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Paul BR, Kumar De U, Sarkar VK, Gandhar JS, Patra MK, Singh MK, Soni S, Eregowda CG. Prognostic Potential of Thrombocyte Indices, Acute Phase Proteins, Electrolytes and Acid-Base Markers in Canine Parvovirus Infected Dogs With Systemic Inflammatory Response Syndrome. Top Companion Anim Med 2023; 56-57:100803. [PMID: 37598980 DOI: 10.1016/j.tcam.2023.100803] [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: 12/18/2022] [Revised: 07/07/2023] [Accepted: 08/14/2023] [Indexed: 08/22/2023]
Abstract
Dogs with canine parvovirus enteritis (CPVE) that develop systemic inflammatory response syndrome (SIRS) frequently have a poor prognosis. The aim of the study was to assess the prognostic potential of thrombocyte indices, acute phase proteins, electrolytes, and acid-base markers in CPVE puppies with SIRS (CPVE-SIRS+) at admission. A case-controlled, prospective, and observational study was performed on 36 CPVE puppies. Mean concentrations of C-reactive protein (CRP), albumin, thrombocyte count, mean platelet volume (MPV), platelet distribution width (PDW), sodium (Na+), potassium (K+), chloride (Cl-) and ionized calcium (iCa) were measured and strong ion difference 3 (SID3), ATOT-albumin and ATOT-total protein were determined in CPVE-SIRS+ survivors and nonsurvivors. A prognostic cut-off value for predicting the disease outcome was determined by receiver operating characteristic (ROC) curve analysis. The mean values of MPV, PDW and CRP were significantly higher and the mean values of albumin, Cl- and ATOT-albumin were significantly lower in CPVE-SIRS+ nonsurvivor than CPVE-SIRS+ survivor puppies on the day of admission, but the thrombocyte count, Na+, K+, iCa, SID3 and ATOT- total protein values did not differ significantly. The positive predictive values (PPVs) for survival using cut-off value of MPV (≤15.08 fL), PDW (≤14.85%), CRP (≤180.7 mg/L), albumin (≥1.795 g/dL), Cl- (≥96.00 mmol/L), and ATOT-albumin (≥7.539) were determined as 100%, 100%, 100%, 80%, 100%, and 80%, respectively with better area under ROC curve and sensitivity. Based on sensitivity, specificity, and PPVs from ROC analysis, it is concluded that the determination of Cl- concentration and MPV at admission followed by CRP will serve as the most appropriate biomarkers in predicting the disease outcome of CPVE puppies that develop SIRS.
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Affiliation(s)
- Babul Rudra Paul
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India
| | - Ujjwal Kumar De
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India.
| | - Varun Kumar Sarkar
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India
| | - Jitendra Singh Gandhar
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India
| | - Manas Kumar Patra
- Livestock Production and Management Section, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India
| | - Mithilesh Kumar Singh
- Immunology Section, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India
| | - Srishti Soni
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India
| | - Chethan Gollahalli Eregowda
- Department of Veterinary Medicine, College of Veterinary Sciences and Animal Husbandry, Selesih, Aizawl, Mizoram, India
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Paul BR, De UK, Sarkar VK, Gandhar JS, Patra MK, Agrawal RK, Singh MK, Soni S, Eregowda CG. Effect of systemic inflammatory response syndrome on thrombocytogram, acute phase proteins, electrolytes, acid-base indices and cytokine expression in naturally canine parvovirus infected dogs. Vet Immunol Immunopathol 2023; 259:110598. [PMID: 37119726 DOI: 10.1016/j.vetimm.2023.110598] [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: 02/18/2023] [Revised: 04/03/2023] [Accepted: 04/22/2023] [Indexed: 05/01/2023]
Abstract
Systemic inflammatory response syndrome (SIRS) in canine parvoviral enteritis (CPVE) is associated with high mortality in young puppies. Changes in acute phase response, thrombocytogram, inflammatory cytokine profiles, and disturbances in electrolyte and acid-base homeostasis are thought to have a significant impact on the development of SIRS. However, the mechanisms causing these perturbations have not been well described in CPVE puppies, especially with SIRS. The purpose of this study was to assess the changes of electrolytes, acid-base indices using strong ion model, acute phase proteins and thrombocytogram in blood and expressions of inflammatory cytokines in blood mononuclear cells of CPVE puppies with or without SIRS at admission. Additionally, the positive predictive value (PPV) and cut-off value with specificity and sensitivity of the biomarkers were determined by receiver operating characteristic (ROC) curve analysis to predict the development of SIRS in CPVE puppies at admission. A case-controlled, prospective and observational study was conducted on fifteen SIRS-positive CPVE, twenty-one SIRS-negative CPVE and six healthy puppies. Our data showed marked hyponatremia, hypokalemia, hypoalbuminemia and hypoproteinemia, decreased ATot-albumin and ATot-total protein and increased mean platelet volume (MPV), platelet distribution width (PDW) and C-reactive protein (CRP) concentration and up-regulation of TNF-α, IL-8 and IL-10 expressions in SIRS-positive CPVE puppies as compared to SIRS-negative CPVE puppies at admission. Based on sensitivity, specificity and AUC from ROC curve analysis and PPV, the CRP concentration in serum at a cut-off value of 141.9 mg/L and TLC of blood at a cut-off value of 3.355 × 103/μL were identified as potential prognostic biomarkers followed by ATot-total protein and total protein at a cut-off value of 11.80 and 4.72 g/dL, respectively to predict the development of SIRS in CPVE puppies at admission. In conclusion, the findings of the current study will help the canine practitioners to institute the time-sensitive and need based interventions to disrupt progression along the continuum of shock and multi-organ dysfunction syndrome in CPVE puppies that develop SIRS at admission.
