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Shipov A, Lenchner I, Milgram J, Libkind R, Klainbart S, Segev G, Bruchim Y. Aetiology, clinical parameters and outcome in 113 dogs surgically treated for septic peritonitis (2004-2020). Vet Rec 2023; 192:e2134. [PMID: 36066034 DOI: 10.1002/vetr.2134] [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: 12/27/2020] [Revised: 07/10/2022] [Accepted: 08/08/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Septic peritonitis (SP) is a common life-threatening condition. The aims of this study were to describe the aetiology, clinicopathological abnormalities, complications, treatment, outcome and prognosis of dogs with SP. METHODS Records of 113 dogs diagnosed and surgically treated for SP between 2004 and 2020 were reviewed. RESULTS Overall survival rate was 74.3%. Parameters at presentation that were significantly associated with mortality were lateral recumbency (p = 0.001) and elevated respiratory rate (p = 0.045). Hypotension during or after surgery (p < 0.001), liver injury (p < 0.001) and acute kidney injury (p < 0.001) were also more common in non-survivors. The source of contamination, number of surgeries or the location of perforation in cases of gastrointestinal tract perforation were not associated with mortality. Delta glucose (serum vs. abdominal) was available in 36 out of 113 dogs and the difference was more than 20 mg/dl in only 22 of out 36 (61.1%) cases. CONCLUSION Liver and kidney injuries play a role in mortality, and early diagnosis and intervention are recommended to prevent multiple organ dysfunction and death. The reported high sensitivity of delta glucose is questionable in diagnosis of SP.
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Affiliation(s)
- Anna Shipov
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Itzik Lenchner
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Josh Milgram
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Rivka Libkind
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Sigal Klainbart
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Gilad Segev
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yaron Bruchim
- Koret School of Veterinary Medicine, Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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Baptista L, Pollard D, Di Bella A. Evaluation of Resting Serum Bile Acid Concentrations in Dogs with Sepsis. Vet Sci 2022; 9:627. [PMID: 36423076 PMCID: PMC9695002 DOI: 10.3390/vetsci9110627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/05/2022] [Accepted: 11/10/2022] [Indexed: 07/30/2023] Open
Abstract
Recent studies in the human literature suggest that serum bile acid concentrations could be an early predictor of short-term survival in critically ill patients. However, there is no available information in the veterinary literature regarding serum bile acid concentrations in dogs with sepsis. We aimed to evaluate if resting serum bile acid concentrations differ between septic and non-septic dogs. This was a retrospective observational study, of medical records at a single referral center over a twelve-year period. Twenty-six client-owned dogs diagnosed with sepsis were identified. Twenty-one dogs presenting with a non-hepatobiliary systemic disease and twenty-nine dogs admitted for an elective orthopedic procedure, considered otherwise healthy, were selected as control groups. Resting serum bile acid concentrations were significantly higher in the septic compared to the non-septic groups (ill control and orthopedic control groups). However, when assessing bile acid concentrations between groups individually, no difference was identified between the septic and the orthopedic control group. These results should be interpreted cautiously.
