the clinical and therapeutic implications of hypocoagulability, hepatocellular injury, and pancreatitis-associated peritoneal fluid in affected dogs.
Collapse
Affiliation(s)
- Ran Nivy
- From the Departments of Internal Medicine, Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, 761001, Israel.,From the Department of Internal Medicine, Ben-Shemen Specialist Referral Center, Ben-Shemen, Israel
| | - Sharon Kuzi
- From the Departments of Internal Medicine, Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, 761001, Israel
| | - Avital Yochai
- From the Departments of Internal Medicine, Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, 761001, Israel
| | - Itamar Aroch
- From the Departments of Internal Medicine, Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, 761001, Israel
| | - Yaron Bruchim
- From the Emergency and Critical Care, Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, 761001, Israel.,From the Department of Internal Medicine, Ben-Shemen Specialist Referral Center, Ben-Shemen, Israel
| |
Collapse
|
15
|
Bjørnkjær-Nielsen KA, Bjørnvad CR. Corticosteroid treatment for acute/acute-on-chronic experimental and naturally occurring pancreatitis in several species: a scoping review to inform possible use in dogs. Acta Vet Scand 2021; 63:28. [PMID: 34256804 PMCID: PMC8276032 DOI: 10.1186/s13028-021-00592-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/02/2021] [Indexed: 12/15/2022] Open
Abstract
Acute pancreatitis in dogs is a prevalent disease characterised by mild to severe inflammation. Treatment with anti-inflammatory corticosteroids has been widely debated but is not generally recommended in veterinary medicine. The objective of the present study was to present current evidence on the effect of corticosteroid treatment for acute/acute-on-chronic pancreatitis across species. These findings were then used to evaluate if and how corticosteroid treatment could influence disease outcome in canine acute/acute-on-chronic pancreatitis. A scoping review was performed by searching the Agricola, CAB Abstracts, MEDLINE and Embase databases to identify relevant articles published before June 24, 2021. The inclusion criteria were English language, original research published in a peer-reviewed journal, and investigation of corticosteroid treatment effects on acute/acute-on-chronic pancreatitis by the outcome parameters clinical score, circulating CRP level, hospitalisation duration, mortality and pancreas histopathology. Research on any species was considered. Studies were rated based on the level of evidence, and methodological quality was evaluated based on similarity between groups at baseline, risk of bias and study group size. The reporting method was based on the PRISMA extension for scoping reviews. One thousand nine hundred fifty-four studies were identified, and 31 met the inclusion criteria. Five were canine studies, with 4 investigating experimentally induced pancreatitis; 5 were human clinical studies; and 21 were rodent studies of experimentally induced pancreatitis. The level of evidence ranged between randomised controlled trials and case series, the estimated risk of bias ranged from low to high, and the sample sizes ranged from very small to moderate. Evidence indicates that adding corticosteroid to symptomatic treatment of acute/acute-on-chronic canine pancreatitis could have a positive influence on disease outcome. However, the analysed evidence was based on several species, including both naturally occurring and experimentally induced pancreatitis; thus, the authors suggest that large randomised controlled studies should be performed in dogs with spontaneously occurring acute/acute-on-chronic pancreatitis to further elucidate a potential benefit of corticosteroid treatment.
Collapse
|
16
|
Keany KM, Fosgate GT, Perry SM, Stroup ST, Steiner JM. Serum concentrations of canine pancreatic lipase immunoreactivity and C-reactive protein for monitoring disease progression in dogs with acute pancreatitis. J Vet Intern Med 2021; 35:2187-2195. [PMID: 34250650 PMCID: PMC8478023 DOI: 10.1111/jvim.16218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/19/2021] [Accepted: 06/22/2021] [Indexed: 12/02/2022] Open
Abstract
Background Reliable biomarkers for monitoring disease progression and management in dogs with acute pancreatitis have not been described. Objective To determine if serum concentrations of canine pancreatic lipase immunoreactivity (cPLI) and C‐reactive protein (CRP) can be used as biomarkers for disease progression in hospitalized dogs with acute pancreatitis. Animals Thirteen hospitalized dogs with acute pancreatitis diagnosed based on clinical signs, serum cPLI concentrations, and imaging findings were enrolled. Methods Serum cPLI and CRP concentrations were determined before and then daily during hospital management and 1 week after hospital discharge. Modified canine activity index (MCAI) and canine acute pancreatitis clinical severity index (CAPCSI) scores were calculated daily for each patient while hospitalized. Results The MCAI scores (P = .03) but not CAPCSI scores (P = .31) were significantly different between dogs that survived to discharge (n = 11) and those that did not (n = 2). Serum cPLI concentration was positively correlated with MCAI (rho = 0.42; P = .01). Serum CRP concentration also was positively correlated with the MCAI (rho = 0.42, P = .01). Conclusions Serum cPLI and possibly CRP could be used as objective biomarkers for clinical changes in hospitalized dogs with acute pancreatitis. Additional studies involving larger numbers of dogs would be warranted to evaluate the broader impact of these findings.
