Peer-reviewed veterinary case report
Protease inhibitors and inflammation linked to outcomes in dogs
By Kuzi, Sharon et al.·Published in Journal of veterinary internal medicine·2020·Department of Small Animal Internal Medicine·View original on PubMed →
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Original publication title: Protease inhibitors, inflammatory markers, and their association with outcome in dogs with naturally occurring acute pancreatitis.
- Species:
- dog
Plain-English summary
A group of 31 dogs diagnosed with acute pancreatitis (AP) showed symptoms like vomiting, abdominal pain, and lethargy. The study found that dogs with higher levels of certain inflammatory markers in their blood had a worse prognosis, with a 19% mortality rate among them. Lower levels of a protein called antithrombin were linked to a higher chance of death, while a scoring system called CAPS helped predict outcomes based on the severity of their condition. The findings suggest that monitoring these markers can help veterinarians assess the severity of pancreatitis in dogs and guide treatment decisions.
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Abstract
BACKGROUND: Acute pancreatitis (AP) presumably is associated with pancreatic protease activation, protease inhibitor (PI) depletion, and inflammatory mediator secretion. OBJECTIVES: Examine PIs and inflammatory mediator concentrations in dogs with AP and their association with death. ANIMALS: Thirty-one dogs diagnosed with AP based on clinical signs, ultrasonographic findings, and increased canine pancreatic lipase immunoreactivity (cPLI) and 51 healthy control dogs. METHODS: Antithrombin and α-antiplasmin activity (ATA and αAP, respectively) and concentrations of α-proteinase inhibitor (αPI), α-macroglobulin (αMG), C-reactive protein (CRP), interleukins (ILs)-2,6,8 and tumor necrosis factor-α (TNF-α) were prospectively measured. Severity of AP was assessed by clinical severity scoring systems. RESULTS: Mortality rate was 19%. Antithrombin activity was lower (P = .004) and maximal CRP, IL-6, and TNF-α concentrations higher (P < .04) in the AP group compared to the controls, whereas IL-2, IL-8, αPI, and αAP concentrations did not differ between groups. Serum αMG concentration was not reliably detected. Serum cPLI, CRP, and IL-6 concentrations were significantly and positively correlated. The ATA was lower (P = .04), and canine acute pancreatitis severity (CAPS) scores higher (P = .009) in nonsurvivors compared to survivors. Higher CAPS scores were associated (P < .05) with decreased ATA and increased cPLI, CRP, and IL-6 concentrations. CONCLUSIONS AND CLINICAL IMPORTANCE: Systemic inflammation in dogs with AP is manifested by increased inflammatory mediator concentrations, correlating with cPLI and CRP concentrations. Hypoantithrombinemia is associated with death. Serum concentrations of αAP and αPI are less useful prognostic markers. The CAPS score is a useful prognostic marker in dogs with AP.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/32893923/