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Affiliation(s)
- Lara Baptista
- Paragon Veterinary Referrals, Red Hall Cres, Wakefield WF1 2DF, UK
| | - Danica Pollard
- Independent Researcher, The Rodhams, Christchurch PE14 9NU, UK
| | - Andrea Di Bella
- Southern Counties Veterinary Specialists, Forest Corner Farm, Ringwood BH24 3JW, UK
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Behling-Kelly E, Haak CE, Carney P, Waffle J, Eaton K, Goggs R. Acute phase protein response and changes in lipoprotein particle size in dogs with systemic inflammatory response syndrome. J Vet Intern Med 2022; 36:993-1004. [PMID: 35420224 PMCID: PMC9151453 DOI: 10.1111/jvim.16420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
Background Improved methodology to measure acute phase proteins and determination of lipoprotein particle‐size distribution (PSD) could be clinically useful in dogs with systemic inflammatory processes. Objectives Evaluate an immunoturbidometric assay for serum amyloid A (SAA) and lipoprotein PSD in dogs with sepsis, nonseptic systemic inflammation, and in healthy controls. Correlate dyslipidemic changes with SAA and C‐reactive protein (CRP) concentrations. Animals Twenty‐five dogs with sepsis, 15 dogs with nonseptic systemic inflammation, and 22 healthy controls. Methods Prospective, case‐control study. Variables included SAA, CRP, and electrophoretic subfractionation of high‐ and low‐density lipoproteins (HDL, LDL). Continuous variables were compared using ANOVA or Kruskal‐Wallis tests with linear regression or Spearman's rank correlation used to assess relationships between variables. Results Median SAA and CRP concentrations were greater in dogs with sepsis (SAA 460 mg/L, interquartile range [IQR] 886 mg/L; CRP 133.2 mg/L, IQR 91.6 mg/L) and nonseptic inflammation (SAA 201 mg/L, IQR 436 mg/L; CRP 91.1 mg/L, IQR 88.6 mg/L) compared to healthy dogs (SAA 0.0 mg/L, IQR 0.0 mg/L; CRP 4.9 mg/L, IQR 0.0 mg/L) P < .0001. A cutoff of >677.5 mg/L SAA was 43.2% sensitive and 92.3% specific for sepsis. Low‐density lipoprotein was higher in dogs with sepsis 29.6%, (mean, SD 14.6) compared to 14.4% (mean, SD 5.6) of all lipoproteins in healthy controls (P = .005). High‐density lipoprotein was not associated with CRP but was negatively correlated with SAA (rs −0.47, P < .0001). Subfractions of LDL and HDL differed between groups (all P < .05). Conclusions and Clinical Importance Measurement of SAA using the immunoturbidometric assay evaluated in this study and lipoprotein PSD in dogs with inflammation might help distinguish septic from nonseptic causes of inflammation.
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Affiliation(s)
- Erica Behling-Kelly
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - Carol E Haak
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - Patrick Carney
- Department of Clinical Sciences, Cornell University, Ithaca, New York, USA
| | - Jessica Waffle
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - Kelly Eaton
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University, Ithaca, New York, USA
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4
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Donati P, Londoño LA, Tunes M, Villalta C, Guillemi EC. Retrospective evaluation of the use of quick Sepsis-related Organ Failure Assessment (qSOFA) as predictor of mortality and length of hospitalization in dogs with pyometra (2013-2019): 52 cases. J Vet Emerg Crit Care (San Antonio) 2022; 32:223-228. [PMID: 35166423 DOI: 10.1111/vec.13103] [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: 10/30/2019] [Revised: 03/04/2020] [Accepted: 03/18/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the prognostic utility of quick Sepsis-related Organ Failure Assessment (qSOFA) for prediction of in-hospital mortality and length of hospitalization in dogs with pyometra. DESIGN Retrospective cohort study from February 2013 to April 2019 SETTING: Tertiary referral hospital ANIMALS: Fifty-two dogs referred with confirmed diagnosis of pyometra INTERVENTIONS: None MEASUREMENTS AND PRINCIPAL OUTCOMES: Sixty-five percent of dogs survived to discharge. A cut-off score of ≥2 for qSOFA was associated with in-hospital mortality (odds ratio 6.51 [95% CI: 1.35 - 31.3]) P = 0.019. The area under the receiver operator characteristic curve for a qSOFA score ≥ 2 for mortality was 0.72 (95% CI: 0.59-0.85), with a sensitivity of 77.8% and a specificity of 66.7%. The mean ± SD number of organs with dysfunction was significantly higher in dogs with a qSOFA score ≥2 1.76 ± 0.83 compared to dogs with a qSOFA score < 2 1.08 ± 1.09, P = 0.015. The presence of a qSOFA score ≥ 2 was associated with a longer time of hospitalization in survivors with a median (interquartile range) length of stay in qSOFA < 2 (48 [33]) hours versus qSOFA score ≥ 2 (78 [52]) hours, P = 0.027. CONCLUSIONS In dogs with pyometra, the qSOFA score was associated with mortality and length of hospitalization. This score might be useful to improve the risk stratification in dogs with pyometra. Further studies are necessary to evaluate the predictive capacity of qSOFA in other septic patient populations.
