Serum canine pancreatic lipase immunoreactivity in experimentally induced and naturally occurring canine monocytic ehrlichiosis (Ehrlichia canis)

Evaluation of Disease Spectrum in Hospitalized Cats with Hyperlipasemia: Pancreatitis Alone Is Rare, Hyperlipasemia without Suspected Pancreatitis Is Common

Histological evidence of pancreatitis is commonly found in necropsy studies in cats. A clinical diagnosis of pancreatitis is challenging due to nonspecific clinical signs, a lack of diagnostic lipase cutoffs, and frequent presence of multiple diseases. It is still unknown how often pancreatitis alone is found in sick cats and how often clinicopathological evidence of pancreatitis in sick cats does not lead to a clinical diagnosis of pancreatitis. Our aims were to evaluate the extent of comorbidities in cats with suspected pancreatitis, evaluate how often sick cats with hyperlipasemia are diagnosed only with non-pancreatic diseases, and compare their clinical findings. Medical records of 563 client-owned hospitalized cats with available lipase activity measurement (LIPC Roche) > 30 U/L (RI, 6-26) were searched and medical diagnoses recorded and grouped by organ system. Clinicopathological findings were compared between cats with pancreatitis alone (PA), pancreatitis with concurrent disease (PD), and no suspected pancreatitis (NP). We found that PA was present in 33 (6%) cats, 159 cats (28%) were in the PD group, and 371 cats (66%) had no suspected pancreatitis (NP). Clinical, laboratory, and ultrasonographic findings did not differ between PA and PD cats. Lipase activities did not differ between the three groups. The most common disease categories in PD and NP cats were gastrointestinal, hepatobiliary, renal/urinary, and endocrine, and renal/urinary, gastrointestinal, cardiac, and musculoskeletal, respectively. We conclude that cats are rarely hospitalized because of suspected pancreatitis alone, and PA cats did not differ clinically from PD cats. Hyperlipasemia in sick cats without a diagnosis of pancreatitis may be due to a reactive pancreatopathy or preexisting chronic pancreatitis.

Immune-Mediated Hemolytic Anemia and Clinically Suspected Acute Pancreatitis in Dogs, a Pilot Study

Acute pancreatitis can be a complication of massive hemolysis, above all when intravascular in nature. Therefore, the aim of this study was to investigate the association between canine immune mediated hemolytic anemia (IMHA) and clinically suspected acute pancreatitis (CSAP) and the role of calculated free plasma hemoglobin (Hbfp) in CSAP occurrence/development. In this cohort study the records of 95 dogs with IMHA and 95 sick dogs with pathologies other than IMHA were compared for CSAP occurrence/development. At presentation, 12/95 dogs with IMHA met criteria for CSAP, while only 3/95 sick control dogs met these criteria (χ2 =1.58, P = .008). Within 7 days of hospitalization 9 additional dogs with IMHA had developed CSAP. The Hbfp was calculated and compared for dogs with IMHA that had/developed CSAP and for those without CSAP. In dogs with IMHA, a calculated Hbfp concentration ≥ 0.08 g/dL resulted in an increased relative risk (RR) of having/developing CSAP (RR = 2.54, 95% CI, 1.51-4.29; P = .003). No significant effect on short-term prognosis in dogs with IMHA was found between those having/developing CSAP and those without CSAP. This study showed that dogs with IMHA have an increased risk of having CSAP and Hbfp concentration may be involved in the pathogenesis of acute pancreatitis.

New insights into the etiology, risk factors, and pathogenesis of pancreatitis in dogs: Potential impacts on clinical practice

While most cases of pancreatitis in dogs are thought to be idiopathic, potential risk factors are identified. In this article we provide a state‐of‐the‐art overview of suspected risk factors for pancreatitis in dogs, allowing for improved awareness and detection of potential dog‐specific risk factors, which might guide the development of disease prevention strategies. Additionally, we review important advances in our understanding of the pathophysiology of pancreatitis and potential areas for therapeutic manipulation based thereof. The outcome of pathophysiologic mechanisms and the development of clinical disease is dependent on the balance between stressors and protective mechanisms, which can be evaluated using the critical threshold theory.

