title: Is Serum Total LDH Evaluation Able to Differentiate between Alimentary Lymphoma and Inflammatory Bowel Disease in a Real World Clinical Setting?
abstract: BACKGROUND
  An increase in enzyme lactate dehydrogenase (LDH) in serum is a negative prognostic factor for survival in cats affected by lymphoma. Measuring LDH at the time of diagnosis has been studied for differentiating neoplastic disease from non-neoplastic disease in dogs. Inflammatory bowel disease (IBD) and alimentary lymphoma are common diseases in cats.
  
  
  OBJECTIVE
  The aim of this study was to determine whether elevation of total LDH occurred in cats with alimentary lymphoma and non-neoplastic gastrointestinal disease, such as IBD, and to evaluate whether this enzyme is useful in supporting the differential diagnosis of these specific diseases.
  
  
  METHODS
  A prospective non-randomized controlled study was carried-out in a real world setting of three Italian private veterinary clinics. Seventy-one client-owned cats with a history of chronic gastrointestinal symptoms were enrolled; 33 cats were histologically diagnosed as having alimentary lymphoma and 38 cats as having IBD. Serum samples of total LDH analysis were measured.
  
  
  RESULTS
  Gender (P = 0.016) and age (P = 0.046) were found to be significant factors influencing the differentiation of serum total LDH between cats with alimentary lymphoma and those with IBD. Despite low diagnostic accuracy in the overall population (63%), a cut-off value of serum total LDH ranging from 0.85- to 1.04-times the upper reference limit showed good capability (accuracy >80%) of differentiating these two conditions in neutered males and cats younger than 8 years of age (AUC: 0.805, 0.833; sensitivities: 76.9%, 83.3%; specificities: 80.0%, 76.5%; PPV: 76.9%, 55.6%; NPV: 80.0%, 92.9%; respectively).
  
  
  CONCLUSIONS
  Although our study showed that gender and age are significant factors in differentiating serum total LDH between cats with alimentary lymphoma and those with IBD, this test had poor diagnostic accuracy in differentiating between these two conditions in the overall population.
authors.affiliation: "Petcare" Veterinary Association, Marzabotto, (BO), Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Terragni
authors.affiliation: Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy.
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Morselli-Labate
authors.affiliation: Faculty of Veterinary Medicine, University of Teramo, Piano d'Accio, (TE), Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Vignoli
authors.affiliation: "Argentina" Polyclinic, Arma di Taggia, (IM), Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Bottero
authors.affiliation: Department of Veterinary Medical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Brunetti
authors.affiliation: Medical Imaging, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.
authors.forename: Jimmy H
authors.initials: JH
authors.lastname: Saunders
mesh_terms: D000367:Age Factors; D000818:Animals; D002371:Cat Diseases / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D002415:Cats; D003937:Diagnosis, Differential; D004067:Digestive System Neoplasms / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000662:veterinary*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000662:veterinary*; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008223:Lymphoma / Q000097:blood / Q000175:diagnosis / Q000201:enzymology / Q000662:veterinary*; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012737:Sex Factors
chemical_list: D007770:L-Lactate Dehydrogenase