Hypovitaminosis D Is Associated with Negative Outcome in Dogs with Protein-Losing Enteropathy: A Retrospective Study of 43 Cases
Karin Allenspach, Dr.med.vet, PhD, DECVIM-CA
Iowa State University, College of Veterinary Medicine, USA
University of London, Royal Veterinary College, Research Support Office, Hertfordshire, U.K.
Overview
Low serum concentrations of vitamin D are prevalent among dogs with protein losing enteropathy (PLE). This presentation describes a retrospective study of 43 dogs that shows, for the first time, low serum concentrations of vitamin D and iCa are highly prevalent in a cohort of PLE dogs, and that low serum vitamin D is significantly associated with poor clinical outcomes.
Key points
- The aim of the study was to assess the prevalence of decreased 25(OH)D serum concentrations in dogs with PLE secondary to inflammatory bowel disease (IBD) and determine if 25(OH)D could be a prognostic indicator of clinical outcome.
- Dogs enrolled in this study were seen at the Royal Veterinary College between 2005 and 2014, and had a clinical diagnosis of PLE. The “good outcome” group (n=21) did well, or died from a different disease, at least 1 year after follow up. The “poor outcome group” (n= 22) was deceased within 4 months of diagnosis. Treatment groups were divided into: diet only, or diet + immunosuppressant.
- Age, breed, CCECAI (Canine Chronic Enteropathy Clinical Activity Index) scores, and body condition score were not predictors of outcome.
- Diet alone was associated with good outcomes in a significantly greater numbers of dogs (13/22).
- Low-serum 25(OH)D concentration in PLE dogs was significantly associated with poor outcome. (median 16.5 nmol/L in poor outcome group vs 37 nmol/L in good outcome group with normal range= 6-81 nmol/L) and this parameter was the only significant risk factor in the multivariate logistic regression analysis.
- Higher serum concentrations of Serum 25(OH)D at time of diagnosis indicated better survival.
Clinical relevance
Dogs with protein losing enteropathy, inflammatory bowel disease, and intestinal lymphoma have variable prognoses. The risk factors for PLE dogs have not been well characterized. This research shows that serum concentrations of vitamin D and iCa may be useful biomarkers to help veterinarians better assess these patients. Nutrition may also improve the outcome for some of these dogs.
