Are Leukocyte and Platelet Abnormalities and Complete Blood Count Ratios Potential Prognostic Markers in Canine Sepsis?

Abstract

Background: Sepsis is a common disease in which early diagnosis and prognosis assessment are the main aims in order to arrange a prompt and effective treatment.Objectives: (1) To compare leukogram parameters (WBC, segmented and band neutrophils, lymphocytes, monocytes), platelet count (PLT), mean platelet volume (MPV), and some leukocyte/platelet ratio such as NLR, NBNLR, PLR, and MLR between dogs with systemic inflammatory response syndrome (SIRS) and sepsis. (2) To investigate any difference in the trend of these latter parameters between survivors and non-survivors septic dogs.Animals: 57 dogs with confirmed sepsis and 57 dogs with non-septic SIRS.Methods: A review of the medical records was conducted in order to find dogs with sepsis. Sepsis was defined as the presence of an infectious focus with fulfillment of systemic inflammatory response syndrome criteria (SIRS). Septic dogs had to have a CBC at admission and another CBC within 48 h from the previous timepoint. Purebreds with CBC breed-related abnormalities were excluded, together with dogs without confirmed sepsis and dogs with only a single CBC. NLR, NBNLR, PLR, and MLR were calculated. Univariate analysis of all blood parameters studied was assessed between SIRS and septic dogs. Generalized Estimating Equations models for repeated measures were used to test if the blood parameters studied were modified between survivors and non-survivors in the septic group.Results: Septic dogs had lower median segmented neutrophils count and NLR compared to SIRS dogs (p = 0.02 and p = 0.04, respectively). Lastly, septic dogs had a higher prevalence of toxic neutrophil than SIRS dogs (p = 0.01). We found that for a 1-unit increase of PLR and MLR, the risk of death increased by 50.5 and 60%, respectively. Conclusion and Clinical Importance:Evaluation of NLR at hospital admission may be a useful marker of inflammation, although it showed low sensitivity in differentiating SIRS and septic dogs. The monitoring of some CBC parameters, especially PLR and MLR may be useful in the establishment of prognosis in septic dogs.

Hematological Status in Septic or Non Septic Dogs due to Parvoviral Enteritis

“…The low monocyte levels detected in the Septic CPE Group of the present study were consistent with previous studies, and it was thought that this finding might be related to immunosuppression due to lymphoid tissue damage (7). In addition, this finding can be explained by the fact that monocytes begin to migrate to the inflamed tissue when the inflammatory response begins as a result of infection (23). The limitations of this study are the limited number of animals which may influence the results of the ROC-based diagnostic performance analysis results and the evaluation of hemogram analysis within the scope of routine laboratory examination.…”

Leukocyte Ratios and Prognosis in Dogs with Primary Immune-Mediated Hemolytic Anemia: A Pilot Study

“…Few studies have investigated the ability of NLR to distinguish sepsis from systemic in ammatory response syndrome in dogs, nding no discriminatory ability for septic peritonitis (Hodgson et al 2018) and pneumonia (Conway et al 2021), and rather good chance to be useful for acute pancreatitis (Neumann S. 2021). A weak association between lower NLR and sepsis and between higher MLR and non-survival in dogs with sepsis was found (Pierini et al 2020).…”

Neutrophil to lymphocyte ratio as a prognostic biomarker in puppies with acute diarrhea

“…A positive correlation between NLR and CADSI in puppies with AD was also demonstrated. Pierini et al 15,21 performed two studies related to NLR in dogs with SIRS and sepsis and reported that the NLR was higher in SIRS+ dogs with various diseases (eg, pyometra, parvoviral enteritis, acute kidney injury, acute pancreatitis, acute cholecystitis, gall bladder mucocele, gastric dilatation-volvulus, diabetic ketoacidosis) than septic dogs. 15 Additionally, a more recent study 21 reported that the median NLR values of septic dogs (10.97) was lower than those of SIRS+ dogs (14.97).…”

“…17 During sepsis progression, production of neutrophils persistently increases, resulting in immature neutrophils into circulation. 21,28 On the other hand, immunosuppression is induced by the release of various anti-inflammatory cytokines, and apoptosis occurs in a large number of lymphocytes. Lymphocytopenia is another condition that can cause an increase in NLR.…”

“…However, information on the utility of NLR in veterinary medicine is lacking and its evaluation has been mostly limited to oncology patients. [18][19][20] There is a limited number of studies evaluating NLR in dogs with SIRS, sepsis, 15,21 and septic peritonitis. 12 To the best of the author's knowledge, there are no studies evaluating NLR in puppies with AD.…”