Serum Pepsinogen-A, Canine Pancreatic Lipase Immunoreactivity, and C-Reactive Protein as Prognostic Markers in Dogs with Gastric Dilatation-Volvulus

I. Israeli, J. Steiner, G. Segev, Philip H Kass, J. S. Suchodolski, P. Sattasathuchana, Y. Bruchim, S. Yudelevitch, I. Aroch

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Pepsinogens are proenzymes secreted by gastric chief cells. In humans, their serum concentrations reflect gastric mucosal morphological and functional status. Objectives: To evaluate serum canine pepsinogen-A (cPG-A), C-reactive protein (CRP), and canine pancreatic lipase immunoreactivity (cPLI) concentrations in dogs with gastric dilatation-volvulus (GDV). Animals: Sixty-six dogs presented with GDV and 79 healthy controls. Methods: Blood was collected prospectively, and records retrospectively reviewed. Results: Median cPG-A concentration was higher in GDV dogs (median, 397 μg/L; range, 37-5,410) compared to controls (median, cPG-A 304 μg/L; range, 18-848; P = .07). Mortality rate in GDV dogs was 22.7%. In nonsurvivors of GDV, median cPG-A was higher compared to survivors (median, 746 μg/L; range, 128-5,409 versus median, 346; range, 36-1,575, respectively; P = .003). The proportion of dogs with increased cPG-A increased with gastric wall damage score (P = .007). An ROC analysis of cPG-A as a predictor of death showed an area under the curve (AUC) of 0.75, higher than lactate (AUC 0.66), and corresponded to a sensitivity and specificity of 53% and 88%, respectively. CRP was increased in 48 dogs (75%), cPLI was >200 μg/L in 26 dogs (39.4%) and >400 μg/L in 12 dogs (18.2%) but both analytes had no association with outcome. Conclusions: Presurgical cPG-A concentration was positively and significantly associated with gastric wall lesion severity, but, based on ROC analysis, it was only a moderate outcome predictor. CRP and cPLI were commonly increased in dogs with GDV.

Original languageEnglish (US)
Pages (from-to)920-928
Number of pages9
JournalJournal of Veterinary Internal Medicine
Volume26
Issue number4
DOIs
StatePublished - Jul 2012

Fingerprint

Gastric Dilatation
Stomach Volvulus
Pepsinogen A
pepsinogen
volvulus
C-reactive protein
blood serum
Lipase
C-Reactive Protein
triacylglycerol lipase
Canidae
stomach
Dogs
dogs
Serum
Stomach
ROC Curve
Area Under Curve
Gastric Chief Cells
Pepsinogens

Keywords

  • Dog
  • Gastrectomy
  • Gastric necrosis
  • Prognosis

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Serum Pepsinogen-A, Canine Pancreatic Lipase Immunoreactivity, and C-Reactive Protein as Prognostic Markers in Dogs with Gastric Dilatation-Volvulus. / Israeli, I.; Steiner, J.; Segev, G.; Kass, Philip H; Suchodolski, J. S.; Sattasathuchana, P.; Bruchim, Y.; Yudelevitch, S.; Aroch, I.

In: Journal of Veterinary Internal Medicine, Vol. 26, No. 4, 07.2012, p. 920-928.

Research output: Contribution to journalArticle

Israeli, I. ; Steiner, J. ; Segev, G. ; Kass, Philip H ; Suchodolski, J. S. ; Sattasathuchana, P. ; Bruchim, Y. ; Yudelevitch, S. ; Aroch, I. / Serum Pepsinogen-A, Canine Pancreatic Lipase Immunoreactivity, and C-Reactive Protein as Prognostic Markers in Dogs with Gastric Dilatation-Volvulus. In: Journal of Veterinary Internal Medicine. 2012 ; Vol. 26, No. 4. pp. 920-928.
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abstract = "Background: Pepsinogens are proenzymes secreted by gastric chief cells. In humans, their serum concentrations reflect gastric mucosal morphological and functional status. Objectives: To evaluate serum canine pepsinogen-A (cPG-A), C-reactive protein (CRP), and canine pancreatic lipase immunoreactivity (cPLI) concentrations in dogs with gastric dilatation-volvulus (GDV). Animals: Sixty-six dogs presented with GDV and 79 healthy controls. Methods: Blood was collected prospectively, and records retrospectively reviewed. Results: Median cPG-A concentration was higher in GDV dogs (median, 397 μg/L; range, 37-5,410) compared to controls (median, cPG-A 304 μg/L; range, 18-848; P = .07). Mortality rate in GDV dogs was 22.7{\%}. In nonsurvivors of GDV, median cPG-A was higher compared to survivors (median, 746 μg/L; range, 128-5,409 versus median, 346; range, 36-1,575, respectively; P = .003). The proportion of dogs with increased cPG-A increased with gastric wall damage score (P = .007). An ROC analysis of cPG-A as a predictor of death showed an area under the curve (AUC) of 0.75, higher than lactate (AUC 0.66), and corresponded to a sensitivity and specificity of 53{\%} and 88{\%}, respectively. CRP was increased in 48 dogs (75{\%}), cPLI was >200 μg/L in 26 dogs (39.4{\%}) and >400 μg/L in 12 dogs (18.2{\%}) but both analytes had no association with outcome. Conclusions: Presurgical cPG-A concentration was positively and significantly associated with gastric wall lesion severity, but, based on ROC analysis, it was only a moderate outcome predictor. CRP and cPLI were commonly increased in dogs with GDV.",
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AU - Israeli, I.

AU - Steiner, J.

AU - Segev, G.

AU - Kass, Philip H

AU - Suchodolski, J. S.

AU - Sattasathuchana, P.

AU - Bruchim, Y.

AU - Yudelevitch, S.

AU - Aroch, I.

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AB - Background: Pepsinogens are proenzymes secreted by gastric chief cells. In humans, their serum concentrations reflect gastric mucosal morphological and functional status. Objectives: To evaluate serum canine pepsinogen-A (cPG-A), C-reactive protein (CRP), and canine pancreatic lipase immunoreactivity (cPLI) concentrations in dogs with gastric dilatation-volvulus (GDV). Animals: Sixty-six dogs presented with GDV and 79 healthy controls. Methods: Blood was collected prospectively, and records retrospectively reviewed. Results: Median cPG-A concentration was higher in GDV dogs (median, 397 μg/L; range, 37-5,410) compared to controls (median, cPG-A 304 μg/L; range, 18-848; P = .07). Mortality rate in GDV dogs was 22.7%. In nonsurvivors of GDV, median cPG-A was higher compared to survivors (median, 746 μg/L; range, 128-5,409 versus median, 346; range, 36-1,575, respectively; P = .003). The proportion of dogs with increased cPG-A increased with gastric wall damage score (P = .007). An ROC analysis of cPG-A as a predictor of death showed an area under the curve (AUC) of 0.75, higher than lactate (AUC 0.66), and corresponded to a sensitivity and specificity of 53% and 88%, respectively. CRP was increased in 48 dogs (75%), cPLI was >200 μg/L in 26 dogs (39.4%) and >400 μg/L in 12 dogs (18.2%) but both analytes had no association with outcome. Conclusions: Presurgical cPG-A concentration was positively and significantly associated with gastric wall lesion severity, but, based on ROC analysis, it was only a moderate outcome predictor. CRP and cPLI were commonly increased in dogs with GDV.

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KW - Gastrectomy

KW - Gastric necrosis

KW - Prognosis

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