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Affiliation(s)
| | - Leonel A Londoño
- Department of Small Animal Clinical Sciences, University of Florida, Gainesville, Florida, USA
| | | | - Cesar Villalta
- Clínica Veterinaria VET`S, Suecia 3580, Providencia, Santiago, Chile
| | - Eliana C Guillemi
- Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina
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Perry KM, Lynch AM, Caudill A, Vigani A, Roberston JB, Vaden S. Clinical features, outcome, and illness severity scoring in 32 dogs with urosepsis (2017-2018). J Vet Emerg Crit Care (San Antonio) 2021; 32:236-242. [PMID: 34730876 DOI: 10.1111/vec.13158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/14/2020] [Accepted: 09/05/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the clinical features, outcome, and utility of illness severity scoring in dogs diagnosed with urosepsis. DESIGN Retrospective study (2017-2018). SETTING University teaching hospital. ANIMALS Thirty-two dogs diagnosed with urosepsis secondary to pyometra, prostatitis, or pyelonephritis. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Urosepsis was identified in 32 dogs, consisting of 9 of 32 (28.1%) with pyometra, 7 of 32 (21.8%) with prostatitis, and 16 of 32 (50%) with pyelonephritis. In total, 28 (87.5%) dogs survived to discharge, with the following group-specific survival rates: pyometra, 9 of 9 (100%); prostatitis, 5 of 7 (71.4%); and pyelonephritis, 14 of 16 (87.5%). Positive bacterial cultures were obtained in 27 of 32 (84.1%) dogs. The most commonly implicated pathogens were Escherichia coli (14/37 [37.8%]), Klebsiella pneumoniae (8/37 [21.6%]), and Staphylococcus pseudintermedius (6/37 [16.2%]). Multiple organ dysfunction syndrome (MODS) was identified in 21 of 32 dogs (65.6%). Although the presence of MODS was not different between survivors and nonsurvivors (P = 0.6), nonsurvivors had more dysfunctional organs (P = 0.04). Nonsurvivors also had higher Acute Patient Physiology and Laboratory Evaluation (APPLEFAST ) scores compared to survivors (P = 0.01). CONCLUSIONS Survival of dogs with urosepsis was good and may be higher than for other sources of sepsis. Compared to survivors, nonsurvivors had more dysfunctional organs and higher illness severity scores, which may be helpful in the assessment and management of dogs with urosepsis.
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Affiliation(s)
- Kayla M Perry
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Alex M Lynch
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Alexander Caudill
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Alessio Vigani
- Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - James B Roberston
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Shelly Vaden
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
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Hofmaenner DA, Kleyman A, Press A, Bauer M, Singer M. The Many Roles of Cholesterol in Sepsis: A Review. Am J Respir Crit Care Med 2021; 205:388-396. [PMID: 34715007 DOI: 10.1164/rccm.202105-1197tr] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE The biological functions of cholesterol are diverse, ranging from cell membrane integrity and signalling, immunity, to the synthesis of steroid and sex hormones, Vitamin D, bile acids and oxysterols. Multiple studies have demonstrated hypocholesterolemia in sepsis, the degree of which is an excellent prognosticator of poor outcomes. However, the clinical significance of hypocholesterolemia has been largely unrecognized. OBJECTIVES/METHODS We undertook a detailed review of the biological roles of cholesterol, the impact of sepsis, its reliability as a prognosticator in sepsis, and the potential utility of cholesterol as a treatment. MEASUREMENTS AND MAIN RESULTS Sepsis affects cholesterol synthesis, transport and metabolism. This likely impacts upon its biological functions including immunity, hormone and vitamin production, and cell membrane receptor sensitivity. Early preclinical studies show promise for cholesterol as a pleiotropic therapeutic agent. CONCLUSIONS Hypocholesterolemia is a frequent condition in sepsis and an important early prognosticator. Low plasma levels are associated with wider changes in cholesterol metabolism and its functional roles, and these appear to play a significant role in sepsis pathophysiology. The therapeutic impact of cholesterol elevation warrants further investigation.
