URINALYSIS IN DOGS WITH ACUTE PANCREATITIS

In acute pancreatitis (AP), kidney injury (KI) could occur via hypovolemia, cytokine-induced ischemia, inflammation and oxidative stress [1]. In people, urinalysis and some urinary biomarkers have been proposed as useful prognostic tools in AP [2]. At the best of our knowledge, there are no studies evaluating urinalysis in canine AP. The aim of the study was to evaluate urinalysis parameters and urinary GGT-to-urinary creatinine (uGGT/uCr) in canine AP and their association with the outcome. AP diagnosis was made if there were compatible clinical (≥2 of the following: abdominal pain, diarrhea, vomiting or hyporexia) and laboratory parameters (acute inflammation), abnormal SNAP® cPL test and abdominal ultrasound abnormalities supporting a diagnosis of AP. Dogs with preexisting diagnosis of chronic kidney disease and/or managed by hemodialysis were excluded. Urine samples were collected and analyzed within 12h from AP diagnosis. For uGGT/uCr, a cut off value of 105 U/g was used [3]. KI was defined if dogs had urinary casts and/or proteinuria. Sediments were classified as active if there were one or more of the following findings: bacteriuria, moderate number of casts and >5 RBCs, WBCs, or epithelial cells/HPF. Dogs were divided into 2 groups (survivors and non-survivors) according to outcome at 15 days from their admission. Normal distribution was assessed using D’Agostino-Pearson test. Specific gravity (SG), urinary protein-to-creatinine ratio (UP/UC) and uGGT/uCr were evaluated in association to the outcome using Mann-Whitney U-test. pH was compared between outcome groups using ttest. Chi square test was used to evaluate dipstick parameters in association with the outcome. Fisher’s exact test was used to compare the severity of UP/UC (≥2) and the presence of kidney injury to the outcome. Odds ratio (OR) was calculated. Seventy clientowned dogs with owners’ consent were retrospectively included. Twenty-four dogs (34%) died. Seven out of 24 dogs were euthanized due to poor clinical condition or to progressive disease. Urine samples were collected by free catch (n=43), cystocentesis (n=19) or catheterization (n=8). Forty dogs showed active sediment (57%). KI was detected in thirty-six dogs (37%) and was associated with mortality (p=0.01 OR 3.9 95% CI 1.3-11.56). Nonsurvivor dogs showed higher dipstick bilirubin levels compared to surviving dogs (p=0.005). By excluding dogs with active sediment, UP/UC ratio ≥2 was associated with mortality (p=0.001 OR 47.5 95% CI 4-571.9). SG, pH and the other dipstick parameters were similar between groups. uGGT/uCr was available in 40 dogs (57%). Twenty-one dogs (53%) had uGGT/uCr over the cut off level and it was not associated with the outcome. No statistical differences were found in uGGT/uCr values between survivor and non-survivor dogs. In our study, UP/UC ≥2 seems to be a negative prognostic factor in dogs with AP. Further studies on uGGT/uCr during canine AP are warranted