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Affiliation(s)
- Babul R Paul
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Ujjwal K De
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India.
| | - Varun K Sarkar
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Jitendra S Gandhar
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Manas K Patra
- Livestock Production and Management Section, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Ravi K Agrawal
- Division of Biological Standardization, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Mithilesh K Singh
- Immunology Section, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Srishti Soni
- Division of Medicine, ICAR-Indian Veterinary Research Institute, Izatnagar 243122, Uttar Pradesh, India
| | - Chethan G Eregowda
- Department of Veterinary Medicine, College of Veterinary Sciences and Animal Husbandry, Selesih, Aizawl 796014, Mizoram, India
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Corda F, Ballocco I, Corda A, Mollica A, Cilano A, Polinas M, Pinna Parpaglia ML. Coagulation Abnormalities in Dogs with Parvoviral Enteritis. Vet Sci 2023; 10:vetsci10010041. [PMID: 36669042 PMCID: PMC9861196 DOI: 10.3390/vetsci10010041] [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: 11/30/2022] [Revised: 12/29/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023] Open
Abstract
Hemostatic alterations have been documented in dogs with canine parvoviral enteritis. This study's aims were to measure the standard coagulation parameters, and to assess the relationship between them and the clinical variables in dogs with canine parvoviral enteritis. Nine client-owned dogs with a canine parvoviral infection were included in a prospective, observational clinical study. Clinical score and coagulation status were assessed at admission. All nine dogs showed alterations of three or more standard coagulation variables. A correlation analysis evidenced a significantly high positive correlation between the activated partial thromboplastin time and clinical score. The present study concurs that dogs with canine parvoviral enteritis have coagulation disorders that are detectable by measuring the standard coagulation parameters.
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Burchell RK, Gal A, Friedlein R, Leisewitz AL. Role of electrolyte abnormalities and unmeasured anions in the metabolic acid-base abnormalities in dogs with parvoviral enteritis. J Vet Intern Med 2020; 34:857-866. [PMID: 32133703 PMCID: PMC7096617 DOI: 10.1111/jvim.15749] [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: 04/28/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The strong ion model (SIM) is an alternative paradigm in the characterization of acid-base disturbances particularly in complex disorders. HYPOTHESIS/OBJECTIVES To compare the acid-base changes in dogs with parvoviral enteritis (PE) using the Henderson-Hasselbalch (HH) approach, with 2 strong ion approaches. ANIMALS Forty-four dogs with PE, and 16 age-matched control dogs. METHODS Prospective controlled observational study. Acid-base status was evaluated using the HH model, Fencl-Stewart (FS) approach and a validated strong ion model (VDM). The acid-base changes according to each model were classified and compared. Statistical correlations between pH, CO2 , and various SIM variables were performed, as well as between the sum of effects (SOE) of the SIM and the individual variables comprising the SOE. RESULTS The HH model identified acid-base disorders in 31/44 cases of which 16/31 were mixed with metabolic acidosis and concurrent respiratory alkalosis the most common (10/31). Using the FS approach, metabolic changes were present 36/42 cases, with changes in free water (FW), chloride, and unmeasured anions (UA) being the most prevalent. Both FW and UA correlated well with pH; however, UA were most consistently abnormal in severe acidemia. Similarly to the HH, the VDM detected acid-base disturbances in 28/44 cases. Major contributors to the acid-base changes were hyponatremia, hypochloremia, and Atot acidosis because of elevated globulins and increased UA. CONCLUSIONS AND CLINICAL IMPORTANCE Acid-base changes are common and complex in dogs with PE, and were easier to understand using a SIM paradigm. Increases in UA have not been documented in PE in dogs.
