Hypovitaminosis D is associated with negative outcome in dogs with protein losing enteropathy: a retrospective study of 43 cases

Abstract

BackgroundHypovitaminosis 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.ResultsClinical (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.ConclusionsLow 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.

Evaluation of serum 25‐hydroxyvitamin D concentrations in a heterogeneous canine ICU population

“…Several recent studies have reported serum 25‐OH‐D concentration in dogs with specific diseases . Low serum 25‐OH‐D concentrations have been detected in dogs with inflammatory bowel disease and chronic enteropathies, and low vitamin D status has been shown to be an outcome predictor in these patients . Similarly, in dogs with heart disease, a significant association between serum 25‐OH‐D concentration and time to clinical manifestation of congestive heart failure or sudden death was demonstrated ( P = 0.02) .…”

“…To the authors’ knowledge, the current study is the first to document serum 25‐OH‐D concentrations in critically ill dogs at the time of ICU admission. Several recent studies have reported serum 25‐OH‐D concentration in dogs with specific diseases . Low serum 25‐OH‐D concentrations have been detected in dogs with inflammatory bowel disease and chronic enteropathies, and low vitamin D status has been shown to be an outcome predictor in these patients .…”

“…In dogs, exposure to ultraviolet light has not been shown to significantly increase dermal vitamin D concentrations, and seasonal variation in vitamin D status does not occur as reported in people . The potential role of vitamin D deficiency in health outcomes in people has inspired animal investigations, including assessment of vitamin D deficiency in chronic degenerative valvular heart disease, infectious diseases, neoplasia, and inflammatory bowel disease . The objective of the present study was to identify the prevalence of vitamin D deficiency in a heterogeneous population of critically ill dogs admitted for intensive care and to determine if vitamin D concentration in these dogs was correlated with illness severity and outcome.…”

Clinical characteristics of dogs with food‐responsive protein‐losing enteropathy

“…Because the FR‐PLE group had significantly lower CIBDAI and CCECAI scores than those found in the IR/NR‐PLE group, the longer survival time of the FR‐PLE group may be attributed to the severity of the disease, which has been shown to be associated with prognosis in dogs with PLE . In addition, other factors, such as body weight, BUN, ALB, and PARR could be associated with survival time . Therefore, further study is needed to evaluate the effect of ULFD itself on the prognosis of dogs with PLE.…”

Vitamin D metabolism in dogs and cats and its relation to diseases not associated with bone metabolism

“…The relationship of vitamin D and diseases has also been investigated in dogs and cats, and some studies found association between low vitamin D status and some types of cancer (Selting, Sharp, Ringold, Thamm, & Backus, 2016;Wakshlag et al, 2011;Weidner et al, 2017), congestive heart failure (Kraus et al, 2014;Osuga et al, 2015), gastrointestinal diseases (Allenspach, Rizzo, Jergens, & Chang, 2017;Gow et al, 2011;Lalor et al, 2014;Titmarsh, Gow, Kilpatrick, Cartwright, et al, 2015;Titmarsh, Gow, Kilpatrick, Sinclair, et al, 2015), acute pancreatitis (Kim et al, 2017), acute polyradiculoneuritis (Laws, Kathrani, Harcourt-Brown, Granger, & Rose, 2018), chronic kidney disease (Cortadellas, Fernandez del Palacio, Talavera, & Bayón, 2010;Galler et al, 2012;Gerber, Hässig, & Reusch, 2003 infectious diseases (Lalor et al, 2012;Rodriguez-Cortes et al, 2017;Rosa, Schoeman, Berry, Mellanby, & Dvir, 2013;. Although these studies do not prove a cause-effect relationship, they provide a basis for future studies to investigate possible positive effects of vitamin D supplementation on improving health status and reducing the risk of developing diseases.…”