Laboratory profile of malnutrition in hospitalized dogs

Abstract

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.

Continuous versus intermittent enteral nutrition in hospitalised dogs and cats using a new scoring system: A prospective clinical study

“…In two veterinary studies, decreased haematocrit and hypoalbuminemia were associated with malnutrition and poor clinical outcome in critically ill patients (Michel 1993;Fabretti et al 2015). One recent veterinary study did not show the importance of monitoring serum albumin alone as a marker of malnutrition, moreover, its level can be significantly affected by the inflammatory response (Fabretti et al 2021). Hypophosphataemia in long-term anorectic patients is a cause of the development of haemolytic anaemia, which is part of the refeeding syndrome (RS) (Mathews 2017).…”

“…The anthropometric parameters, history (such as weight loss, body mass index, triceps skin fold, appetite), and biomarkers (such as albumin, prealbumin, cholesterol and lymphocyte count) are usually used for nutritional assessment (Keller 2019). Only a few veterinary studies deal with the determination of biomarkers and risk factors of malnutrition in dogs (Michel 1993;Fabretti et al 2015;Fabretti et al 2021). However, no study to the author's knowledge has focused on the development of a nutritional scoring system or other rating scale incorporating both clinical and laboratory parameters to provide an objective nutritional assessment in dogs and cats.…”

Clinical and Hemato-biochemical Studies on Canine Anemia

“…2B) included Toxocara canis (2 cases) and mixed infection with Toxocara canis and Toxascaris leonina (2 cases) that explain the elevation of both parameters. Significant elevation of lymphocytic count wasn't conclusive as there is no correlation between lymphocytic count and nutrition (Fabretti et al, 2015;Keller, 2019;Fabretti et al, 2021). Significant (P≤0.001) elevation of monocytes in affected dogs reflects stress monocytosis that depends mainly on severity and duration of deficiencies.…”

Avaliação nutricional e laboratorial como preditores do tempo de hospitalização, gravidade da doença de base e mortalidade em cães

“…Other studies have described low TF and TBIC values as indicators of disease or poor prognosis (Nakajima et al, 2012(Nakajima et al, , 2014Fabretti et al, 2021). This reduction in serum concentrations of TF and TBIC is a result of the action of cytokines (such as IL-1, IL-6 and TNF-α), secreted in inflammatory processes, which alter the profile of hepatic synthesis of proteins (TF is a negative APP) (Pires et al, 2011;Zalles Cueto et al, 2012).…”