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Affiliation(s)
- Daniel A Hofmaenner
- University College London, 4919, Bloomsbury Inst of Intensive Care Medicine, London, United Kingdom of Great Britain and Northern Ireland.,University Hospital Zurich, Institute of Intensive Care Medicine, Zurich, Switzerland
| | - Anna Kleyman
- University College London, 4919, Bloomsbury Inst of Intensive Care Medicine, London, United Kingdom of Great Britain and Northern Ireland
| | - Adrian Press
- Jena University Hospital Center for Sepsis Control and Care, 553346, Jena, Germany
| | - Michael Bauer
- University Hospital Jena, Dep. of Anesthesiology and Intensive Care Medicine, Jena, Germany
| | - Mervyn Singer
- University College London, 4919, Bloomsbury Inst of Intensive Care Medicine, London, United Kingdom of Great Britain and Northern Ireland;
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Leukocytes Ratios in Feline Systemic Inflammatory Response Syndrome and Sepsis: A Retrospective Analysis of 209 Cases. Animals (Basel) 2021; 11:ani11061644. [PMID: 34206019 PMCID: PMC8227061 DOI: 10.3390/ani11061644] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 12/14/2022] Open
Abstract
Simple Summary Feline sepsis is a life-threatening syndrome in which blood diagnostic and prognostic markers are limited. We investigated the differences in neutrophil-to-lymphocyte ratio and other white-blood-cell ratios between healthy and sick cats (systemic inflammation (SIRS) and/or septic cats) and then the use of these ratios as prognostic markers. This study included 76 healthy cats (blood-donors), 54 cats with SIRS and 79 cats with sepsis. A cat with an NLR > 4.53 had a 44-fold chance to have SIRS or sepsis, although only BLR and BNLR were different between SIRS and sepsis groups. The NLR has been shown as a prognostic marker in sick cats. This is a novel investigation about leukocyte ratios in the cat, and the NLR may be used as a prognostic parameter in cats with SIRS or sepsis, and BLR and BNLR demonstrate themselves as promising tools in differentiating SIRS from sepsis. Abstract Sepsis is a challenging condition in which hematological prognostic and diagnostic markers in cats are limited. The aims of this study were to test if there are any differences in leukocyte ratios (NLR, BLR and BNLR) between healthy, SIRS and septic cats (sick cats), and if, within sick cats, NLR, BLR and BNLR may be prognostic markers. A retrospective medical database study included 76 healthy cats (blood-donors), 54 SIRS and 79 septic cats. SIRS group was defined if cats fulfilled SIRS criteria. Sepsis was confirmed with an infectious focus on cytology or a positive culture for bacterial infection. Leukocyte ratios were compared among the three study groups and between survivors and non-survivors in sick cats. NLR resulted significantly higher in the sick group compared to healthy cats (p < 0.0001), although NLR was not different between SIRS and sepsis. An NLR > 4.53 had a sensitivity of 76% and a specificity of 93.4% to detect SIRS/sepsis (OR 44.8 95%CI 17–107). Only BLR and BNLR were significantly different between SIRS and sepsis. NLR was associated with mortality in the sick group (p = 0.04). Although NLR resulted higher in sick cats than healthy, BLR and BNLR demonstrated as promising tools in differentiating SIRS from sepsis. NLR was associated with mortality in sick cats.
