title: Hypovitaminosis D is associated with negative outcome in dogs with protein losing enteropathy: a retrospective study of 43 cases.
abstract: BACKGROUND
  Hypovitaminosis D has previously been shown to be prevalent amongst dogs with protein losing enteropathy (PLE). The hypothesis of this study was that Low 25-hydroxyvitamin D (25(OH) D) serum concentrations could be a risk factor for negative outcome in dogs with PLE. Forty-three dogs diagnosed with PLE (2005-2014) and which serum Vitamin D serum concentrations were collected and archived at -80 Degrees C were analyzed. Post-diagnostic communication with referring veterinarians was made to determine outcome of PLE dogss: Dogs which died due to PLE within 4 months after diagnosis (negative outcome group, n = 22) and dogs alive or which died due to another disease at the end point of the study (1 year after diagnosis, good outcome group, n = 21). Serum samples taken at the time of diagnosis were analysed for ionized calcium (iCa) concentrations and serum 25(OH) D concentration.
  
  
  RESULTS
  Clinical (CCECAI) scores, age at PLE diagnosis, and iCa concentrations were not significantly different between dog groups. A significantly greater (p < 0.001) number of PLE dogs treated with hydrolyzed or elimination diet alone showed good outcome as compared to the PLE negative outcome group. Median serum 25(OH) D concentration was significantly (p = 0.017) lower in dogs with negative outcome versus PLE dogs with good outcome. Using logistic regression analysis, 25(OH) D serum concentration was shown to be a statistically significant factor for outcome determination. Cox regression analysis yielded a hazard ratio of 0.974 (95% CI 0.949, 0.999) per each one nmol/l increase in serum 25(OH) D concentration.
  
  
  CONCLUSIONS
  Low serum 25(OH) D concentration in PLE dogs was significantly associated with poor outcome. Further studies are required to investigate the clinical efficacy of Vitamin D (cholecalciferol) as a potential therapeutic agent for dogs with PLE.
authors.affiliation: Department of Clinical Sciences and Services, University of London, North Mymms, Hertfordshire, UK. allek@iastate.edu.|Department of Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, 50011, USA. allek@iastate.edu.
authors.forename: K
authors.identifier: http://orcid.org/0000-0002-2168-5809
authors.initials: K
authors.lastname: Allenspach
authors.affiliation: Department of Clinical Sciences and Services, University of London, North Mymms, Hertfordshire, UK.
authors.forename: J
authors.initials: J
authors.lastname: Rizzo
authors.affiliation: Research Support Office, Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK.
authors.forename: A E
authors.initials: AE
authors.lastname: Jergens
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA.
authors.forename: Y M
authors.initials: YM
authors.lastname: Chang
mesh_terms: D000818:Animals; D002118:Calcium / Q000097:blood; D004032:Diet / Q000662:veterinary; D004283:Dog Diseases / Q000097:blood* / Q000401:mortality; D004285:Dogs; D005260:Female; D008297:Male; D011504:Protein-Losing Enteropathies / Q000097:blood / Q000401:mortality / Q000662:veterinary*; D012189:Retrospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000662:veterinary*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium
keywords: Dog; Ionized calcium; Outcome; Protein losing enteropathy (PLE); Risk factors; Vitamin D3