Collapse
Affiliation(s)
- Kirstin M Keany
- MedVet New Orleans, Louisiana and MedVet Mandeville, Louisiana, USA
| | - Geoffrey T Fosgate
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - Sean M Perry
- Department of Veterinary Services, Mississippi Aquarium, Gulfport, Mississippi, USA
| | - Shannon T Stroup
- MedVet New Orleans, Louisiana and MedVet Mandeville, Louisiana, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| |
Collapse
|
17
|
Hope A, Bailen EL, Shiel RE, Mooney CT. Retrospective study evaluation of DGGR lipase for diagnosis, agreement with pancreatic lipase and prognosis in dogs with suspected acute pancreatitis. J Small Anim Pract 2021; 62:1092-1100. [PMID: 34233038 DOI: 10.1111/jsap.13379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Activity of 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase is considered to be more pancreas specific than traditional lipase assays. The aim of this study was to evaluate the diagnostic performance of DGGR lipase activity for suspected acute pancreatitis in dogs and to assess its prognostic usefulness. METHODS Retrospective study of case records for suspected acute pancreatitis based on clinician-stated diagnosis, point-of-care and quantitative canine pancreas-specific lipase (cPL) results and consistent ultrasonographic features. Diagnostic performance of DGGR lipase was assessed by receiver-operating characteristic curve analysis, agreement by Cohen's kappa (κ) and prognostic value by multiple regression analysis. RESULTS Median DGGR lipase activity was significantly (P < 0.001) higher in dogs with suspected acute pancreatitis [93.7 (range, 11.0-2853.0) U/L (n = 158)] compared to those with no evidence of pancreatitis [range, 20.9 (6.7-89.0) U/L (n = 356)]. A DGGR lipase activity >42.15 U/L had the best combined diagnostic sensitivity (81.0%) and specificity (92.1%). Previously established cut-offs (>130 and >80 U/L) had sensitivities of 40.5 and 43.0%, and specificities of 100 and 99.7%, respectively. There was near perfect (κ = 0.821) and substantial (κ = 0.751) agreement between DGGR lipase activity >42.15 U/L and quantitative cPL concentrations ≥200 and ≥400 μg/L, respectively. DGGR lipase activity but not quantitative cPL concentration was statistically (P = 0.043, odds ratio = 0.999) predictive of discharge but clinical utility is questionable. CLINICAL SIGNIFICANCE Using DGGR lipase at the lower cut-off could provide an additional test for supporting a diagnosis of acute pancreatitis in dogs particularly if cPL results are not available. Larger studies are required to more fully assess its value in prognostication.
Collapse
Affiliation(s)
- A Hope
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin 4, Ireland
| | - E L Bailen
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin 4, Ireland
| | - R E Shiel
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin 4, Ireland
| | - C T Mooney
- Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin 4, Ireland
| |
Collapse
|
18
|
Dupont N, Jessen LR, Moberg F, Zyskind N, Lorentzen C, Bjørnvad CR. A retrospective study of 237 dogs hospitalized with suspected acute hemorrhagic diarrhea syndrome: Disease severity, treatment, and outcome. J Vet Intern Med 2021; 35:867-877. [PMID: 33638574 PMCID: PMC7995406 DOI: 10.1111/jvim.16084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 01/26/2021] [Accepted: 02/02/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Few studies have investigated management and outcome in dogs with acute hemorrhagic diarrhea syndrome (AHDS), and there is a paucity of data on dogs with concurrent signs of sepsis. OBJECTIVES To report outcome in dogs with suspected AHDS according to disease severity and antimicrobial treatment, and to evaluate effect of fluid resuscitation on clinical criteria. ANIMALS Two hundred thirty-seven dogs hospitalized with suspected AHDS. METHODS Retrospective study based on medical records. Disease severity was evaluated using AHDS index, systemic inflammatory response syndrome (SIRS) criteria, and serum C-reactive protein (CRP) according to 3 treatment groups: No, 1, or 2 antimicrobials. RESULTS Sixty-two percent received no antimicrobials, 31% received 1 antimicrobial, predominantly aminopenicillins, and 7% received 2 antimicrobials. At admission, median AHDS index was 13 (interquartile range, 11-15), which decreased significantly after the first day's hospitalization (P < .001) for all groups. Compared with no antimicrobials (7%), more dogs had ≥2 SIRS criteria in the antimicrobial groups (15% and 36%, respectively). C-reactive protein (CRP) correlated positively with AHDS index at hospitalization (P < .001). Across treatment groups, rehydration markedly reduced number of clinical SIRS criteria. Survival to discharge was 96%, lower for dogs receiving 2 antimicrobials (77%, P < .05). CONCLUSIONS AND CLINICAL IMPORTANCE The majority of dogs hospitalized with suspected AHDS improve rapidly with symptomatic treatment only, despite signs of systemic disease on initial presentation. The often-used SIRS criteria might be a poor proxy for identifying dogs with AHDS in need of antimicrobial treatment, in particular when hypovolemic. The role of CRP in clinical decision-making or prognostication warrants further investigation.
Collapse
Affiliation(s)
- Nana Dupont
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lisbeth Rem Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Frida Moberg
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nathali Zyskind
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Lorentzen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | |
Collapse
|
19
|
Kuzi S, Mazaki-Tovi M, Suchodolski JS, Rimer D, Lidbury JA, Steiner JM, Buono A, Nivy R, Segev G, Aroch I. Protease inhibitors, inflammatory markers, and their association with outcome in dogs with naturally occurring acute pancreatitis. J Vet Intern Med 2020; 34:1801-1812. [PMID: 32893923 PMCID: PMC7517856 DOI: 10.1111/jvim.15895] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/15/2020] [Accepted: 08/19/2020] [Indexed: 12/13/2022] Open
Abstract
Background Acute pancreatitis (AP) presumably is associated with pancreatic protease activation, protease inhibitor (PI) depletion, and inflammatory mediator secretion. Objectives Examine PIs and inflammatory mediator concentrations in dogs with AP and their association with death. Animals Thirty‐one dogs diagnosed with AP based on clinical signs, ultrasonographic findings, and increased canine pancreatic lipase immunoreactivity (cPLI) and 51 healthy control dogs. Methods Antithrombin and α2‐antiplasmin activity (ATA and α2AP, respectively) and concentrations of α1‐proteinase inhibitor (α1PI), α2‐macroglobulin (α2MG), C‐reactive protein (CRP), interleukins (ILs)‐2,6,8 and tumor necrosis factor‐α (TNF‐α) were prospectively measured. Severity of AP was assessed by clinical severity scoring systems. Results Mortality rate was 19%. Antithrombin activity was lower (P = .004) and maximal CRP, IL‐6, and TNF‐α concentrations higher (P < .04) in the AP group compared to the controls, whereas IL‐2, IL‐8, α1PI, and α2AP concentrations did not differ between groups. Serum α2MG concentration was not reliably detected. Serum cPLI, CRP, and IL‐6 concentrations were significantly and positively correlated. The ATA was lower (P = .04), and canine acute pancreatitis severity (CAPS) scores higher (P = .009) in nonsurvivors compared to survivors. Higher CAPS scores were associated (P < .05) with decreased ATA and increased cPLI, CRP, and IL‐6 concentrations. Conclusions and Clinical Importance Systemic inflammation in dogs with AP is manifested by increased inflammatory mediator concentrations, correlating with cPLI and CRP concentrations. Hypoantithrombinemia is associated with death. Serum concentrations of α2AP and α1PI are less useful prognostic markers. The CAPS score is a useful prognostic marker in dogs with AP.