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Pierini A, Gori E, Lippi I, Lubas G, Marchetti V. Are Leukocyte and Platelet Abnormalities and Complete Blood Count Ratios Potential Prognostic Markers in Canine Sepsis? Front Vet Sci 2020; 7:578846. [PMID: 33195586 PMCID: PMC7661429 DOI: 10.3389/fvets.2020.578846] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/05/2020] [Indexed: 12/29/2022] Open
Abstract
Background: Sepsis is a common disease in which early diagnosis and prognosis assessment are the main aims in order to arrange a prompt and effective treatment. Objectives: (1) To compare leukogram parameters (WBC, segmented and band neutrophils, lymphocytes, monocytes), platelet count (PLT), mean platelet volume (MPV), and some leukocyte/platelet ratio such as NLR, NBNLR, PLR, and MLR between dogs with systemic inflammatory response syndrome (SIRS) and sepsis. (2) To investigate any difference in the trend of these latter parameters between survivors and non-survivors septic dogs. Animals: 57 dogs with confirmed sepsis and 57 dogs with non-septic SIRS. Methods: A review of the medical records was conducted in order to find dogs with sepsis. Sepsis was defined as the presence of an infectious focus with fulfillment of systemic inflammatory response syndrome criteria (SIRS). Septic dogs had to have a CBC at admission and another CBC within 48 h from the previous timepoint. Purebreds with CBC breed-related abnormalities were excluded, together with dogs without confirmed sepsis and dogs with only a single CBC. NLR, NBNLR, PLR, and MLR were calculated. Univariate analysis of all blood parameters studied was assessed between SIRS and septic dogs. Generalized Estimating Equations models for repeated measures were used to test if the blood parameters studied were modified between survivors and non-survivors in the septic group. Results: Septic dogs had lower median segmented neutrophils count and NLR compared to SIRS dogs (p = 0.02 and p = 0.04, respectively). Lastly, septic dogs had a higher prevalence of toxic neutrophil than SIRS dogs (p = 0.01). We found that for a 1-unit increase of PLR and MLR, the risk of death increased by 50.5 and 60%, respectively. Conclusion and Clinical Importance: Evaluation of NLR at hospital admission may be a useful marker of inflammation, although it showed low sensitivity in differentiating SIRS and septic dogs. The monitoring of some CBC parameters, especially PLR and MLR may be useful in the establishment of prognosis in septic dogs.
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Affiliation(s)
- Alessio Pierini
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Pisa, Italy
| | - Eleonora Gori
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Pisa, Italy
| | - Ilaria Lippi
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Pisa, Italy
| | - George Lubas
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Pisa, Italy
| | - Veronica Marchetti
- Department of Veterinary Sciences, Veterinary Teaching Hospital "Mario Modenato", University of Pisa, Pisa, Italy
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Tan AWK, Epstein SE, Hopper K. Period prevalence and mortality rates associated with hypocholesterolaemia in dogs and cats: 1,375 cases. J Small Anim Pract 2020; 61:669-675. [PMID: 32767372 DOI: 10.1111/jsap.13204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/09/2020] [Accepted: 06/25/2020] [Indexed: 12/26/2022]
Abstract
To determine the period prevalence of hypocholesterolaemia and the associated mortality rates in dogs and cats at a university teaching hospital. The secondary aim was to identify disease processes associated with hypocholesterolaemia. MATERIALS AND METHODS Medical records over a 5-year period were reviewed to determine the severity of hypocholesterolaemia and its associated mortality rate. Medical records of animals with moderate to severe hypocholesterolaemia (<2.59 mmol/L in dogs, <1.81 mmol/L in cats) were analysed further. Animals with hospital-acquired hypocholesterolaemia were identified. RESULTS Among 16,977 dogs and 3,788 cats that had at least one cholesterol measurement, the period prevalence of hypocholesterolaemia was 7.0% in dogs and 4.7% in cats. The mortality rate of hypocholesteraemic dogs and cats was 12% in both species which was significantly higher than that of animals with normal serum cholesterol. The degree of hypocholesterolaemia was significantly associated with mortality. Dogs, but not cats, with hospital-acquired hypocholesterolaemia had a higher mortality rate than those presenting with hypocholesterolaemia. Disease of hepatic, gastrointestinal and lymphoreticular systems were most commonly associated with hypocholesterolaemia, and infectious and neoplastic disease were the most commonly associated pathophysiologic processes in both species. Lymphoma was over-represented in dogs with neoplasia. CLINICAL SIGNIFICANCE Hypocholesterolaemia is not a frequent abnormality but was associated with mortality in this study and may be a negative prognostic indicator. It is not known if hypocholesterolaemia is simply a marker for disease severity, or if it is has active physiologic effects contributing to poor outcomes.
