Gisela Arndt

Use of C‐reactive protein to predict outcome in dogs with systemic inflammatory response syndrome or sepsis

BACKGROUND There is a high mortality rate in patients with systemic inflammatory response syndrome (SIRS) or sepsis. Therefore, an early diagnosis and prognostic assessment is important for optimal therapeutic intervention. The objective of the study was to evaluate if baseline values and changes in serum C-reactive protein (CRP) might predict survival in dogs with SIRS and sepsis. DESIGN Prospective study; July 2004 to July 2005. SETTING Small Animal Clinic, Berlin, Clinic of Small Animal Medicine, Munich. ANIMALS Sixty-one dogs. MEASUREMENTS AND MAIN RESULTS For the CRP analysis blood was drawn on day 0, 1, and 2; CRP was measured using a commercial ELISA test kit. Thirteen dogs suffered from nonseptic SIRS and 48 dogs from sepsis. The 14-day survival rate was 61% (69% nonseptic SIRS, 58% sepsis). Serum CRP was higher in sick dogs compared with controls (P<0.001). Over the 3-day period surviving dogs (n=31) displayed a significantly greater decrease in CRP than nonsurvivors (n=10) (P=0.001). No correlation was found between the initial CRP concentrations and the survival rate. The changes in CRP corresponded to the survival rate (P=0.01). CONCLUSION There was no significant relationship between the survival rate in dogs with nonseptic SIRS or sepsis and the initial serum CRP concentrations. There was a correlation between decreasing CRP concentrations and recovery from disease. However, the changes in CRP concentrations over a 3-day period correctly predicted survival in 94% of dogs and death in 30% of the dogs (false positive rate 22%).

Infections with Anaplasma phagocytophilum in dogs in Germany.

The main objectives of this prospective study were to establish prevalence of Anaplasma phagocytophilum infections in dogs from Northeast Germany; and to evaluate the hematological parameters of sero- or real-time PCR-positive clinically healthy dogs. The mean prevalence of A. phagocytophilum seropositivity of 522 dogs (258 suspected to have anaplasmosis, 264 healthy) was 43%. There was no difference between sick (46.9%) and healthy dogs (39.8%) (p=0.100). The PCR test was positive in 30 dogs (20 sick, 10 healthy); morulae were found in 12 of them. Twenty-six of 30 dogs tested PCR-positive between May and September (p<0.05). There was no difference with regard to abnormal CBC parameters between seropositive and seronegative clinically healthy dogs. The CBC was within reference range in 10 PCR-positive clinically healthy dogs suggesting a routine examination of blood donors for A. phagocytophilum in endemic areas to minimize the risk of transmission.

Pulmonary Abnormalities in Dogs with Leptospirosis

BACKGROUND Leptospirosis in dogs is a multiorgan disease affecting mostly kidneys and liver. OBJECTIVES The objective was to characterize prevalence, clinical, and radiological features and outcome of dogs with leptospirosis and pulmonary abnormalities. ANIMALS Fifty dogs with leptospirosis. METHODS Medical records of dogs diagnosed with leptospirosis at the Small Animal Clinic, Berlin, were reviewed. Diagnosis was based on microscopic agglutination test, blood or urine polymerase chain reaction, and histopathology. Based on clinical and/or radiological signs, patients were grouped into dogs with lung abnormalities (group 1) or without (group 2). Severity of respiratory distress was scored as mild to moderate (grade 1) or severe (grade 2). Thoracic radiographs were scored based on pulmonary changes and location as grade 1 (caudal interstitial pattern), 2 (generalized mild to moderate reticulonodular interstitial pattern), or 3 (generalized severe reticulonodular interstitial pattern with patchy alveolar consolidations). Results of CBC and biochemistry were compared between groups. RESULTS Thirty-five dogs had radiological pulmonary changes (grade 1: 5; grade 2: 14; grade 3: 16); 31 of them had pulmonary distress (grade 1: 13, grade 2: 18). Sixty-seven percent of the dogs with dyspnea grade 2 were mainly euthanized because of respiratory distress. Fifteen percent of the dogs with dyspnea grade 1 and 21% without clinical respiratory signs were euthanized because of acute renal failure or sepsis. CONCLUSIONS AND CLINICAL IMPORTANCE In 70% of dogs with leptospirosis pulmonary changes were detected. Lung involvement represented a severe complication causing increased case fatality depending on the severity of respiratory distress.

