Serum concentrations of lipid-soluble vitamins in dogs with exocrine pancreatic insufficiency treated with pancreatic enzymes

Abstract

Background: In humans, exocrine pancreatic insufficiency (EPI) is associated with deficiencies in lipid-soluble vitamins. Little is reported regarding lipid-soluble vitamin status in dogs with EPI.

Hypothesis/objectives: Compare serum concentrations of retinol, 25-hydrocholecalciferol (25OHD), and α-tocopherol among dogs with EPI, those with subclinical EPI (sEPI), and healthy dogs. Detect associations between serum concentrations of lipid-soluble vitamins and residual clinical signs in treated dogs with EPI and sEPI.

Animals: Twenty dogs with EPI and five dogs with sEPI receiving pancreatic enzyme replacement therapy. Ten healthy dogs sampled before and after 10 days of pancreatic enzyme supplementation.

Methods: Case-control study. Serum retinol and α-tocopherol concentrations were measured by high-performance liquid chromatography. Serum 25OHD concentrations were measured by radioimmunoassay.

Results: Serum retinol concentration was significantly lower in dogs with EPI (median, 490 ng/mL; range, 322-990 ng/mL) and serum α-tocopherol concentration was significantly lower in dogs with EPI (median, 11.51 μg/L; range, 4.8-27.1 μg/L) and sEPI (median, 12.66 μg/L; range, 10.21-21.03 μg/L) compared with healthy dogs (median, 1203 ng/mL; range, 637-1768 ng/mL and median, 43.54 μg/L; range, 34.26-53.97 μg/L, respectively). Dogs with weight loss had significantly lower 25OHD (mean, 243.50 nmol/L; standard deviation [SD], 3.54 nmol/L) than dogs with stable weight (314.0 nmol/L; SD, 138.38 nmol/L).

Conclusions and clinical importance: Altered homeostasis of lipid-soluble vitamins is present in dogs with EPI and sEPI, despite enzyme replacement therapy. Additional studies are needed to determine the clinical relevance of these findings and the therapeutic potential of lipid-soluble vitamin supplementation in dogs with EPI and sEPI.

Keywords: malabsorption; retinol; tocopherol; vitamin A; vitamin D; vitamin E.

Figure 1

Comparison of serum retinol concentrations. Serum concentrations of retinol were compared between groups. Retinol was significantly lower in dogs with EPI compared with sEPI dogs and healthy controls. The line within the box represent the median value, the “x” within the box represents the mean, the box depicts the interquartile range, the whiskers show the maximum and minimum values less than or equal to 1.5 times the interquartile range. The open dot represents an outlier defined by a value greater than 1.5 times the interquartile range. An asterisk (*) denotes a statistically significant difference (*P < .001)

Figure 2

Comparison of serum 25OHD concentrations. Serum concentrations of 25OHD were compared between groups. There was no significant difference in 25OHD concentrations between groups. The line within the box represent the median value, the “x” within the box represents the mean, the box depicts the interquartile range, the whiskers show the maximum and minimum values

Figure 3

Comparison of serum α‐tocopherol concentrations. Serum concentrations of α‐tocopherol were compared between groups. α‐tocopherol was significantly lower in dogs with EPI and sEPI compared with healthy controls. The line within the box represent the median value, the “x” within the box represents the mean, the box depicts the interquartile range, the whiskers show the maximum and minimum. Asterisks (*) denote statistically significant differences (*P < .001; **P = .02)

Figure 4

Serum concentrations of 25OHD in dogs with persistent weight loss. When dogs with EPI and sEPI were combined into a single group, those with persistent weight loss were found to have significantly lower serum 25OHD compared to dogs with stable weight. the line within the box represent the median value, the “x” within the box represents the mean, the box depicts the interquartile range, the whiskers show the maximum and minimum values. An asterisk (*) denotes a statistically significant difference (*P < .043)