Collapse
Affiliation(s)
- Sharon Kuzi
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Michal Mazaki-Tovi
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Dar Rimer
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Joerg M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Agostino Buono
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Ran Nivy
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Gilad Segev
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Itamar Aroch
- Department of Small Animal Internal Medicine, The Hebrew University Veterinary Teaching Hospital and Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| |
Collapse
|
20
|
El Morsy EM, Ahmed MA. Carvedilol attenuates l-arginine induced acute pancreatitis in rats through modulation of oxidative stress and inflammatory mediators. Chem Biol Interact 2020; 327:109181. [DOI: 10.1016/j.cbi.2020.109181] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 05/29/2020] [Accepted: 06/15/2020] [Indexed: 12/18/2022]
|
21
|
Gori E, Pierini A, Lippi I, Ceccherini G, Perondi F, Marchetti V. Evaluation of C-reactive protein/albumin ratio and its relationship with survival in dogs with acute pancreatitis. N Z Vet J 2020; 68:345-348. [PMID: 32539626 DOI: 10.1080/00480169.2020.1780995] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aims: To evaluate the association between the C-reactive protein (CRP)/albumin (ALB) ratio and survival in dogs with acute pancreatitis and its use as a prognostic marker for survival. Methods: Medical records of a veterinary referral hospital in Italy were retrospectively searched for dogs that were admitted with acute pancreatitis between January 2015 and April 2019, in which the concentrations of CRP and ALB in serum were measured at admission. The CRP/ALB ratio was calculated and the time between admission and discharge or death was recorded. Mortality rates overall and for dogs that died within 2 days of admission were calculated. A univariable Cox proportional hazard model was used to assess the relationship between survival time and CRP/ALB ratio. Results: Seventy-one dogs were included in the study. Of these, 19 died within 2 days of presentation; an early mortality rate of 26.8%, while 27 died before discharge for an overall mortality rated of 38%. Dogs with higher CRP/ALB ratio had a significantly greater mortality rate than dogs with lower CRP/ALB ratio: for every 1-unit increase in CRP/ALB ratio, the hazard of death over the study period increased by 130% (hazard ratio = 2.34; 95% CI = 1.53-3.58; p < 0.001). The optimal CRP/ALB ratio cut-off point for predicting mortality was 0.56, with a sensitivity and specificity of 88.9% and 68.2%, respectively (AUC = 0.82; p < 0.001). Conclusions: As in humans, the CRP/ALB ratio, may be a promising, though not particularly specific, prognostic marker for increased risk of death in dogs with acute pancreatitis.
Collapse
Affiliation(s)
- E Gori
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Italy
| | - A Pierini
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Italy
| | - I Lippi
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Italy
| | - G Ceccherini
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Italy
| | - F Perondi
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Italy
| | - V Marchetti
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Italy
| |
Collapse
|
22
|
Hindenberg S, Bauer N, Moritz A. Extremely high canine C-reactive protein concentrations > 100 mg/l - prevalence, etiology and prognostic significance. BMC Vet Res 2020; 16:147. [PMID: 32434519 PMCID: PMC7237877 DOI: 10.1186/s12917-020-02367-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/10/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In human medicine, extremely high CRP (C-reactive protein) concentrations > 100 mg/l are indicators of bacterial infection and the need of antibiotic treatment. Similar decision limits for septic pneumonia are recommended for dogs but have not yet been evaluated for other organ systems. The aim of the retrospective study was to investigate the prevalence and evaluate dogs with CRP concentrations > 100 mg/l regarding the underlying etiology, the affected organ system and the prognostic significance. RESULTS Prevalence of CRP > 100 mg/l was investigated in dogs presented between 2014 and 2015 and was 12%. For evaluation of etiology and organ systems, dogs with CRP > 100 mg/l presented between 2014 and 2016 were enrolled. Dogs were classified into 4 main disease categories, i.e. inflammatory, neoplastic, tissue damage or "diverse". Diseases were assigned to the affected organ system. If an organ classification was not possible, dogs were classified as "multiple". 147 dogs with CRP 101-368 mg/l were included and classified into disease categories: 86/147 (59%) with inflammatory etiology (among these, 23/86 non-infectious, 44/86 infectious (33/44 bacterial), 19/86 inflammation non-classifiable), 31/147 (21%) tissue damage, 17/147 (12%) neoplastic (all malignant) and 13/147 (9%) diverse diseases. The affected organ systems included 57/147 (39%) multiple, 30/147 (20%) trauma, 21/147 (14%) gastrointestinal tract, 10/147 (7%) musculoskeletal system, 8/147 (5%) respiratory tract, 7/147 (5%) urinary/reproductive tract, 6/147 (4%) skin/subcutis/ear, 6/147 (4%) central/peripheral nervous system and 2/147 (1%) heart. The disease group (p = 0.081) or organ system (p = 0.17) did not have an impact on CRP. Based on CRP, a detection of bacterial infection was not possible. The prognostic significance was investigated by determining the 3-months survival and hospitalization rate in a subgroup with known outcome. The 3-months survival rate was 46/73 (63%) while the majority 66/73 (90%) of patients was hospitalized. CONCLUSIONS CRP concentrations > 100 mg/l are occasionally seen in a clinic population. They indicate a severe systemic disease of various etiologies with guarded prognosis. Extremely high CRP concentrations do not allow a conclusion of the underlying etiology or an identification of bacterial inflammation.
