Malnutrition is associated with increased mortality in humans with inflammatory bowel disease. Therefore, the aims of our study were to determine if historical, clinical, and laboratory parameters of malnutrition at the time of diagnosis in dogs with protein-losing enteropathy (PLE) due to chronic enteropathy (CE) or lymphangiectasia affect mortality following treatment failure.
The medical records between 2010 and 2017 were retrospectively searched for canine cases of PLE, diagnosed with CE or lymphangiectasia on histopathology of intestinal biopsies. Neoplastic causes, including alimentary lymphoma, were excluded. For each case, historical, clinical, and laboratory parameters at the time of diagnosis was recorded and follow-up obtained by telephone contact with the referring veterinary practice. Dogs with a body condition score (BCS) below 4/9 were categorized as under-conditioned, dogs with a BCS of 5/9 as ideal-conditioned, and dogs with a BCS of above 5/9 as over-conditioned. Dogs with a BCS of 4/9 were placed in the under-conditioned or ideal-conditioned group based on the clinician’s written assessment.
Seventy-one dogs were identified; 47 (66 %) were under-conditioned (median: 3; range: 1 to 4), 18 (25 %) ideal-conditioned (median: 4; range: 4 to 5) and 6 (8 %), over-conditioned (median: 6 to 6 - 7; range: 5 - 6 to 8). Sixty-one dogs (88 %) had documented weight loss at the time of diagnosis; 30 (43 %) had severe (≥10 %), 22 (32 %) had moderate (5 - 9.9 %), and 9 (13 %) had mild (0.1-4.9%) loss. Two dogs were lost to follow-up and 29 out of 69 dogs (42 %) died or were euthanized following treatment failure. There were no significant effects of body condition score, percentage weight loss, body weight, appetite, serum albumin, cholesterol, cobalamin, and folate concentrations, canine chronic enteropathy activity index, and duration of signs on mortality (P>0.05). However, dogs that had higher caloric intake at diagnosis had increased number of days to death or euthanasia following treatment failure (P = 0.002, correlation coefficient = 0.571).
Parameters associated with malnutrition at the time of diagnosis of PLE due to CE or lymphangiectasia in dogs in this study were not a predictor of mortality following treatment failure and therefore cannot be used to predict response to treatment. However, alternative measures of malnutrition may be required to definitively investigate the role of malnutrition in the prognosis of canine PLE.
University of Bristol
Dr. Kathrani graduated from the Royal Veterinary College, London, UK in 2006 and completed her rotating small animal medicine and surgery internship at the Queen Mother Hospital for Animals, Royal Veterinary College in 2007. She finished her PhD in canine inflammatory bowel disease at the Royal Veterinary College in 2011. Dr Kathrani then completed a three year residency program in small animal internal medicine at Cornell University in July 2014, and is board certified in small animal internal medicine. Dr. Kathrani also completed a two year residency program in small animal clinical nutrition at UC Davis in July 2016, and is board certified in small animal nutrition. Dr. Kathrani is currently a senior lecturer in small animal medicine at the University of Bristol.
Thursday, June 14
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