title: Serum pepsinogen-A, canine pancreatic lipase immunoreactivity, and C-reactive protein as prognostic markers in dogs with gastric dilatation-volvulus.
abstract: BACKGROUND
  Pepsinogens are proenzymes secreted by gastric chief cells. In humans, their serum concentrations reflect gastric mucosal morphological and functional status.
  
  
  OBJECTIVE
  To evaluate serum canine pepsinogen-A (cPG-A), C-reactive protein (CRP), and canine pancreatic lipase immunoreactivity (cPLI) concentrations in dogs with gastric dilatation-volvulus (GDV).
  
  
  METHODS
  Sixty-six dogs presented with GDV and 79 healthy controls.
  
  
  METHODS
  Blood was collected prospectively, and records retrospectively reviewed.
  
  
  RESULTS
  Median cPG-A concentration was higher in GDV dogs (median, 397 μg/L; range, 37-5,410) compared to controls (median, cPG-A 304 μg/L; range, 18-848; P = .07). Mortality rate in GDV dogs was 22.7%. In nonsurvivors of GDV, median cPG-A was higher compared to survivors (median, 746 μg/L; range, 128-5,409 versus median, 346; range, 36-1,575, respectively; P = .003). The proportion of dogs with increased cPG-A increased with gastric wall damage score (P = .007). An ROC analysis of cPG-A as a predictor of death showed an area under the curve (AUC) of 0.75, higher than lactate (AUC 0.66), and corresponded to a sensitivity and specificity of 53% and 88%, respectively. CRP was increased in 48 dogs (75%), cPLI was >200 μg/L in 26 dogs (39.4%) and >400 μg/L in 12 dogs (18.2%) but both analytes had no association with outcome.
  
  
  CONCLUSIONS
  Presurgical cPG-A concentration was positively and significantly associated with gastric wall lesion severity, but, based on ROC analysis, it was only a moderate outcome predictor. CRP and cPLI were commonly increased in dogs with GDV.
authors.affiliation: Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel. Dr_Inbar@yahoo.com
authors.forename: I
authors.initials: I
authors.lastname: Israeli
authors.forename: J
authors.initials: J
authors.lastname: Steiner
authors.forename: G
authors.initials: G
authors.lastname: Segev
authors.forename: P H
authors.initials: PH
authors.lastname: Kass
authors.forename: J S
authors.initials: JS
authors.lastname: Suchodolski
authors.forename: P
authors.initials: P
authors.lastname: Sattasathuchana
authors.forename: Y
authors.initials: Y
authors.lastname: Bruchim
authors.forename: S
authors.initials: S
authors.lastname: Yudelevitch
authors.forename: I
authors.initials: I
authors.lastname: Aroch
mesh_terms: D000818:Animals; D002097:C-Reactive Protein / Q000378:metabolism*; D004283:Dog Diseases / Q000097:blood* / Q000201:enzymology / Q000473:pathology; D004285:Dogs; D005260:Female; D013271:Gastric Dilatation / Q000097:blood / Q000201:enzymology / Q000473:pathology / Q000662:veterinary*; D008049:Lipase / Q000097:blood*; D008297:Male; D020116:Pepsinogen A / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D013277:Stomach Volvulus / Q000097:blood / Q000201:enzymology / Q000473:pathology / Q000662:veterinary*
chemical_list: D020116:Pepsinogen A; D002097:C-Reactive Protein; D008049:Lipase