Collapse
Affiliation(s)
- Sarah Hindenberg
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig-University Giessen, Frankfurter Str. 114, 35392, Giessen, Germany.
| | - Natali Bauer
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig-University Giessen, Frankfurter Str. 114, 35392, Giessen, Germany
| | - Andreas Moritz
- Department of Veterinary Clinical Sciences, Clinical Pathology and Clinical Pathophysiology, Justus-Liebig-University Giessen, Frankfurter Str. 114, 35392, Giessen, Germany
| |
Collapse
|
23
|
Cridge H, Mackin AJ, Lidbury JA, Suchodolski JS, Steiner JM. Comparative repeatability of pancreatic lipase assays in the commercial and in-house laboratory environments. J Vet Intern Med 2020; 34:1150-1156. [PMID: 32249988 PMCID: PMC7255685 DOI: 10.1111/jvim.15763] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/13/2020] [Indexed: 12/28/2022] Open
Abstract
Background Sensitivity and specificity for commercial and in‐house pancreatic lipase immunoreactivity (cPLI) assays have been reported, but repeatability under routine clinical conditions is unknown. Objectives To determine:Coefficient of variation (CV) between replicates of a commercial assay (Spec cPL) and 2 in‐house assays (VetScan cPL, Vcheck cPL) under routine conditions. Effects of sample condition or personnel on results. Potential directional bias between assays.
Animals Serum from 12 canine clinical patients. Methods Prospective study. Serum Spec cPL, VetScan cPL, and Vcheck cPL (6 aliquots each) were measured, and CVs were calculated, effects of sample condition and personnel were assessed using a linear mixed model, and direction of bias was assessed using least square mean cPLI concentration. Results Mean %CVs for Spec cPL, VetScan cPL, and Vcheck cPL were 5.5, 17.0, and 23.7%. Three of 6 VetScan cPL samples and 5/9 Vcheck cPL samples had an unacceptably high %CV (>20%). Transportation (Spec cPL) and sample condition or personnel (VetScan cPL, Vcheck cPL) did not affect repeatability. Least square mean cPL was higher for Spec cPL (807.9 μg/L) than for VetScan cPL (558.5 μg/L) or Vcheck cPL (399.8 μg/L). Conclusions and Clinical Importance For clinical use, the commercial Spec cPL has the highest repeatability, and Vcheck cPL has significantly lower repeatability. Both in‐house assays evaluated may provide discrepant categorical results (“pancreatitis” versus “equivocal” versus “not pancreatitis”) for the same sample. In‐house pancreatic lipase concentrations may be lower than those determined by the Spec cPL assay.
Collapse
Affiliation(s)
- Harry Cridge
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Andrew J Mackin
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| |
Collapse
|
24
|
Kim H, Kim HJ, Kang JH, Kang BT, Yang MP. Evaluation of serum C-reactive protein and high mobility group box 1 concentrations in 22 dogs with acute pancreatitis: a pilot study. Vet Q 2020; 39:122-130. [PMID: 31401946 PMCID: PMC6830977 DOI: 10.1080/01652176.2019.1655178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: High mobility group box 1 (HMGB1) is an important mediator of systemic inflammatory response syndrome (SIRS) in humans with severe acute pancreatitis (AP), but there is little information regarding its role in dogs. Aim: To compare the serum concentrations of C-reactive protein (CRP) and HMGB1 in healthy dogs and those with AP with or without SIRS. Methods: The study included 22 dogs with AP and 20 healthy dogs. CRP and HMGB1 were assessed by ELISA. Statistical analyses were conducted by non-parametric tests. Results: Median (interquartile range) serum CRP and HMGB1 concentrations were significantly (P < 0.05) higher in dogs with AP [60.56 (14.50-140.10) µg/mL and 0.35 (0.03-1.12) ng/mL, respectively] than in healthy dogs [2.23 (1.75-5.14) µg/mL and 0.02 (0.01-0.05) ng/mL, respectively]. After the recommended treatments for AP, serum CRP concentration in AP dogs significantly decreased, but that of HMGB1 in AP dogs significantly increased. There was also a significant difference in median serum HMGB1 concentration between AP dogs with and without SIRS. The use of serum HMGB1 concentration of 0.35 ng/mL to distinguish AP dogs with and without SIRS was associated with a sensitivity of 87.5% and a specificity of 71.5%. A positive correlation was identified between HMGB1 and clinical severity of AP. All AP dogs had a positive outcome during hospitalization [6.0 (1.5-6.0) days]. Conclusion: Results indicate that HMGB1 might be a useful biomarker for the progression of AP and may play a role in progression of AP into SIRS in dogs.