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Affiliation(s)
- A W K Tan
- William R. Pritchard, Veterinary Medical Teaching Hospital, University of California, Davis, 1 Garrod Dr, Davis, CA, 95616, USA
| | - S E Epstein
- Department of Veterinary Surgical and Radiological Sciences, University of California, Davis, 2112 Tupper Hall, Davis, CA, 95616, USA
| | - K Hopper
- Department of Veterinary Surgical and Radiological Sciences, University of California, Davis, 2112 Tupper Hall, Davis, CA, 95616, USA
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Bowman C, Viall A, Rudinsky A, Gilor C, Palerme JS. Hypocholesterolemia in cats: a multicenter retrospective study of 106 cats. J Feline Med Surg 2020; 22:768-773. [PMID: 31710272 PMCID: PMC10814506 DOI: 10.1177/1098612x19886398] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to describe the clinicopathologic findings and associated diseases found in a population of hypocholesterolemic cats referred to two tertiary care facilities. METHODS An electronic medical record search was performed at two veterinary university referral centers to identify cats with serum cholesterol values below the reference interval between January 2004 and 2016. Clinicopathologic data were reviewed for each case and cats were classified into specific disease categories based on clinical diagnosis. Median cholesterol values were compared between disease categories, as well as between survivors and non-survivors. RESULTS In total, 106 hypocholesterolemic cats were included. The median age of the cats was 6 years (range 0.24-18 years). The most common disease categories were gastrointestinal (25.9%), hepatobiliary (19.8%), hematologic (14.8%) and urogenital (14.8%). Though median serum cholesterol values did not differ significantly between survivors and non-survivors, cats with concurrent hypoalbuminemia were at higher risk (odds ratio 15.6, 95% confidence interval 5.2-46.6; P <0.0001) of not surviving to discharge than cats with normal serum albumin concentrations. CONCLUSIONS AND RELEVANCE Taken together, our data suggest that while the degree of hypocholesterolemia did not appear to influence survival rates, the concurrent presence of hypocholesterolemia and hypoalbuminemia was associated with a worse prognosis.
