Evaluation of Serum Apolipoprotein A1 in Canine Sepsis.

Abstract

Decreased serum apolipoprotein A1 (Apo-A1) concentration is associated with mortality in human sepsis. The diagnostic and prognostic role of serum Apo-A1 concentrations in canine sepsis was evaluated. Serum samples from septic dogs (= 91) and healthy controls (= 15) were retrospectively analyzed. According to the sepsis origin, four categories were identified: parvoviral enteritis (= 26), pyometra (= 20), septic peritonitis (= 19), and miscellanea (= 26). The canine acute patient physiologic and laboratory evaluation fast score (APPLE), serum C-reactive protein (CRP) and albumin concentrations were reviewed in all enrolled dogs. Increased CRP (252.6 &#xb1; 119.2 mg/L; Reference Interval: 0-8.5 mg/L) and significant lower serum albumin and Apo-A1 concentrations were documented in dogs with sepsis (22.8 &#xb1; 5.3 g/L and 1.17 &#xb1; 0.27 g/L, respectively) compared to healthy ones (33.1 &#xb1; 2.5 g/L and 1.32 &#xb1; 0.05 g/L, respectively) (< 0.0001). According to the origin of sepsis, only the subgroup of dogs with septic peritonitis had significantly lower Apo-A1 (1.03 &#xb1; 0.26 g/L) concentrations compared to healthy dogs (< 0.001). No significant differences were found in serum albumin and CRP concentrations, and in APPLEscore values among the different subgroups of sepsis. Diagnosis of septic peritonitis was associated with a higher frequency of death (= 0.006). In septic dogs, significant lower Apo-A1 concentrations were detected in non-survivors (1.02 &#xb1; 0.28 g/L;= 27) compared to survivors (1.23 &#xb1; 0.24 g/L;= 64;= 0.0007). Moreover, significant higher values of the APPLEscore were calculated in non-survivors (26 &#xb1; 4;= 19) compared to survivors (23 &#xb1; 4;= 51) (= 0.0114). According to the area under the ROC curve analysis, Apo-A1 <96 mg/dl had a fair accuracy (AUC = 0.72) to correctly predict mortality (= 0.0004). Apo-A1 might support a diagnosis of canine septic peritonitis with a potential prognostic significance. Further prospective studies are warranted.