Accuracy of 1,2-o-Dilauryl-rac-glycero-3-glutaric Acid-(6'-methylresorufin) Ester (DGGR)-Lipase to Predict Canine Pancreas-Specific Lipase (cPL) and Diagnostic Accuracy of Both Tests for Canine Acute Pancreatitis

Different lipase assays have variable reported diagnostic accuracies for acute pancreatitis (AP) in dogs. The aims of this retrospective study were to evaluate optimal cutoffs for 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6′-methylresorufin) ester (DGGR)-lipase to predict diagnostic cutoffs of canine pancreas-specific lipase (cPL; IDEXX). DGGR-lipase activity and cPL from the same blood draw in 301 dogs with a variety of diseases were compared using Spearman’s rank correlation, Cohen’s kappa agreement, and receiver operating characteristic (ROC) curves. Activity of DGGR-lipase (10−15,616 U/L) and cPL concentrations (8.1−≥2000 µg/L) were highly correlated (rs = 0.91). Areas under the ROC curves (AUCs) to predict cPL >200 and ≥400 µg/L with DGGR-lipase were 0.97 and 0.99, with optimal cutoffs of 143 U/L (sensitivity (Se) 91.7%; specificity (Sp) 95.3%) and 205 U/L (Se 97.5%; Sp 96.4%), and Cohen’s kappa agreements of 0.87 and 0.92, respectively. AUCs for a clinical diagnosis of AP, assigned to 87/301 dogs, with DGGR-lipase (0.75) and cPL (0.76) did not differ significantly (p = 0.48); optimal cutoffs were 161 U/L for DGGR (Se 67%; Sp 81%) and 235 µg/L for cPL (Se 68%; Sp 84%). To conclude, DGGR-lipase is a highly accurate predictor of cPL with a comparable performance when used to diagnose AP in dogs.

Erythrocyte sedimentation rate, C-reactive protein, and interleukin-6 as inflammatory biomarkers in dogs naturally infected with Ehrlichia canis

Background and Aim

Canine monocytotropic ehrlichiosis (CME), a tick-borne disease, leads to a systemic inflammatory response syndrome; it is thus important to assess the intensity of inflammation in order to treat it appropriately. The current study was designed to evaluate hematological, biochemical, and inflammatory parameters in dogs naturally infected with Ehrlichia canis compared with those in healthy dogs. We also assessed the relationship among several inflammation-related parameters and considered these parameters for use as inflammatory biomarkers of CME.

Materials and Methods

Twenty-eight dogs were divided into two groups based on the results of nested polymerase chain reaction for detecting E. canis, comprising a healthy group (n=11) and an infected group (n=17). A blood sample was collected from each dog to evaluate hematological, biochemical, and inflammatory parameters, with the obtained results being statistically compared between the groups. Moreover, the correlations of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) were investigated in the 28 dogs.

Results

In the infected group, the mean levels of red blood cells, hemoglobin, and hematocrit were significantly lower than in the healthy group, while the mean lymphocyte and monocyte counts were higher. The mean levels of ESR and CRP were significantly higher (p<0.05) in the infected group, whereas no significant differences were found in IL-6 levels between the two groups. In the correlation analysis, ESR and CRP levels were highly correlated (p<0.01, r=0.531).

Conclusion

Elevated ESR and CRP levels were found in dogs naturally infected with E. canis, which also presented mild to moderate inflammation in this study. Moreover, CRP was significantly correlated with ESR, so ESR and CRP may serve as inflammatory biomarkers for monitoring CME.

Advances in the diagnosis of acute pancreatitis in dogs

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.

Hyperlipasemia in critically ill dogs with and without acute pancreatitis: Prevalence, underlying diseases, predictors, and outcome

Background

Hyperlipasemia is frequent in critically ill people without evidence of acute pancreatitis (AP), and has been associated with increased morbidity and mortality.

Objective

To evaluate the prevalence of hyperlipasemia at admission and development of hyperlipasemia during hospitalization in critically ill dogs, explore factors associated with hyperlipasemia, and evaluate association with outcome.

Animals

Critically ill, client owned dogs (n = 1360), presented on emergency and admitted to the intensive care unit, that had 1,2‐o‐dilauryl‐rac‐glycero‐3‐glutaric acid‐(6′‐methylresorufin) ester (DGGR) lipase activity measured within 24 hours of admission.

Methods

Retrospective cross‐sectional study of clinical and laboratory records.

Results

The DGGR lipase activity was increased >3× the upper reference limit at admission in 216/1360 (16%) dogs, of which 70/216 (32%) had a clinical diagnosis of AP. Other primary conditions associated with hyperlipasemia were renal, endocrine, and immune‐mediated diseases, and upper airway obstruction. Predictors of hyperlipasemia at admission were prior glucocorticoid administration, vomiting and abdominal pain, increased age, plasma bilirubin and creatinine concentrations, and decreased hematocrit. Of dogs with repeat measurements, 78/345 (23%) had significantly increased lipase during hospitalization, of which 13/78 (17%) had a clinical diagnosis of AP. Other primary conditions associated with in‐hospital hyperlipasemia were renal and immune‐mediated disorders. Predictors of developing hyperlipasemia during hospitalization were hemodialysis events, increased plasma bilirubin and creatinine concentrations, and decreased hematocrit. Hyperlipasemia both at admission and during hospitalization was associated with longer hospitalization and higher mortality.

