Plasma procalcitonin concentrations predict organ dysfunction and outcome in dogs with sepsis

Abstract

BackgroundProcalcitonin (PCT) is a valuable prognostic biomarker in human sepsis that is predictive of organ dysfunction, septic shock and mortality. Data on PCT in dogs is limited. This study aimed to investigate the prognostic value of baseline and serial PCT measurements in dogs with sepsis and to determine the association between PCT and sepsis severity and the presence of organ dysfunction. PCT concentrations were measured in citrated plasma samples collected from 53 dogs with sepsis at the time of admission (T0, n = 53) and at 24 h (T1, n = 35) and 48 h (T2, n = 30) post-admission using a commercial ELISA. Dogs were classified by sepsis severity (sepsis without organ dysfunction; severe sepsis; septic shock) and outcome (survivors; non-survivors). Organ dysfunctions were recorded at T0 and during hospitalization, and the APPLEfast score calculated at T0. Healthy dogs (n = 12) were used as controls.ResultsThere were 18 septic dogs without organ dysfunction, 24 dogs with severe sepsis and 11 with septic shock. Baseline PCT concentrations were significantly greater in dogs with sepsis compared to healthy controls (P < 0.0001), and in dogs with septic shock compared to dogs without cardiovascular compromise (P = 0.01). Baseline PCT was significantly correlated with organ dysfunction (P = 0.003). Declining PCT concentrations were documented in survivors at T1 and T2 compared to PCT at T0 (P = 0.0006), and PCT clearance at 24 h was significantly higher in survivors (n = 38) compared to non-survivors (n = 15) (P = 0.037). Canine APPLEfast score was not predictive of sepsis severity, the development of MODS or outcome.ConclusionIn dogs with sepsis, PCT concentrations at hospital admissions are predictive of organ dysfunction and septic shock. Serial procalcitonin monitoring may offer valuable prognostic information in canine sepsis, wherein early decreases in PCT concentrations are associated with survival.Electronic supplementary materialThe online version of this article (10.1186/s12917-018-1427-y) contains supplementary material, which is available to authorized users.

Serum procalcitonin concentrations in dogs with induced endotoxemia

“…Although endotoxemia in dogs secondary to LPS administration continues to be a common experimental model to simulate sepsis, the sources, concentrations and kinetics of LPS in dogs, and subsequent expression of PCT with naturally occurring sepsis are likely to be highly variable. In 2 previous studies evaluating PCT in dogs with naturally occurring sepsis, PCT was significantly elevated compared to healthy controls, however there was considerable variability in the PCT concentrations within these subjects . Interestingly, serial PCT concentrations were assessed in 1 of these groups, with survivors having significantly improved PCT concentrations by 48 hours compared to nonsurvivors …”

“…Although previous studies have documented increased PCT in dogs with clinical evidence of naturally occurring sepsis, this study evaluated serial concentrations of PCT in dogs with experimentally induced endotoxemia. The temporal course of induction and subsequent decline of PCT after a single dose of LPS documented in the current study are similar to those described in humans and horses.…”

“…Dogs with a clinical suspicion of sepsis have significantly higher serum PCT concentrations than do healthy controls . Furthermore, higher PCT concentrations are associated with the development of multiple organ dysfunction syndrome and septic shock in dogs . Additionally, reduction in PCT concentration in the first 24 hours is associated with survival and recovery from sepsis …”

“…14 Furthermore, higher PCT concentrations are associated with the development of multiple organ dysfunction syndrome and septic shock in dogs. 15 Additionally, reduction in PCT concentration in the first 24 hours is associated with survival and recovery from sepsis. 15 However, there is no data on serial concentrations of PCT in dogs in response to LPS administration in a controlled setting.…”

“…15 Additionally, reduction in PCT concentration in the first 24 hours is associated with survival and recovery from sepsis. 15 However, there is no data on serial concentrations of PCT in dogs in response to LPS administration in a controlled setting. The aim of the present study was to evaluate the response of serum PCT concentration after a single sublethal injection of LPS to healthy dogs.…”