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Affiliation(s)
- Claudia Bowman
- VCA Care Specialty and Emergency Animal Hospital, Santa Barbara, CA, USA
| | - Austin Viall
- Department of Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Adam Rudinsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Chen Gilor
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Jean-Sébastien Palerme
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
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11
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Torrente C, Manzanilla EG, Bosch L, Villaverde C, Pastor J, Ruiz de Gopegui R, Tvarijonaviciute A. Adiponectin as a sepsis biomarker in dogs: Diagnostic and prognostic value. Vet Clin Pathol 2020; 49:333-344. [PMID: 32510619 DOI: 10.1111/vcp.12858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 09/20/2019] [Accepted: 10/10/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Adiponectin (ADPN) is an adipocytokine with insulin-sensitizing, vascular-protective, and anti-inflammatory properties for which concentration changes occur in response to inflammation. Little is known about the regulation of ADPN and the impact of this adipocytokine in septic dogs. OBJECTIVE We aimed to assess the diagnostic and prognostic value of ADPN vs other traditional acute-phase proteins (APPs), such as albumin (ALB), haptoglobin (HPT), fibrinogen (FBG), ferritin (FRT), and C-reactive protein (CRP) in dogs with naturally acquired sepsis. METHODS This prospective observational study included 20 dogs with sepsis, 27 with low-grade systemic inflammation (LGSI), and 18 clinically healthy dogs as controls. For method analyses, plasma samples were obtained from all dogs on admission and then every 24-48 hours until discharge or death in the septic group. RESULTS Septic dogs had lower ADPN (2.4 ± 0.46 vs 4.5 ± 0.41mg/L, P < .001) dand ALB (17 ± 1 vs 22 ± 0.8g/L, P = .002), and tended to have higher CRP (87 ± 4.8 vs 73 ± 4.1mg/L, P < .079) concentrations than dogs with LGSI on admission. Only ADPN and ALB were able to successfully discriminate animals with LGSI from those presenting with sepsis with areas under the curve (AUCs) for the receiver operating characteristic (ROC) curves of 0.811 and 0.789, respectively. In the septic group, ADPN concentration did not differ between survivors and non-survivors, either on admission or at discharge or death. CONCLUSIONS Although plasma ADPN can be used as a reliable negative APP in dogs with sepsis, further studies are warranted to confirm the usefulness of this biomarker in terms of disease progression and recovery.
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Affiliation(s)
- Carlos Torrente
- Servei d'Emergències i Cures Intensives, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.,Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Edgar G Manzanilla
- Teagasc, Animal and Grassland Research Center, Moorepark, Cork and School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Luis Bosch
- Servei d'Emergències i Cures Intensives, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.,Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | | | - Josep Pastor
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Rafael Ruiz de Gopegui
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Pathology, Interlab-UMU, Campus of Excellence Mare Nostrum, University of Murcia, Espinardo, Murcia, Spain
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Torrente C, Manzanilla EG, Bosch L, Villaverde C, Pastor J, de Gopegui RR, Tvarijonaviciute A. The diagnostic and prognostic value of paraoxonase-1 and butyrylcholinesterase activities compared with acute-phase proteins in septic dogs and stratified by the acute patient physiologic and laboratory evaluation score. Vet Clin Pathol 2019; 48:740-747. [PMID: 31789474 DOI: 10.1111/vcp.12807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 04/16/2019] [Accepted: 04/26/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Sepsis is a complex syndrome that involves an increased oxidative stress status and dysregulation of cholinergic neurotransmission. Paraoxonase-1 (PON-1) and butyrylcholinesterase (BChE) activities have been identified as significant biomarkers to monitor such disorders in human septic patients. OBJECTIVE We aimed to determine the diagnostic and prognostic value of PON-1 and BChE vs other traditional acute-phase proteins such as albumin (ALB) and C-reactive protein (CRP) in septic dogs. METHODS This prospective observational study included 20 dogs with a diagnosis of sepsis, 27 with low-grade systemic inflammation (LGSI), and 10 healthy dogs that served as controls. Plasma samples were obtained from all dogs for analysis on admission, and then every 24-48 hours until discharge or death in the septic group. RESULTS Dogs with sepsis had lower PON-1 activity compared with dogs in the LGSI group (1.1 ± 0.10 vs 1.6 ± 0.08 U/mL, P = .002), but no differences in BChE activity were detected between the groups. PON-1, ALB, and CRP could successfully discriminate healthy animals from those with sepsis looking at the area under the curve (AUC) of the receiver operator characteristics curves (ROCs), which were 0.828, 0.903 and 1.000, respectively. Finally, although no differences were found among the groups for PON-1 or BChE activity, the nonsurvivor septic dogs had higher CRP (P = .002), lower ALB (P = .025) levels, and tended to have lower PON-1 (P = .082) activities than the survivors at patient death or discharge. CONCLUSION Septic dogs showed lower plasma PON-1 and higher BChE activities, but only PON-1 activity correlated with disease severity. Further studies are warranted to describe the usefulness of these new biomarkers of sepsis progression and recovery in dogs.