Conclusions and Clinical Importance

Significant DGGR‐hyperlipasemia is frequent in critically ill dogs and associated with a variety of nonpancreatic conditions and negative outcome.

Microbial lipases and their industrial applications: a comprehensive review

Lipases are very versatile enzymes, and produced the attention of the several industrial processes. Lipase can be achieved from several sources, animal, vegetable, and microbiological. The uses of microbial lipase market is estimated to be USD 425.0 Million in 2018 and it is projected to reach USD 590.2 Million by 2023, growing at a CAGR of 6.8% from 2018. Microbial lipases (EC 3.1.1.3) catalyze the hydrolysis of long chain triglycerides. The microbial origins of lipase enzymes are logically dynamic and proficient also have an extensive range of industrial uses with the manufacturing of altered molecules. The unique lipase (triacylglycerol acyl hydrolase) enzymes catalyzed the hydrolysis, esterification and alcoholysis reactions. Immobilization has made the use of microbial lipases accomplish its best performance and hence suitable for several reactions and need to enhance aroma to the immobilization processes. Immobilized enzymes depend on the immobilization technique and the carrier type. The choice of the carrier concerns usually the biocompatibility, chemical and thermal stability, and insolubility under reaction conditions, capability of easy rejuvenation and reusability, as well as cost proficiency. Bacillus spp., Achromobacter spp., Alcaligenes spp., Arthrobacter spp., Pseudomonos spp., of bacteria and Penicillium spp., Fusarium spp., Aspergillus spp., of fungi are screened large scale for lipase production. Lipases as multipurpose biological catalyst has given a favorable vision in meeting the needs for several industries such as biodiesel, foods and drinks, leather, textile, detergents, pharmaceuticals and medicals. This review represents a discussion on microbial sources of lipases, immobilization methods increased productivity at market profitability and reduce logistical liability on the environment and user.

Haematopathological Changes in Dogs Affected with Ehrlichia Canis in Lesvos

Canine Ehrlichiosis is an important immunosuppressive tick borne disease in dogs. The geographical distribution and transmission is mostly related with Rhipicephalus sanguineus which acts as a vector. There is no predilection of age or sex; all breeds may be infected with Canine Monocytic Ehrlichiosis (CME). The primary targets are monocytic cells. Platelet disorders and serum protein alterations are the principal hematological and biochemical consequences of infections. Clinical signs are almost non-specific. A definitive diagnosis requires: visualization of morulae within monocytes on cytology, detection of serum antibodies with E. canis, the IFA test, or the PCR. The objective of this study was to present information about haematological and biochemical tests of E. canis infected dogs in Lesvos island in Greece, which is an endemic area.

Spleen evaluation using contrast enhanced ultrasonography and Doppler in dogs with subclinical ehrlichiosis

The aim of this study was to evaluate the splenic parenchyma of dogs with subclinical ehrlichiosis using Doppler and contrast-enhanced ultrasonography and provide reference values for this organ in affected animals. Seventeen dogs naturally infected with E. canis were selected for this study. Splenic parenchyma echotexture and echogenicity, size and borders were determined by ultrasound scan. The vascular indices of the splenic artery were determined by Doppler. SonoVue, at 0.1mL per animal, was used in microbubble contrast-enhanced ultrasonography to determine wash in, wash out and peak enhancement time in the splenic tissue. B-mode ultrasonography revealed splenomegaly with rounded borders, heterogeneous echotexture and mixed echogenicity. The vascular indices of the splenic artery were: systolic velocity of 22.59±8.07cm/s, diastolic velocity of 5.25±4.66cm/s and resistance index of 0.71±0.14; values not yet reported in Veterinary Medicine. Contrast-enhanced ultrasonography recorded wash in time of 5.31±0.7s, peak enhancement time of 18.56±2.90s and wash out time of 94.56±35.21s. The combination of conventional ultrasonography of the spleen and hemodynamic evaluation by Doppler and contrast-enhanced ultrasonography is important for the diagnosis of canine ehrlichiosis and could help monitor the clinical evolution of subclinical cases.