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Affiliation(s)
- Richard K Burchell
- Veterinary and Biomedical Sciences, James Cook University, Townsville, Queensland, Australia
| | - Arnon Gal
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Ryan Friedlein
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Andrew L Leisewitz
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
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Petini M, Drigo M, Zoia A. Prognostic value of systemic inflammatory response syndrome and serum concentrations of acute phase proteins, cholesterol, and total thyroxine in cats with panleukopenia. J Vet Intern Med 2020; 34:719-724. [PMID: 31977127 PMCID: PMC7096634 DOI: 10.1111/jvim.15704] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 01/10/2020] [Indexed: 01/08/2023] Open
Abstract
Background Feline parvovirus (FPV) is a common and potentially lethal infectious agent in cats. Objective To assess the prognostic value of age, neuter status, serum concentrations of serum amyloid A (SAA), haptoglobin, cholesterol and total thyroxine (tT4), and the presence of systemic inflammatory response syndrome (SIRS) in cats with panleukopenia. Animals Client‐owned cats with FPV infection diagnosed by a positive fecal ELISA test, positive PCR on feces or blood or both. Methods Retrospective cohort study. The electronic medical database was searched for cats with FPV infection presented between January 2010 and January 2018. Cats were divided into survivors and nonsurvivors according to their survival status 28 days after hospital admission. The prognostic importance of each variable was investigated univariately and by multivariable Cox's proportional‐hazards regression. Finally, receiver operator characteristic (ROC) curve analysis was used to identify the best cutoff value for discriminating survivors from nonsurvivors for the statistically significant prognostic predictors identified by multivariable analysis. Results Seventy cats were enrolled in the study. Multivariable analysis determined that only serum tT4 concentration at hospital admission was significantly (P = .01) associated with survival. A cutoff value of 0.82 μg/dL was identified by ROC curve analysis for serum tT4 concentration in discriminating survivors from nonsurvivors. Sensitivity at this cutoff was 73.9% and specificity was 82.9% (area under the curve, 0.783; 95% confidence interval, 0.668‐0.873; P < .0001). Conclusion and Clinical Relevance Serum tT4 concentration at hospital admission has prognostic value in cats with FPV infection.
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Affiliation(s)
- Matteo Petini
- Division of Internal Medicine, San Marco Veterinary Clinic, Padua, Italy
| | - Michele Drigo
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Italy
| | - Andrea Zoia
- Division of Internal Medicine, San Marco Veterinary Clinic, Padua, Italy
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Venn EC, Barnes AJ, Hansen RJ, Boscan PL, Twedt DC, Sullivan LA. Serum D-lactate concentrations in dogs with parvoviral enteritis. J Vet Intern Med 2020; 34:691-699. [PMID: 31919893 PMCID: PMC7096611 DOI: 10.1111/jvim.15688] [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: 11/03/2018] [Accepted: 12/11/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Dogs infected with canine parvovirus (CPV) have compromised intestinal epithelial barrier integrity. Production of D-lactate by enteric bacteria may directly reflect disease severity or contribute to metabolic acid-base status in these dogs. HYPOTHESIS Serum D-lactate concentration will be increased in CPV dogs compared to healthy controls and correlate with markers of disease severity and acid-base status. ANIMALS Dogs with CPV undergoing treatment (n = 40) and healthy control dogs (n = 9). METHODS Prospective observational study. Dogs with CPV had a baseline and daily CBC, venous blood gas with serum electrolyte concentrations, composite clinical severity score, and serum D-lactate concentration performed. A single serum D-lactate measurement was obtained from healthy control dogs. RESULTS The CPV dogs had a higher D-lactate concentration (mean ± SD) of 469 ± 173 μM compared to controls, 306 ± 45 μM (P < .001). There was no difference in baseline D-lactate concentrations for CPV survivors (474 ± 28 μM), versus nonsurvivors (424 ± 116 μM; P = .70). D-lactate concentration decreased over the first 4 days of treatment (-9.6 μM/d; P = .46). Dogs hospitalized for <4 days had lower baseline D-lactate concentrations compared to those hospitalized ≥4 days (400 ± 178 μM versus 520 ± 152 μM; P = .03). No sustained correlation over time between serum D-lactate concentration and clinical severity score or recorded acid-base results. CONCLUSIONS AND CLINICAL IMPORTANCE Serum D-lactate concentrations are higher in dogs with CPV compared to healthy controls but do not appear to be clinically relevant. No relationship identified between serum D-lactate concentrations and markers of CPV disease severity, acid-base status, or outcome.