Collapse
Affiliation(s)
- Hakhyun Kim
- Veterinary Medical Center and College of Veterinary Medicine, Chungbuk National University , Cheongju , Chungbuk , Republic of Korea
| | - Hyung-Jin Kim
- Veterinary Medical Center and College of Veterinary Medicine, Chungbuk National University , Cheongju , Chungbuk , Republic of Korea
| | - Ji-Houn Kang
- Veterinary Medical Center and College of Veterinary Medicine, Chungbuk National University , Cheongju , Chungbuk , Republic of Korea
| | - Byeong-Teck Kang
- Veterinary Medical Center and College of Veterinary Medicine, Chungbuk National University , Cheongju , Chungbuk , Republic of Korea
| | - Mhan-Pyo Yang
- Veterinary Medical Center and College of Veterinary Medicine, Chungbuk National University , Cheongju , Chungbuk , Republic of Korea
| |
Collapse
|
25
|
Yoon JS, Kim S, Kang JH, Park J, Yu D. Alterations in serum protein electrophoresis profiles during the acute phase response in dogs with acute pancreatitis. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2020; 84:74-78. [PMID: 31949331 PMCID: PMC6923814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/19/2019] [Indexed: 06/10/2023]
Abstract
The quantification of serum proteins is a useful tool for diagnosing and monitoring various diseases that involve changes in the concentrations of these proteins. As canine acute pancreatitis (AP) accompanies the systemic inflammatory response syndrome, serum proteins such as C-reactive protein (CRP) have been used as inflammatory markers for dogs with AP. The goal of this study was to investigate the overall profiles of serum proteins by serum protein electrophoresis (SPE) and to determine the concentration of acute phase proteins (APPs) in dogs with AP in order to better understand serum protein profiles as diagnostic markers in these dogs. Decreased levels of albumin and increased levels of alpha-2 globulin were observed in dogs with AP by SPE. Among APPs, elevated concentrations of CRP, serum amyloid A (SAA), and haptoglobin were detected. The concentration of SAA was positively correlated with that of CRP, which suggests that SAA could be a sensitive marker of inflammation in dogs with AP, similar to CRP.
Collapse
|
26
|
Kuzi S, Mazor R, Segev G, Nivy R, Mazaki-Tovi M, Chen H, Rimer D, Duneyevitz A, Yas E, Lavy E, Aroch I. Prognostic markers and assessment of a previously published clinical severity index in 109 hospitalised dogs with acute presentation of pancreatitis. Vet Rec 2019; 187:e13. [PMID: 31662578 DOI: 10.1136/vr.105364] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Acute pancreatitis (AP) is common in dogs. Nevertheless, validated clinical severity index (CSI) scoring systems to assess severity and guide treatment in current, large-scale studies are unavailable. METHODS This is a retrospective study including 109 dogs. Pancreatitis was diagnosed based on clinical signs, abdominal sonographic evidence, positive pancreatic lipase assays and experts' assessment consensus. RESULTS The survival rate was 75 per cent (82 dogs). Azotaemia and presence of local complications (ie, ascites) and secondary complications (ie, acute kidney injury and acute respiratory distress syndrome) were significantly associated with death. In agreement with the previously published CSI, respiratory anomalies were significantly associated with death. However, in disagreement with that study, high scores in the kidney and local abdominal complication categories and the sum of scores of all nine categories, but not high gastrointestinal category score, were also significantly associated with death. A final CSI score of at least 4 was associated with death. CONCLUSIONS This study has validated a nine-category CSI, proven a useful assessment tool in dogs with AP. Several previously reported and novel prognostic markers were assessed.
Collapse
Affiliation(s)
- Sharon Kuzi
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Reut Mazor
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Gilad Segev
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Ran Nivy
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Michal Mazaki-Tovi
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Hilla Chen
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Dar Rimer
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Asia Duneyevitz
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Einat Yas
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Eran Lavy
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| | - Itamar Aroch
- Internal Medicine, Hebrew University of Jerusalem Koret School of Veterinary Medicine, Rehovot, Israel
| |
Collapse
|
27
|
Yuki M, Aoyama R, Hirano T, Tawada R, Ogawa M, Naitoh E, Kainuma D, Nagata N. Investigation of serum cortisol concentration as a potential prognostic marker in hospitalized dogs: a prospective observational study in a primary care animal hospital. BMC Vet Res 2019; 15:170. [PMID: 31126272 PMCID: PMC6534851 DOI: 10.1186/s12917-019-1919-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 05/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dogs with various medical diseases are usually treated at hospitals; however, the prognostic markers in dogs remain unknown. The aim of this study was to investigate the ability of serum cortisol concentration (SCC) to predict the prognosis of dogs with medical diseases. At 0 and 24 h after hospitalization, the neutrophil count, lymphocyte count, blood glucose concentration, and SCC were measured. Survival for 30 days from the time of hospitalization was investigated, and the dogs were divided into a survivor group and a non-survivor group. RESULTS The neutrophil count at 24 h, SCC at 24 h, increase in SCC from 0 to 24 h (Inc-SCC), and the rate of increase in SCC from 0 to 24 h (R-Inc-SCC) were significantly higher in the non-survivor group than in the survivor group. The area under the receiver operating characteristic (ROC) curve values for the neutrophil count at 24 h, SCC at 24 h, Inc-SCC, and R-Inc-SCC were 0.695, 0.72, 0.63, and 0.66, respectively. Using the highest area under the ROC curve value, the sensitivity and specificity of SCC at a cutoff level of 6.6 μg/dL for predicting mortality were 89.5 and 61.9%, respectively. Moreover, the Kaplan-Meier curves confirmed the significant prognostic influence of SCC at 24 h. CONCLUSIONS SCC as a marker of stress is a useful biomarker for predicting the prognosis of dogs with medical diseases requiring hospital treatment.