Butyrylcholinesterase as a marker of inflammation and liver injury in the acute and subclinical phases of canine ehrlichiosis

The aim of this study was to evaluate the role of butyrylcholinesterase (BChE) as a marker of inflammation and liver injury in the acute and subclinical phases of canine ehrlichiosis. Forty-two serum samples of dogs naturally infected with Ehrlichia canis were used, of which 24 were from animals with the acute phase of the disease and 18 with subclinical disease. In addition, sera from 17 healthy dogs were used as negative controls. The hematocrit, BChE activity, hepatic injury (alanine aminotransferase (ALT) and aspartate aminotransferase (AST)), nitric oxide, and cytokines levels were evaluated. The BChE activity was significantly elevated (P<0.05) in dogs with the acute phase of the disease when compared to healthy animals. However, there was a reduction on BChE activity on dogs with subclinical disease compared to the other two groups. AST and ALT levels were significantly higher (P<0.05) in the acute phase, as well as the inflammatory mediators (NOx, TNF-α, INF-γ, IL-4, IL-6) when compared to the control group. On the other hand, IL-10 levels were lower in the acute phase. Based on these results, we are able to conclude that the acute infection caused by E. canis in dogs leads to an increase on seric BChE activity and some inflammatory mediators. Therefore, this enzyme might be used as a marker of acute inflammatory response in dogs naturally infected by this bacterium.

Serum canine pancreatic-specific lipase concentrations in dogs with naturally occurring Babesia rossi infection

Babesia rossi is the cause of a highly virulent multisystemic disease with a variable outcome, which is a reliable model of systemic inflammatory response syndrome (SIRS). The objective of this study was to determine the concentration of canine pancreatic-specific lipase (cPL) in a population of dogs with naturally acquired B. rossi infection. In addition, the associations between serum cPL and death and SIRS status were examined. An observational study recruited 87 dogs diagnosed with B. rossi infection and serum cPL concentrations were measured daily until discharge or death. The median concentration of serum cPL was 124.0 µg/L (interquartile range: 51.0 µg/L - 475.5 µg/L) on admission (n = 87) and 145.5 µg/L (62.3 µg/L - 434.0 µg/L) on day two of hospitalisation (n = 40). Twenty-four dogs (28%) had a serum cPL concentration within the diagnostic range for pancreatitis (> 400 µg/L) at admission with 13 dogs (32.5%) presenting as such on the second day of hospitalisation. The median concentration of serum cPL in dogs with SIRS was 158 µg/L (interquartile range: 52.5 µg/L - 571.5 µg/L; n = 53), which was significantly higher than in those without SIRS (75 µg/L; 50.3 µg/L - 131.8 µg/L; n = 32) (P = 0.018). This study demonstrated that an unexpectedly high number of dogs diagnosed with naturally acquired canine babesiosis had a serum cPL concentration within the diagnostic range for acute pancreatitis and a significantly higher serum cPL concentration was found in dogs that were classified as having SIRS.

Canine vector-borne infections in Mauritius

Background

Canine vector-borne diseases have a worldwide distribution, but to the best of our knowledge, no research has been carried out to evaluate their presence on the Indian Ocean island of Mauritius. An investigation into canine vector-borne infections was conducted in dogs (n = 78) resident at an animal shelter in Port Louis, Mauritius using a combination of traditional microscopy and serological methods.

Methods

Ticks were manually collected from the stray dog population for identification as well as for quantifying tick burdens. Blood was also collected from each dog via either the jugular vein or the cephalic vein, and was stored in EDTA tubes. The stored blood was then used to measure PCV values, make blood smears for the identification of parasites, and used for serological testing of vector-borne disease.

Results

A total of 178 ticks were collected from 52 dogs and identified as Rhipicephalus sanguineus (175/178) or Amblyomma variegatum (3/178). Twenty-six (33%; 95% CI 23, 45) dogs were seropositive for Ehrlichia spp., and 12 (15%; 95% CI 8, 25) for Anaplasma spp., Dirofilaria antigen was detected in 14 (18%; 95% CI 10, 28), and nine (12%; 95% CI 5, 21) dogs had Hepatozoon canis gamonts observed in blood films during microscopic examination. Eleven (14%; 95% CI 7, 24) dogs were co-infected with two pathogens. Borrelia burgdorferi antibodies were not detected in any dogs.

Conclusions

Infection with these pathogens had no significant effect on the packed cell volume (PCV), but high tick burdens were significantly associated with the presence of a tick-borne pathogen. This is the first study of its kind on the dog population in Mauritius and demonstrates the presence of previously undocumented canine vector-borne infections on the island. The relatively high proportion of infected dogs within the study should alert clinicians to the presence of canine vector-borne diseases on the island of Mauritius.