Evaluation of asymmetric dimethylarginine as an inflammatory and prognostic marker in dogs with acute pancreatitis

Abstract

Background: Asymmetric dimethylarginine (ADMA) has been proposed as a severity marker in humans with acute pancreatitis (AP).Objectives: To evaluate ADMA in dogs with AP compared with healthy dogs and its association with severity of disease, mortality, and indicators of the systemic inflammatory response syndrome (SIRS), including serum C-reactive protein (CRP) concentration, WBC count, and band neutrophils.Animals: Fifty-four dogs with AP and a control group (CG) of 28 healthy dogs.Methods: Cohort study including dogs with AP diagnosed using clinical and laboratory variables, abnormal canine pancreatic lipase (cPL) concentration, and compatible abdominal ultrasound examination findings performed within 48 hours of admission.Canine AP severity (CAPS) was calculated. Serum concentration of ADMA was measured using high performance liquid chromatography. Blood donor-, staff-, and student-owned dogs were enrolled in the CG.Results: Dogs with AP had higher median admission serum ADMA concentrations compared with the CG (62 versus 48.5 μg/dL; P = .003). Dogs with CAPS ≥11 had higher serum ADMA concentrations than did dogs with CAPS <11 (92 versus 54.6 μg/dL P = .009). Univariable analysis for mortality, CAPS score, band neutrophils, CRP, and ADMA were included in multivariable logistic regression, in which only ADMA was associated with mortality (P = .02). Survivors had a significant decrease in ADMA at first reevaluation compared to admission (P = .02).Conclusions and Clinical Importance: Because serum ADMA concentrations were higher in AP dogs compared with the CG, it may have value as a biomarker in the diagnosis of AP in dogs. In addition, because ADMA was associated with mortality, it may have prognostic value. canine, inflammation, pancreas, severityAbbreviations: ADMA, asymmetric dimethylarginine; AP, acute pancreatitis; CAPS, canine acute pancreatitis severity; CG, control group; cPL, canine pancreatic lipase; CRP, C-reactive protein; NO, nitric oxide; NOS, nitric oxide species; SIRS, systemic inflammatory response syndrome.

Progression of lipase activity and pancreatic lipase immunoreactivity in dogs hospitalized for acute pancreatitis and correlation with clinical features

“…Disease duration before presentation often is not described in dogs with pancreatitis. Most publications do not mention duration of clinical signs before the presentation 1,3,5,9,12,15,16,29‐40 . Some studies included dogs with a predefined disease duration, but did not report the actual duration of clinical signs 6,41,42 .…”

“…Most publications do not mention duration of clinical signs before the presentation. 1 , 3 , 5 , 9 , 12 , 15 , 16 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 Some studies included dogs with a predefined disease duration, but did not report the actual duration of clinical signs. 6 , 41 , 42 Some studies consider acute as short as 2 days, 43 others consider 10 days, 6 2 weeks, 41 or 3 weeks 44 as acute.…”

Evaluation of serum miR‐216a and miR‐375 as biomarkers in dogs with acute pancreatitis

“…Dogs with AP and healthy dogs visited our institution between May 2019 and April 2022. Acute pancreatitis was clinically diagnosed if all of the following enrollment criteria were met: (a) at least two of the following acute clinical signs (duration ≤3 days): abdominal pain, diarrhea, vomiting, and hyporexia 18 ; (b) ultrasonographic findings consistent with AP, such as hypoechoic and enlarged pancreatic parenchyma with irregular margins and irregular shape, hyperechoic mesentery, or presence of localized abdominal fluid 19 ; and (c) serum Spec cPL (IDEXX Reference Laboratory Inc., Westbrook, ME) concentrations >400 μg/L (RI, 0‐200 μg/L). 7 For the healthy controls group, client‐owned clinically healthy dogs which were presented for routine health examination, were included in the study based on the unremarkable findings on physical examination, CBC, serum biochemistry profiles, Spec cPL, serum electrolyte analysis, urinalysis, survey radiography, and abdominal ultrasonography.…”

Prognostic Role of Red Cell Distribution Width and Other Routine Clinico-Pathological Parameters in Dogs with Acute Pancreatitis

“…As in human beings with acute pancreatitis (AP), several potential laboratory prognostic markers have been proposed for CAP. In particular, different serum markers, such as C-reactive protein (CRP) [ 3 , 7 ], CRP-to-albumin ratio [ 8 ], canine pancreatic lipase (cPL), and specific canine pancreatic lipase-(Spec cPL) [ 2 , 9 , 10 ], 1,2-o-dilauryl-rac-glycero-3-glutaric acid-6-methylresorufin ester [DGGR] lipase [ 10 , 11 ], azotemia (i.e., serum urea and creatinine) [ 1 , 12 , 13 ], and asymmetric dimethylarginine [ 14 ], as well as some urinary markers, namely urine protein-to-creatinine ratio [ 15 ], urinary GGT-to-creatinine ratio [ 15 ], and plasma coagulative factor antithrombin [ 9 ], have been studied with debatable prognostic results. Furthermore, many of these parameters can be variably expensive, are time consuming and not rapidly available at patient admission.…”