Peer-reviewed veterinary case report
Case Report: Persistent Moderate-to-Severe Creatine Kinase Enzyme Activity Elevation in a Subclinical Dog
- Journal:
- Frontiers in Veterinary Science
- Year:
- 2021
- Authors:
- Melissa Gunther et al.
- Affiliation:
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ, United States · CH
- Species:
- dog
Plain-English summary
A 4-year-old male mixed breed dog was taken to the vet for a routine check-up, where they found that his creatine kinase (CK) enzyme levels were much higher than normal. Despite this finding, the dog showed no signs of illness, such as being very tired, not eating, or having trouble moving. The vet ran tests to rule out infections that could cause muscle problems and started treatment with an antibiotic, but the CK levels remained high. Further tests like an echocardiogram and muscle biopsy were suggested, but the owner chose not to proceed with them. Over the next five years, the dog continued to have normal check-ups and showed no symptoms, even though his CK levels stayed elevated.
Abstract
A 4-year-old, male-castrated, mixed breed dog was presented for a routine wellness examination at which time a moderate increase in serum creatine kinase (CK) enzyme activity (hyperCKemia) (15,137 IU/L; reference interval 10–200 IU/L), and moderate increases in alanine transaminase and aspartate aminotransferase enzyme activities were first identified. There was no history of clinical abnormalities (e.g., lethargy, lameness, anorexia, dysphagia, weakness, gait abnormalities, or exercise intolerance) and the physical examination was unremarkable. The dog was screened for several relevant potential infectious diseases known to cause inflammatory myopathies and was treated empirically with clindamycin. The serum total CK enzyme activity remained increased, which prompted recommendations for an echocardiogram, electromyogram (EMG), and muscle biopsy acquisition. The echocardiogram and electrocardiographic monitoring were unremarkable. The EMG and muscle biopsies were declined by the owner. The dog was evaluated several times in the subsequent 5 years and remained subclinical with unremarkable physical examinations despite a persistent moderate-to-severe hyperCKemia. Differential diagnoses considered most likely in this dog were an occult/latent hereditary muscular dystrophic disorder or idiopathic hyperCKemia, a phenomenon not yet reported in the veterinary literature. This report describes for the first time, clinical and diagnostic features of a subclinical dog with persistent moderate-to-severe hyperCKemia.
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Search related cases →Original publication: https://doi.org/10.3389/fvets.2021.757294