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Affiliation(s)
- Emilee C Venn
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Alex J Barnes
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Ryan J Hansen
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Pedro L Boscan
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - David C Twedt
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - Lauren A Sullivan
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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Hasuda A, Flaiban K, Lisbôa J, Gomes L, Polizelli I, Santana L. Identifying hydric, electrolytic and acid-base imbalances through traditional and quantitative approaches in dogs with hemorrhagic gastroenteritis. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Vomiting and diarrhea are two important clinical signs that can cause significant electrolytic and acid-base imbalances. The purposes of this study were to characterize hydric, electrolytic and acid-base disorders presented by puppies with hemorrhagic gastroenteritis and to compare the traditional and quantitative approaches to acid-base status interpretation. Sixty-one animals with a history of vomiting and/or diarrhea were used in this study and the following tests were performed: complete blood count, total plasma protein concentration and hemogasometry. Mean, standard deviation and Kappa values were calculated. The imbalances characterized by both approaches were: 42 (69%) animals without imbalance, 17 (28%) with metabolic alkalosis and 2 (3%) with metabolic acidosis by the traditional approach and 17 (28%) dogs without imbalance, 26 (43%) with metabolic alkalosis and 18 (29%) with metabolic acidosis by the quantitative approach. The agreement calculated between two approaches coincide in 28 cases, with a moderate Kappa value equivalent to 0.459. The most found imbalances were metabolic alkalosis, hypokalemia, and mild dehydration. Most of acid-base disturbances were not identified by the traditional approach, whereas by the quantitative approach, they were easily determined. Thus quantitative approach proved to be superior in identification of possible acid-base imbalances.
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Affiliation(s)
- A.L. Hasuda
- Universidade Estadual de Londrina, Brazil; Universidade Estadual de Londrina, Brazil
| | | | | | - L.A. Gomes
- Universidade Estadual de Londrina, Brazil
| | - I.G. Polizelli
- Universidade Estadual de Londrina, Brazil; Universidade Estadual de Londrina, Brazil
| | - L.S. Santana
- Universidade Estadual de Londrina, Brazil; Universidade Estadual de Londrina, Brazil
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Chalifoux NV, Burgess HJ, Cosford KL. The association between serial point-of-care test results and hospitalization time in canine parvovirus infection (2003-2015). THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2019; 60:725-730. [PMID: 31281189 PMCID: PMC6563894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The objectives of this study were to describe serial point-of-care test results in dogs infected with canine parvovirus (CPV), highlight clinicopathologic abnormalities at various timepoints, and investigate their association with the duration of hospitalization. Two-hundred and four dogs positive for CPV at the Western College of Veterinary Medicine between 2003 and 2015 were included. Data were recorded pertaining to emergency panel and venous blood gas tests at presentation, and every 12 hours thereafter (+/- 4 hours) for the first 72 hours of hospitalization. Common persistent abnormalities included hypoproteinemia, acidosis, hyponatremia, hypochloremia, hyperkalemia, and hyperbicarbonatemia. Ionized hypocalcemia was associated with a longer duration of hospitalization and mild hyperkalemia was associated with a shorter duration of hospitalization (P < 0.05). This study suggests that the use of point-of-care tests for in-hospital monitoring may provide insight into CPV case complexity and predict total hospitalization times.
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Affiliation(s)
- Nolan V Chalifoux
- Department of Small Animal Clinical Sciences (Chalifoux, Cosford) and the Department of Veterinary Pathology (Burgess), Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4
| | - Hilary J Burgess
- Department of Small Animal Clinical Sciences (Chalifoux, Cosford) and the Department of Veterinary Pathology (Burgess), Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4
| | - Kevin L Cosford
- Department of Small Animal Clinical Sciences (Chalifoux, Cosford) and the Department of Veterinary Pathology (Burgess), Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4
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