Small Animal Medicine Resident Tufts Millbury, Massachusetts, United States
Abstract:
Background: Serum C-reactive protein (CRP) is an inflammatory biomarker in dogs. It is unknown whether CRP is elevated in dogs with diabetic ketoacidosis (DKA). Hypothesis/
Objectives: Serum CRP will be increased in dogs with DKA but not in dogs with stable, outpatient-managed diabetes mellitus (DM). Increased serum CRP in DKA dogs will correlate with immunoreactive pancreatic lipase (cPL) and ultrasound pancreatitis assessment score (UPASS). Animals: Twenty-one dogs with DKA and 15 dogs with stable, outpatient-managed DM presented to an academic hospital.
Methods: Prospective case control study. Serum CRP (Cornell Diagnostic Center) and Vcheck cPL (BioNote, Inc) were determined on admission (DKA) or during an outpatient visit (stable DM). DKA dogs had an ultrasound within 24 hours and an UPASS assigned by a single boarded radiologist. Mann-Whitney and Spearman correlation were used to analyze data with p < 0.05 considered significant.
Results: All stable DM dogs had serum CRP below the limit of detection (5mg/L) while 16/21 (76%) DKA dogs had a statistically significant (p = 0.0001) increase (21.9mg/L (5-259.3mg/L). Nineteen of 21 (90%) DKA dogs and 2/15 (13%) stable DM dogs had a cPL >400 ng/ml (p = 0.0001). In DKA dogs, serum CRP was not correlated with cPL (rho = 0.191, p = 0.41) or UPASS (rho = 0.242, p = 0.29). Conclusions/Clinical Importance: Stable DM dogs have normal serum CRP. DKA is marked by high serum CRP that are not correlated with the presence of pancreatitis. The cause of increased serum CRP in DKA dogs will require additional investigation.