Collapse
Affiliation(s)
- Masashi Yuki
- Yuki Animal Hospital, 2-99 Kiba-cho, Minato-ku, Aichi, Japan.
| | - Reina Aoyama
- Yuki Animal Hospital, 2-99 Kiba-cho, Minato-ku, Aichi, Japan
| | - Takashi Hirano
- Yuki Animal Hospital, 2-99 Kiba-cho, Minato-ku, Aichi, Japan
| | - Reina Tawada
- Yuki Animal Hospital, 2-99 Kiba-cho, Minato-ku, Aichi, Japan
| | - Mizuho Ogawa
- Yuki Animal Hospital, 2-99 Kiba-cho, Minato-ku, Aichi, Japan
| | - Eiji Naitoh
- Yuki Animal Hospital, 2-99 Kiba-cho, Minato-ku, Aichi, Japan
| | - Daiki Kainuma
- Yuki Animal Hospital, 2-99 Kiba-cho, Minato-ku, Aichi, Japan
| | - Noriyuki Nagata
- Yuki Animal Hospital, 2-99 Kiba-cho, Minato-ku, Aichi, Japan
| |
Collapse
|
28
|
Okanishi H, Nagata T, Nakane S, Watari T. Comparison of initial treatment with and without corticosteroids for suspected acute pancreatitis in dogs. J Small Anim Pract 2019; 60:298-304. [PMID: 30868606 DOI: 10.1111/jsap.12994] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/21/2019] [Accepted: 01/25/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To compare initial treatment with and without corticosteroids for acute pancreatitis in dogs and investigate the therapeutic efficacy and prognosis. MATERIALS AND METHODS Sixty-five dogs were included in this non-blinded, non-randomised clinical study. Dogs with acute pancreatitis received treatment either with dose of 1 mg/kg/day prednisolone (n=45) or without prednisolone (n=20). Response to treatment was based on changes in the C-reactive protein concentration, improvement in clinical signs, duration of hospitalisation, mortality and recurrence rate. RESULTS From the third day of hospitalisation, C-reactive protein concentration was significantly lower in the prednisolone group than that in the non-prednisolone group. The number of days required to reach a C-reactive protein concentration of <2 mg/dL and clinical score of ≤2 was significantly lower in the prednisolone group. The mortality rate 1 month after discharge was significantly lower in the prednisolone group (11.3% versus 46.1%). CLINICAL SIGNIFICANCE In dogs with acute pancreatitis, initial treatment with prednisolone resulted in earlier reductions in C-reactive protein concentration and earlier improvement of clinical signs.
Collapse
Affiliation(s)
- H Okanishi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Medicine, Faculty of Bioresource Sciences, Nihon University, Fujisawa, 252-0880, Japan.,Nakane Animal Hospital, Tokyo, 115-0045, Japan
| | - T Nagata
- Nakane Animal Hospital, Tokyo, 115-0045, Japan
| | - S Nakane
- Nakane Animal Hospital, Tokyo, 115-0045, Japan
| | - T Watari
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Medicine, Faculty of Bioresource Sciences, Nihon University, Fujisawa, 252-0880, Japan
| |
Collapse
|
29
|
Hall H, Valls Sànchez F, Gardini A, Corbetta D, Florey J. Cerebellar ischaemic infarct: a rare complication of pancreatitis. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Harriet Hall
- Internal MedicineDick White ReferralsSix Mile BottomUK
- School of Veterinary Medicine and ScienceUniversity of NottinghamLeicestershireUK
| | | | | | - Davide Corbetta
- School of Veterinary Medicine and ScienceUniversity of NottinghamLeicestershireUK
| | - Jess Florey
- Internal MedicineDick White ReferralsSix Mile BottomUK
| |
Collapse
|
30
|
Fabrès V, Dossin O, Reif C, Campos M, Freiche V, Maurey C, Pilot-Storck F, Desquilbet L, Benchekroun G. Development and validation of a novel clinical scoring system for short-term prediction of death in dogs with acute pancreatitis. J Vet Intern Med 2019; 33:499-507. [PMID: 30770578 PMCID: PMC6430934 DOI: 10.1111/jvim.15421] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 01/08/2019] [Indexed: 12/13/2022] Open
Abstract
Background Acute pancreatitis (AP) is associated with a high death rate in dogs, but accurate predictors of early death are still lacking. Objectives To develop a scoring system for prediction of short‐term case fatality in dogs with AP. Animals One hundred sixty‐nine dogs with AP including 138 dogs in the training cohort and 31 dogs in the validation cohort. Methods Multicenter, retrospective cohort study. Survival analysis was used to assess the associations with short‐term death (within 30 days after admission). Independent predictors of death were identified by a stepwise selection method and used for the score calculation. Results Death rate within 30 days after admission was 33% in the training cohort. Four independent risk factors for short‐term death were identified in the training cohort: presence of systemic inflammatory response syndrome, coagulation disorders, increased creatinine and ionized hypocalcemia. Canine Acute Pancreatitis Severity (CAPS) score was developed to predict short‐term death, integrating these 4 factors in a weighted way. A simplified version of CAPS score (sCAPS) including respiratory rate instead of SIRS was also assessed. The area under the receiver‐operating characteristic curve (AUC) of CAPS and sCAPS scores was 0.92 in the training cohort with an optimal cutoff of 11 (sensitivity, 89%; specificity, 90%) and 6 (sensitivity, 96%; specificity, 77%), respectively. CAPS and sCAPS score were validated in the validation cohort with respective AUC of 0.91 and 0.96. Conclusions and Clinical Importance We propose 2 scoring systems that allow early and accurate prediction of short‐term death in dogs with AP.