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Affiliation(s)
- Carlos Torrente
- Servei d'Emergències i Cures Intensives, Fundació Hospital Clínic Veterinari-UAB, Bellaterra, Spain.,Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Edgar G Manzanilla
- Animal and Grassland Research and Innovation Centre, Teagasc Moorepark, Fermoy, Cork and School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - Luis Bosch
- Servei d'Emergències i Cures Intensives, Fundació Hospital Clínic Veterinari-UAB, Bellaterra, Spain.,Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - Josep Pastor
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Rafael Ruiz de Gopegui
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Asta Tvarijonaviciute
- Interdisciplinary Laboratory of Clinical Pathology, Interlab-UMU, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
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Pierini A, Gori E, Lippi I, Ceccherini G, Lubas G, Marchetti V. Neutrophil-to-lymphocyte ratio, nucleated red blood cells and erythrocyte abnormalities in canine systemic inflammatory response syndrome. Res Vet Sci 2019; 126:150-154. [PMID: 31493682 DOI: 10.1016/j.rvsc.2019.08.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/19/2019] [Accepted: 08/27/2019] [Indexed: 12/30/2022]
Abstract
Systemic inflammatory response syndrome (SIRS) is the manifestation of the systemic response to an infectious or non-infectious disease. We evaluated the association between erythrocyte parameters, including nucleated red blood cells (NRBCs) and leukocyte ratios (NLR, neutrophil-to-lymphocyte ratio; BLR, band neutrophil-to-lymphocyte ratio; BLNR, band neutrophil-to-neutrophil-to-lymphocyte ratio). A review of the medical records was conducted searching SIRS dogs among those admitted to our intensive care unit and a SIRS grading was obtained based on how many criteria were fulfilled. The Acute Patient Physiology and Laboratory Evaluation (APPLEfast) score was assessed in each dog. Survival rate was assessed 15 days after admission. Dogs with clinical and/or clinicopathological signs of hemolytic or hemorrhagic disorders were excluded. Dogs with ≥2 criteria of SIRS along with a documented underlying infectious cause were recorded as septic (32/90, 35%). A SIRS grading >2 (p = .001) and an APPLEfast score > 25 (p = .03) were associated with mortality. Twenty-two of SIRS dogs (24%) showed circulating NRBCs. The occurrence of circulating NRBCs was associated with the mortality in SIRS groups (p = .0025). The median NLR was 11.69 and NLR was lower in septic dogs compared to non-septic ones (p = .0272). APPLEfast, SIRS grading and circulating NRBCs may be considered as negative prognostic factors in canine SIRS. NLR could be a useful tool in dogs with SIRS, which was significantly lower in the septic group. Further prospective, large-scale studies investigating BLR and BNLR in canine SIRS are warranted.
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Affiliation(s)
- A Pierini
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, Via Livornese Lato monte, San Piero a Grado, 56122 Pisa, Italy.
| | - E Gori
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, Via Livornese Lato monte, San Piero a Grado, 56122 Pisa, Italy
| | - I Lippi
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, Via Livornese Lato monte, San Piero a Grado, 56122 Pisa, Italy
| | - G Ceccherini
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, Via Livornese Lato monte, San Piero a Grado, 56122 Pisa, Italy
| | - G Lubas
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, Via Livornese Lato monte, San Piero a Grado, 56122 Pisa, Italy
| | - V Marchetti
- Veterinary Teaching Hospital "Mario Modenato", Department of Veterinary Sciences, University of Pisa, Via Livornese Lato monte, San Piero a Grado, 56122 Pisa, Italy
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