Acute pancreatitis (AP) is a common disease in dogs characterized by a wide spectrum of clinical signs, as anorexia, vomiting, diarrhoea and abdominal pain. AP can lead to kidney injury via hypovolemia, cytokine-induced ischemia, inflammation and oxidative stress. The aim of the study was to evaluate the prevalence of kidney injury in dogs with AP. The study enrolled 65 dogs with positivity to SNAP cPL® test and clinical and laboratory signs suggestive of AP. Dogs with non-pancreatic acute abdominal disease were excluded. WBC, neutrophil count, serum C-reactive protein (CRP), serum creatinine (SrCr) and urea and urinalysis were evaluated at time of diagnosis. The magnitude of AP was assessed using the clinical severity index (CSI) as described by Mansfield (2008). The patients were divided into two groups: survivors and non-survivors. Non-survivors included dogs, which died within seven days from admission. Data were statistically analysed using GraphPad Prism® for Mac. The study population was composed by intact (n=30) and spayed females (n=13), and intact (n=34) and neutered males (n=2). Patients showed median age of 8.8 (0.4–14.6) years, BCS of 5/9 (2/9-7/9) and body weight of 16 (2.5-64) kg. Overall seven-day survival was 67.7% 44/65 dogs . CSI≥5 was associated with poor outcome (p=0.047) and elevated CRP (p=0.014). Dogs with CRP three-fold higher than upper reference range, showed a significantly poorer outcome (p=0.0003). SrCr>1.5 mg/dL and urea>55 mg/dL above the reference range were significantly associated with increased risk of death (p<0.0001 and p<0.0009 respectively). In this study ove all mo tality ate was 32.3% and 37% in dogs wit CSI≥4. Howeve in t is cohort of dogs median CSI was 4 and 66% of dogs were in CSI≥4 g oup. o t is eason median CSI was used to divide dogs into two g oups and dogs wit CSI≥5 n=32 ave been associated with increased risk of death (13/32, 40%). Previous study reported an overall mortality rate of 23% for all dogs and 53% for dogs wit CSI sco e≥4. evious studies have failed to find a correlation between CRP and outcome or CSI. In our cohort of patients C s owed a low sensibility and it was associated wit CSI≥5. Patients with 3xCRP showed a significantly higher risk of death; comorbility or multi organic dysfunction syndrome could be more frequent in these patients. In canine AP elevated SrCr has been reported as prognostic marker. Previous study found that dogs with renal damage sco e 2 anu ia o a otemia≥1.5-fold increase in serum urea and SrCr) had a higher mortality rate than dogs with renal damage score 0 or 1. However, renal damage score was a part of a multiple organ CSI, making the role of azotemia unclear. In a more recent study, 55% of dogs with AP showed elevated SrCr, but it was not prognostic. In this cohort of dogs, elevation in serum urea or SrCr have been associated with poor outcome.

KIDNEY INJURY IN DOGS WITH ACUTE PANCREATITIS

MARCHETTI, VERONICA;PIERINI, ALESSIO;Gori E;LIPPI, ILARIA;PERONDI, FRANCESCA;CECCHERINI, GIANILA;GUIDI, GRAZIA
2016-01-01

Abstract

Acute pancreatitis (AP) is a common disease in dogs characterized by a wide spectrum of clinical signs, as anorexia, vomiting, diarrhoea and abdominal pain. AP can lead to kidney injury via hypovolemia, cytokine-induced ischemia, inflammation and oxidative stress. The aim of the study was to evaluate the prevalence of kidney injury in dogs with AP. The study enrolled 65 dogs with positivity to SNAP cPL® test and clinical and laboratory signs suggestive of AP. Dogs with non-pancreatic acute abdominal disease were excluded. WBC, neutrophil count, serum C-reactive protein (CRP), serum creatinine (SrCr) and urea and urinalysis were evaluated at time of diagnosis. The magnitude of AP was assessed using the clinical severity index (CSI) as described by Mansfield (2008). The patients were divided into two groups: survivors and non-survivors. Non-survivors included dogs, which died within seven days from admission. Data were statistically analysed using GraphPad Prism® for Mac. The study population was composed by intact (n=30) and spayed females (n=13), and intact (n=34) and neutered males (n=2). Patients showed median age of 8.8 (0.4–14.6) years, BCS of 5/9 (2/9-7/9) and body weight of 16 (2.5-64) kg. Overall seven-day survival was 67.7% 44/65 dogs . CSI≥5 was associated with poor outcome (p=0.047) and elevated CRP (p=0.014). Dogs with CRP three-fold higher than upper reference range, showed a significantly poorer outcome (p=0.0003). SrCr>1.5 mg/dL and urea>55 mg/dL above the reference range were significantly associated with increased risk of death (p<0.0001 and p<0.0009 respectively). In this study ove all mo tality ate was 32.3% and 37% in dogs wit CSI≥4. Howeve in t is cohort of dogs median CSI was 4 and 66% of dogs were in CSI≥4 g oup. o t is eason median CSI was used to divide dogs into two g oups and dogs wit CSI≥5 n=32 ave been associated with increased risk of death (13/32, 40%). Previous study reported an overall mortality rate of 23% for all dogs and 53% for dogs wit CSI sco e≥4. evious studies have failed to find a correlation between CRP and outcome or CSI. In our cohort of patients C s owed a low sensibility and it was associated wit CSI≥5. Patients with 3xCRP showed a significantly higher risk of death; comorbility or multi organic dysfunction syndrome could be more frequent in these patients. In canine AP elevated SrCr has been reported as prognostic marker. Previous study found that dogs with renal damage sco e 2 anu ia o a otemia≥1.5-fold increase in serum urea and SrCr) had a higher mortality rate than dogs with renal damage score 0 or 1. However, renal damage score was a part of a multiple organ CSI, making the role of azotemia unclear. In a more recent study, 55% of dogs with AP showed elevated SrCr, but it was not prognostic. In this cohort of dogs, elevation in serum urea or SrCr have been associated with poor outcome.
2016
978-88-909092-8-3
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11568/804794
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