Accuracy and reproducibility of the TonoVet® rebound tonometer in birds of prey

OBJECTIVE To examine the accuracy and reproducibility of intraocular pressure (IOP) measurements obtained by the TonoVet rebound tonometer. Animals studied  Freshly enucleated healthy eyes of 44 free-ranging birds of prey out of the species Haliaeetus albicilla, Accipiter gentilis, Accipiter nisus, Buteo buteo, Falco tinnunculus, Strix aluco, Asio otus and Tyto alba euthanized because of unrelated health problems. PROCEDURES IOP readings from the TonoVet were compared with a manometric device, with IOP being set from 5 to 100 mmHg in steps of 5 mmHg by adjusting the height of a NaCl solution reservoir connected to the eye. Reproducibility of the TonoVet readings was determined by repeated measurements. RESULTS TonoVet and manometer values showed a strong linear correlation. In the Accipitridae, the TonoVet tended to increasingly overestimate IOP with increasing pressure, while in the other families, it increasingly underestimated it. In the Sparrowhawk, the values almost represent the ideal line. Reproducibility of TonoVet values decreases with increasing pressure in the clinically important range from 5 to 60 mmHg. CONCLUSION IOP values measured with the TonoVet demonstrated species specific deviation from the manometric measurements. These differences should be considered when interpreting IOP values. Using the regression formulae presented, corrected IOP values could be calculated in a clinical setting.

Reference Intervals for Intraocular Pressure Measured by Rebound Tonometry in Ten Raptor Species and Factors Affecting the Intraocular Pressure

Abstract Intraocular pressure (IOP) was measured with the TonoVet rebound tonometer in 10 raptor species, and possible factors affecting IOP were investigated. A complete ophthalmic examination was performed, and IOP was assessed in 2 positions, upright and dorsal recumbency, in 237 birds belonging to the families Accipitridae, Falconidae, Strigidae, and Tytonidae. Mean IOP values of healthy eyes were calculated for each species, and differences between families, species, age, sex, left and right eye, as well as the 2 body positions were evaluated. Physiologic fluctuations of IOP were assessed by measuring IOP serially for 5 days at the same time of day in 15 birds of 3 species. Results showed IOP values varied by family and species, with the following mean IOP values (mm Hg ± SD) determined: white-tailed sea eagle (Haliaeetus albicilla), 26.9 ± 5.8; red kite (Milvus milvus), 13.0 ± 5.5; northern goshawk (Accipiter gentilis), 18.3 ± 3.8; Eurasian sparrowhawk (Accipiter nisus), 15.5 ± 2.5; common buzzard (Buteo buteo), 26.9 ± 7.0; common kestrel (Falco tinnunculus), 9.8 ± 2.5; peregrine falcon, (Falco peregrinus), 12.7 ± 5.8; tawny owl (Strix aluco), 9.4 ± 4.1; long-eared owl (Asio otus), 7.8 ± 3.2; and barn owl (Tyto alba), 10.8 ± 3.8. No significant differences were found between sexes or between left and right eyes. In goshawks, common buzzards, and common kestrels, mean IOP was significantly lower in juvenile birds than it was in adult birds. Mean IOP differed significantly by body position in tawny owls (P  =  .01) and common buzzards (P  =  .04). By measuring IOP over several days, mean physiologic variations of ±2 mm Hg were detected. Differences in IOP between species and age groups should be considered when interpreting tonometric results. Physiologic fluctuations of IOP may occur and should not be misinterpreted. These results show that rebound tonometry is a useful diagnostic tool in measuring IOP in birds of prey because it provides rapid results and is well tolerated by birds.

Evaluation of a point-of-care test for canine C-reactive protein.

BACKGROUND In veterinary medicine, there is increasing interest in measuring C-reactive protein (CRP) as a tool for diagnosis and monitoring of inflammatory diseases. Reported CRP concentrations for healthy dogs have ranged from 0 to 8.9 mg/L. OBJECTIVES The aims of this study were to evaluate a canine-specific point-of-care (POC) lateral flow immunoassay for qualitative CRP measurement in healthy and diseased dogs and to compare results with those obtained by a quantitative ELISA. METHODS Blood samples from 73 client-owned dogs were available for testing: 16 healthy dogs and 57 dogs with a variety of infectious, inflammatory, or neoplastic diseases. CRP was measured in heparinized whole blood samples and serum with the TECO medical Dog CRP-visual POC test. A red line develops in the POC device if CRP is ≥ 5 mg/L, and results are scored as negative or positive. An ELISA validated previously for canine serum was used as the reference method. RESULTS For all dogs, serum CRP concentrations measured by the ELISA ranged from 0.1 to ≥ 350 mg/L (median = 38 mg/L). Percentages of the CRP POC test results that agreed with the ELISA results were 98.6% for whole blood and 97.3% for serum samples. For serum samples, sensitivity of the POC test was 96.4% and specificity was 81.3%. For whole blood, sensitivity was 94.7% and specificity was 93.8%. CONCLUSIONS The POC test had very good agreement with the ELISA test and had high sensitivity and specificity; therefore, it can be used as a qualitative test to screen for increases in CRP concentrations.