Collapse
Affiliation(s)
- Virginie Fabrès
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Olivier Dossin
- Department of Clinical Sciences, Université de Toulouse ENVT, Toulouse, France.,IRSD, Université de Toulouse INSERM, INRA, ENVT, UPS, Toulouse, France
| | - Clémence Reif
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Miguel Campos
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,Division of Small Animal Internal Medicine, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland.,U955 - IMRB, Team 10 - Biology of the neuromuscular system, Inserm, UPEC, Ecole nationale vétérinaire d'Alfort, Maisons-Alfort, France
| | - Valerie Freiche
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Christelle Maurey
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Fanny Pilot-Storck
- U955 - IMRB, Team 10 - Biology of the neuromuscular system, Inserm, UPEC, Ecole nationale vétérinaire d'Alfort, Maisons-Alfort, France
| | - Loïc Desquilbet
- U955 - IMRB, Team 10 - Biology of the neuromuscular system, Inserm, UPEC, Ecole nationale vétérinaire d'Alfort, Maisons-Alfort, France.,Department of Biostatistic and Epidemiology, Ecole nationale vétérinaire d'Alfort, Maisons-Alfort, France
| | - Ghita Benchekroun
- Department of Internal Medicine, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,U955 - IMRB, Team 10 - Biology of the neuromuscular system, Inserm, UPEC, Ecole nationale vétérinaire d'Alfort, Maisons-Alfort, France
| |
Collapse
|
31
|
Sharp CR, Goggs R, Blais MC, Brainard BM, Chan DL, deLaforcade AM, Rozanski E. Clinical application of the American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines to small animal cases. J Vet Emerg Crit Care (San Antonio) 2019; 29:121-131. [PMID: 30729652 DOI: 10.1111/vec.12804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/27/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To illustrate the application of the Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines to the management of dogs and cats at risk of developing thrombosis using a case-based approach. ETIOLOGY Dogs and cats become at risk of developing thrombosis from a wide range of conditions. These conditions often involve a specific insult followed by an inflammatory response and when combined with other contributing factors (eg, hypercoagulability, vascular endothelial injury, hemodynamic changes) create favorable conditions for thrombosis. DIAGNOSIS Development of thrombosis in small animals remains challenging to demonstrate. Compatible clinical signs, the presence of known risk factors, and supporting diagnostic tests may be highly suggestive of the development of thrombosis. THERAPY Therapeutic recommendations in accordance with the CURATIVE guidelines for dogs and cats are described in specific case vignettes presented. Discussion is centered on antithrombotic drug choices and dosing protocols, as outlined in Domains 2 and 3 of the CURATIVE guidelines. Where appropriate, guidelines related to therapeutic monitoring (Domain 4) and discontinuation of antithrombotics (Domain 5) were included. PROGNOSIS In small animals at risk of developing thrombosis, overall prognosis may be improved by following consensus-based recommendations on the use of antithrombotics as outlined in the CURATIVE guidelines. Whether such interventions have any impact on outcome requires further investigation.
Collapse
Affiliation(s)
- Claire R Sharp
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University, Murdoch, Australia
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY
| | - Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA
| | - Daniel L Chan
- Department Clinical Science and Services, The Royal Veterinary College, North Mymms, UK
| | - Armelle M deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| |
Collapse
|
32
|
Wang Y, Li L. Predicative values of C-reactive protein for the therapeutic effects of ulinastatin combined with somatostatin in severe acute pancreatitis and for the severity of gastrointestinal failure. Exp Ther Med 2018; 16:3165-3171. [PMID: 30233671 DOI: 10.3892/etm.2018.6577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 02/02/2018] [Indexed: 02/02/2023] Open
Abstract
Severe acute pancreatitis (SAP) is a serious systemic disease with high mortality. Ulinastatin is a drug widely used for patients with SAP and multiple organ failure syndrome. The present study aimed to investigate the capacity of the serum C-reactive protein (CRP) levels to predict the therapeutic effects of ulinastatin combined with somatostatin as well as determine the severity of SAP. SAP patients were treated with ulinastatin combined with somatostatin and serum CRP levels were measured. The computed tomography severity index (CTSI), acute physiology and chronic health evaluation II (APACHE II) and gastrointestinal failure scores were used to determine the therapeutic effects. All patients were assigned to the effective group and the ineffective group. Receiver operating characteristic curve analysis was performed to determine the sensitivity and specificity of CRP levels in predicting the severity of SAP and patient prognosis. Logistic regression analysis was adopted to investigate the factors influencing the therapeutic effects. Prior to and after treatment, serum CRP levels in patients of the effective and ineffective groups were significantly different. After treatment, serum CRP levels in patients of the effective group exhibited a more obvious reduction. The sensitivity and specificity of serum CRP levels in predicting the therapeutic effects of ulinastatin combined with somatostatin in SAP patients upon hospital admission were 0.813 and 0.934, respectively. Serum CRP levels were positively correlated with APACHE II, CTSI and gastrointestinal failure scores of SAP patients. The logistic regression demonstrated that serum albumin, creatinine and CRP levels on admission were factors influencing the therapeutic effects of ulinastatin combined with somatostatin in SAP patients. These results indicate that serum CRP levels may have a predictive value regarding the therapeutic effects of ulinastatin combined with somatostatin and are an indicator of the severity of gastrointestinal failure in SAP.
Collapse
Affiliation(s)
- Yinjia Wang
- Intensive Care Unit, The First People's Hospital of Kunming, Kunming, Yunnan 650224, P.R. China
| | - Li Li
- Intensive Care Unit, The First People's Hospital of Kunming, Kunming, Yunnan 650224, P.R. China
| |
Collapse
|
33
|
Bennike TB, Bellin MD, Xuan Y, Stensballe A, Møller FT, Beilman GJ, Levy O, Cruz-Monserrate Z, Andersen V, Steen J, Conwell DL, Steen H. A Cost-Effective High-Throughput Plasma and Serum Proteomics Workflow Enables Mapping of the Molecular Impact of Total Pancreatectomy with Islet Autotransplantation. J Proteome Res 2018; 17:1983-1992. [PMID: 29641209 DOI: 10.1021/acs.jproteome.8b00111] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Blood is an ideal body fluid for the discovery or monitoring of diagnostic and prognostic protein biomarkers. However, discovering robust biomarkers requires the analysis of large numbers of samples to appropriately represent interindividual variability. To address this analytical challenge, we established a high-throughput and cost-effective proteomics workflow for accurate and comprehensive proteomics at an analytical depth applicable for clinical studies. For validation, we processed 1 μL each from 62 plasma samples in 96-well plates and analyzed the product by quantitative data-independent acquisition liquid chromatography/mass spectrometry; the data were queried using feature quantification with Spectronaut. To show the applicability of our workflow to serum, we analyzed a unique set of samples from 48 chronic pancreatitis patients, pre and post total pancreatectomy with islet autotransplantation (TPIAT) surgery. We identified 16 serum proteins with statistically significant abundance alterations, which represent a molecular signature distinct from that of chronic pancreatitis. In summary, we established a cost-efficient high-throughput workflow for comprehensive proteomics using PVDF-membrane-based digestion that is robust, automatable, and applicable to small plasma and serum volumes, e.g., finger stick. Application of this plasma/serum proteomics workflow resulted in the first mapping of the molecular implications of TPIAT on the serum proteome.
