In-hospital mortality in dogs with protein-losing enteropathy and associated risk factors

Abstract

Background: Risk factors associated with negative outcomes in dogs with protein-losing enteropathy (PLE) are well documented. However, mortality before hospital discharge and associated risk factors are not well described.

Hypothesis/objectives: Report the percentage of dogs with PLE that do not survive to hospital discharge and identify associated risk factors.

Animals: One-hundred and seven dogs presented to a referral hospital and diagnosed with PLE caused by inflammatory enteritis, intestinal lymphangiectasia or both.

Methods: Retrospective cross-sectional study assessing hospital records. Data on in-hospital mortality and cause were assessed, and presenting signs, treatments prescribed, neutrophil count, lymphocyte count, serum albumin, globulin, and C-reactive protein (CRP) concentrations, and histopathologic findings were compared between survivors and non-survivors.

Results: In-hospital mortality was 21.5% with the most common causes including financial limitations, failure to improve and aspiration pneumonia. Factors associated with mortality during hospitalization included longer duration of hospitalization (P = .04), longer duration of clinical signs (P = .02) and an increase in serum CRP concentration after 1-3 days of in-hospital treatment (P = .02). Higher mortality was identified in Pugs (odds ratio [OR], 4.93; 95% confidence interval [CI], 1.41-17.2; P = .01) and was a result of presumptive aspiration pneumonia in 5/6 of these dogs.

Conclusions and clinical importance: Protein-losing enteropathy in dogs has substantial mortality during hospitalization. Monitoring for improvement in CRP concentration after treatment during hospitalization may help predict survival to discharge. Pugs have increased in-hospital mortality because of aspiration pneumonia; measures to prevent, recognize, and promptly treat this complication may improve outcomes in this breed.

Keywords: C‐reactive; canine; diarrhea; gastrointestinal; pneumonia; pug.

FIGURE 1

The difference in change of serum C‐reactive protein (CRP) concentration from admission to 1–3 days of in‐hospital treatment between dogs with protein‐losing enteropathy surviving or not surviving until hospital discharge. A significant difference was found in the change in CRP from day 0 to 1‐3 days after treatment in‐hospital between survivors and non‐survivors: −11 (+/−40.8) mg/dL vs. +28 (+/−39.1) mg/dL (P = .02).