C‐reactive protein, tumor necrosis factor α, and interleukin‐6 in dogs with pyometra and SIRS

Abstract

Objective: To determine the frequency of the systemic inflammatory response syndrome (SIRS) in canine pyometra and to evaluate the relationship between C‐reactive protein (CRP), tumor necrosis factor α (TNFα), interleukin‐6 (IL‐6), and SIRS.Design: Prospective clinical study.Setting: Veterinary teaching hospital.Animals: Fifty‐three clinical cases of canine pyometra and 19 healthy control bitches.Interventions: Upon admission to the veterinary hospital, history and physical examination findings, including previously defined clinical SIRS parameters, were documented. Blood samples were obtained for hematology and biochemical tests and for CRP, TNFα, and IL‐6 analysis. The diagnosis of pyometra was confirmed by histopathology of the uterus after ovariohysterectomy. After surgery, clinical SIRS parameters, length of hospitalization, and mortality were recorded.Measurements and main results: Pyometra dogs were grouped as SIRS positive (30/53; 57%) or SIRS negative (23/53; 43%). Logistic regression showed that CRP was the only parameter that significantly related to SIRS apart from the clinical criteria that define this syndrome. The mortality rate was low (2/53; 3.8%), and conclusions regarding association with SIRS could not be drawn. A positive SIRS status, high plasma CRP concentration, and high body temperature were variables that related to increased morbidity reflected by the length of hospitalization.Conclusions: SIRS was seen in 57% of canine pyometra cases and a positive SIRS status showed a positive association with prolonged hospitalization. The mortality rate was low (3.3%) among SIRS positive dogs, indicating that progression to multiple organ dysfunction syndrome (MODS) rarely occurs in surgically treated cases of pyometra. CRP was associated with SIRS and with prolonged hospitalization. Further studies of plasma CRP may be warranted in canine intensive care cases susceptible to development of SIRS and MODS.

Köpeklerde Pyometranın Bazı Oksidatif Stres Parametreleri, İnflamatorik Mediyatörler ve Nötrofil Segmentasyonu Üzerine Etkileri

“…Oxidative stress was not obviously occurred in PG in this study and also this might reflected on the mortality rate. Respiratory and heart rates and body temperatures were similar with the previous studies [5,15] . Breed distribution in PG was similar with the breeds with high risk, but three German shepherd bitches in PG that was determined to have a low risk of developing pyometra was in contrast by Egenvall et al [4] .…”

“…Microcytic anaemia in PG may be occurred because of the blood loss into the uterus, iron deficiency, and toxic effects of the pyometra on the bone marrow or lipid peroxidation damage on erythrocytes membranes. In contrast with the other studies [5,18] none of the biochemical variables were found significantly different between the groups, before and 15 days after OVH. PLT was significantly lower in PG before the OVH, but increased after 15 days.…”

“…In a previous study, the mortality rate in PG was 4% [5] . In humans with pyometra accompanied by SIRS, the mortality rate was found 6-7% [14] that is much higher compared to dogs.…”

“…Pyometra sometimes might turn into SIRS when it is not diagnosed properly or treated adequately. In under some conditions SIRS might lead to multiple organ dysfunction syndrome (MODS) and the development of MODS can increase the risk of mortality [5] . An imbalanced immune response to proinflammatory cytokines may cause SIRS turn into MODS.…”

“…Unfortunately, SIRS cannot be only detected with these criteria and only 64% of sepsis condition can be diagnosed in dogs. In humans, TNF-α level increases in the presence of SIRS and MODS, IL-6 and C-reactive protein (CRP) levels increase in septic conditions [5] .…”