Malnutrition occurs when the supply of available nutrients is less than organic demand. It is an underdiagnosed problem in veterinary medicine and can result in several negative metabolic consequences, with greater morbidity and mortality. Currently, the classification of nutritional status (NS) is performed subjectively in veterinary medicine, so studies and discoveries about laboratory markers (objectives) of malnutrition are desirable. This study evaluated the correlations between several laboratory variables (practical and low-cost measurements) and the nutritional status (NS) of 246 dogs from a veterinary school hospital in southern Brazil. In this way, the laboratory profile of malnutrition in this population is evident. NS was classified by body condition score (BCS) and muscle mass score (MMS). A patient was considered to be malnourished if the BCS was less than 3 (values from 1 to 9). The laboratory variables analyzed were hemogram, cholesterol, total protein (TP), albumin, C-reactive protein (CRP), CRP/albumin ratio, total iron-binding capacity (TIBC), transferrin (TF), transferrin saturation index (TSI), and transthyretin. The means and standard deviations of the variables, correlation analyses, and comparative analyses (Kruskal-Wallis in α = 5%) were calculated. This research aimed to identify objective and practical malnutrition markers that help in the elaboration of a protocol for nutritional evaluation in diseased dogs. Low values of TF, TIBC, TP, hemogram, and TSI elevation were indicative of malnutrition. Additionally, cholesterol and albuminemia are not good markers of malnutrition in dogs with systemic diseases. For the graduation of the inflammatory state (important to differentiate inflammatory hypoproteinemia from protein malnutrition), it is more reliable to measure the CRP/albumin ratio. Canine transthyretin cannot be measured with reagents designed for humans, such as those used in this study. It was possible to conclude that laboratory indicators of malnutrition in sick dogs include low values of TF, TIBC, and TP, anemia, and elevations of TSI. The joint changes in these markers gradually reinforced the diagnosis.

The objective of this research was to creates a reference interval for C-reactive protein (CRP)/albumin ratio (CAR) in the canine species and to analyze the potential of CRP, albumin and the relationship between both, to serve as indicators of disease severity, length of hospital stay (LoS) and mortality in this species. For this, an outcome study was conducted in a Veterinary Teaching Hospital in southern Brazil. One hundred ninety dogs were included randomly, without distinction of gender, age, or breed, from June 2013 to November 2016. Plasma was collected from them and analyzed for assessment of CRP and albumin. The reference range stipulated for CAR in dogs was 0.36-0.60, as determined by the confidence interval of mean resamplings (in percentiles). The frequencies mean, and standard deviations of the variables, correlation analysis, and comparative analysis (Kruskal-Wallis in α = 5%) were calculated. Elevation (above reference) of CAR was determined to be proportional to the severity of the underlying disease, and CRP means were reasonable. Besides, hypoalbuminemia was indicative of systemic disease, but not of severity. Thus, CAR was a better marker of disease severity than were CRP and albumin, analyzed separately. Concerning LoS, there was a positive correlation with CAR (p<0.01) in patients, and the same was not observed with CRP and albumin. Concerning mortality, hypoalbuminemia was the only marker valid in animals with a critical illness (p=0.04). In conclusion, CAR is a better marker of disease severity and LoS in dogs than are CRP and albumin analyzed separately.

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Malnutrition is common in small animals, but underdiagnosed in veterinary medicine. It is associated to biochemical and physical changes, and frequently has clinical complications and poor prognosis. Its early recognition allows a correct nutritional management, which increases survival. Currently, many studies focus on the efficacy of laboratory markers of nutritional status (NS) and prognosis. We reviewed the literature with focus on the following markers: erythrogram, leukogram, cholesterol, albumin, total protein, serum transferrin, and C-reactive protein. Hypocholesteronemia, hypoproteinemia, hypoalbuminemia and normochromic normocytic anemia are indicators of chronic malnutrition and poor prognosis. The interpretation of NS should occur along with inflammatory markers to differentiate malnutrition from inflammation.

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