Prognostic usefulness of blood leukocyte changes in canine parvoviral enteritis

Abstract

Background: Despite treatment, many dogs still die of complications related to canine parvoviral (CPV) enteritis. Effective prognostication would be beneficial in managing this disease.

Hypothesis: We hypothesize that the occurrence of leukocytopenias at admission and at 24 and 48 hours after admission, and changes in absolute leukocyte counts over time, could be used to predict outcome.

Animals: Sixty-two puppies with confirmed CPV.

Methods: A prospective study was performed. CBC was performed daily until discharge or death (in which case a postmortem examination was performed).

Results: Of the nonsurvivors (10/62; 16%), 9 died because of complications of the disease and 1 was euthanized because of a poor prognosis. There was a statistical significant difference in the occurrence of leukocytopenias between groups at 24 and 48 hours postadmission. The survivors showed a significant increase over time in certain leukocyte types (specifically lymphocytes) compared with values at admission. The positive predictive value for survivors was high. Nonsurvivors had marked thymic and lymphoid atrophy and marked bone marrow hypocellularity.

Conclusion: An accurate prognosis could be obtained at 24 hours after admission by evaluating the change in total leukocyte, band neutrophil, lymphocyte, monocyte, and eosinophil counts.

Figure 1

Box plot (representing the interquartile range) of the total WBC count over days in puppies (survivors and nonsurvivors) with canine parvoviral enteritis for the first 3 days postadmission. The box incorporates the middle 50% of the observations with the line inside the box as the median. The whiskers extend to the smallest and largest observations, indicating the range of the data. Outliers, values that are 1.5 times removed from the interquartile range, are plotted separately as dots. Note: The number of dogs evaluated decreased by day as indicated in Table 1.

Figure 2

Box plot (representing the interquartile range) of the band neutrophil count over days in puppies (survivors and nonsurvivors) with canine parvoviral enteritis for the first 3 days postadmission. See Figure 1 legend for an explanation. Note: The number of dogs evaluated decreased by day as indicated in Table 1.

Figure 3

Box plot (representing the interquartile range) of the lymphocyte count over days in puppies (survivors and nonsurvivors) with canine parvoviral enteritis for the first 3 days postadmission. See Figure 1 legend for an explanation. Note: The number of dogs evaluated decreased by day as indicated in Table 1.

Figure 4

Box plot (representing the interquartile range) of the monocyte count over days in puppies (survivors and nonsurvivors) with canine parvoviral enteritis for the first 3 days postadmission. See Figure 1 legend for an explanation. Note: The number of dogs evaluated decreased by day as indicated in Table 1.

Figure 5

Box plot (representing the interquartile range) of the eosinophil count over days in puppies (survivors and nonsurvivors) with canine parvoviral enteritis for the first 3 days post admission. See Figure 1 legend for an explanation. Note: the number of dogs evaluated decreased by day as indicated in Table 1.