Hypocobalaminaemia in dogs with acute gastrointestinal diseases

Abstract

ObjectivesThe objectives of this study were to investigate the prevalence of hypocobalaminaemia in dogs with acute gastrointestinal diseases and to evaluate its relationship with disease severity and outcome.Materials and MethodsMedical records of dogs presented for acute gastrointestinal signs that a serum cobalamin concentration measured between September 2019 and 2021 were included in this study. Hypocobalaminaemia was defined as serum cobalamin concentration <200 pmol/L, and low‐normal cobalamin was defined as serum cobalamin concentration of 200 to 295 pmol/L. Duration of clinical signs prior to presentation, Acute Patient Physiologic and Laboratory Evaluation (APPLE) fast score, length of hospitalisation and outcome were recorded.ResultsThirty‐three dogs were included. Seventeen dogs were diagnosed with acute gastrointestinal disease of unknown aetiology, seven dogs with parvoviral enteritis, three dogs with acute haemorrhagic diarrhoea syndrome and six dogs with miscellaneous diseases. The prevalence of hypocobalaminaemia in this population was 30.3% and low‐normal cobalamin concentration was detected in 18.2% of dogs. There was no statistically significant relationship between the detection of hypocobalaminaemia or low‐normal cobalamin and the duration of clinical signs before presentation, length of hospitalisation or Acute Patient Physiologic and Laboratory Evaluation fast score on admission. Mortality rate was 3%.Clinical SignificanceHypocobalaminaemia and low‐normal cobalamin are common findings in dogs with acute gastrointestinal diseases. The therapeutic significance and potential implications for prognosis of hypocobalaminaemia in these patients requires further investigation.

Implications of hypocobalaminemia as a negative prognostic marker in juvenile dogs with parvovirus enteritis

“…Additionally, in our study we found significant differences in several hematological variables between groups (hematocrit, WBC, total neutrophils), but most importantly we detected a significant positive correlation between CBL and WBC (spearman’s rho 0.378, p = 0.039), which indicates that CBL concentrations are lower with worsening leukopenia and possibly disease severity. This hypothesis can be supported by the fact that we detected a significant negative correlation between CBL and APPLE score (spearman’s rho −0.416, p = 0.025), a connection that was not found in a previous study ( 36 ).…”

“…A recent study demonstrated that approximately 48% of dogs with acute gastrointestinal disorders have low CBL concentrations ( 36 ). Our results are consistent with previous studies, were young patients with parvoviral infection showed lower CBL compared to healthy controls ( 24 ).…”

“…Dogs with parvoviral infection frequently receive antibiotics to treat or prevent possible bacterial translocation, secondary to intestinal epithelial loss, exacerbated by the virus causing leukopenia and neutropenia. The prolonged use of antibiotics could additionally lead to other long-term effects, to worsening dysbiosis of the intestinal microbiome and consequently worsening hypocobalaminemia and failure to respond to supplementation ( 36 , 42 , 43 ). In our PG all patients had to receive antibiotics, but no significant differences were found when different antimicrobial protocols were compared.…”