Collapse
Affiliation(s)
- Tue Bjerg Bennike
- Department of Pathology , Harvard Medical School , Boston , Massachusetts , United States.,Department of Pathology , Boston Children's Hospital , Boston , Massachusetts , United States.,Precision Vaccines Program , Boston Children's Hospital , Boston , Massachusetts , United States.,Department of Health Science and Technology , Aalborg University , Aalborg , Denmark
| | - Melena D Bellin
- Department of Surgery , University of Minnesota Medical Center , Minneapolis , Minnesota , United States.,Department of Pediatrics , University of Minnesota Medical Center , Minneapolis , Minnesota , United States
| | - Yue Xuan
- Thermo Fisher Scientific , Bremen , Germany
| | - Allan Stensballe
- Department of Health Science and Technology , Aalborg University , Aalborg , Denmark
| | | | - Gregory J Beilman
- Department of Surgery , University of Minnesota Medical Center , Minneapolis , Minnesota , United States
| | - Ofer Levy
- Precision Vaccines Program , Boston Children's Hospital , Boston , Massachusetts , United States.,Division of Infectious Diseases, Department of Medicine , Boston Children's Hospital , Boston , Massachusetts , United States
| | - Zobeida Cruz-Monserrate
- Division of Gastroenterology, Hepatology and Nutrition , The Ohio State University Wexner Medical Center , Columbus , Ohio United States
| | - Vibeke Andersen
- Focused Research Unit for Molecular Diagnostic and Clinical Research (MOK), IRS-Center Sonderjylland , Hospital of Southern Jutland , Aabenraa , Denmark.,Institute of Molecular Medicine , University of Southern Denmark , Odense , Denmark
| | - Judith Steen
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, and Department of Neurology , Harvard Medical School , Boston , Massachusetts , United States
| | - Darwin L Conwell
- Division of Gastroenterology, Hepatology and Nutrition , The Ohio State University Wexner Medical Center , Columbus , Ohio United States
| | - Hanno Steen
- Department of Pathology , Harvard Medical School , Boston , Massachusetts , United States.,Department of Pathology , Boston Children's Hospital , Boston , Massachusetts , United States.,Precision Vaccines Program , Boston Children's Hospital , Boston , Massachusetts , United States
| |
Collapse
|
34
|
Raghu C, Ekena J, Cullen JM, Webb CB, Trepanier LA. Evaluation of potential serum biomarkers of hepatic fibrosis and necroinflammatory activity in dogs with liver disease. J Vet Intern Med 2018; 32:1009-1018. [PMID: 29485210 PMCID: PMC5980386 DOI: 10.1111/jvim.15064] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/08/2018] [Accepted: 01/16/2018] [Indexed: 02/06/2023] Open
Abstract
Background Serum interleukin 6 (IL‐6), chemokine ligand 2 (CCL2), C‐reactive protein (CRP), and the ratio of aspartate transaminase to alanine transaminase (AST:ALT) have been correlated with fibrosis and necroinflammatory activity in humans with various hepatopathies. Hypothesis/Objectives To determine whether increases in serum IL‐6, CCL2, CRP, or AST:ALT were associated with moderate to severe fibrosis or necroinflammatory activity in dogs with various hepatopathies. Animals Forty‐four client‐owned dogs with clinical evidence of liver disease and 10 healthy purpose‐bred dogs, all undergoing liver biopsies by laparoscopy or laparotomy. Methods Measurement of serum IL‐6, CCL2, CRP, AST, and ALT before scheduled liver biopsy and evaluation of liver histopathology using the METAVIR scoring system used in human medicine, blinded to clinical presentation. Results Median serum IL‐6 was approximately twice as high in dogs with high fibrosis scores (15.5 pg/mL; range, 1.4 to 235 pg/mL) compared to dogs with low fibrosis scores (7.6 pg/mL; range, 1.4 to 148.1 pg/mL), with marginal significance (P = .05). Median serum CCL2 was significantly higher in dogs with active necroinflammation (444 pg/mL; range, 144 to 896 pg/mL) compared to dogs without detectable necroinflammation (326 pg/mL; range, 59 to 1692 pg/mL; P = .008), but with considerable overlap between groups. Neither serum CRP nor AST:ALT ratios were significantly different based on fibrosis or necroinflammatory scores. Conclusions and Clinical Importance Because of substantial variability among dogs, single measurements of IL‐6 and CCL2 have limited diagnostic utility for identifying fibrosis or necroinflammation, respectively, in dogs with various chronic liver diseases. The value of these biomarkers should be explored further in monitoring response to treatment in individual dogs with chronic hepatopathies.
Collapse
Affiliation(s)
- Chantel Raghu
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Joanne Ekena
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - John M Cullen
- Department of Public Health and Pathobiology, North Carolina State University, College of Veterinary Medicine, Raleigh, North Carolina
| | - Craig B Webb
- Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Lauren A Trepanier
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| |
Collapse
|