Prognostic value of systemic inflammatory response syndrome and serum concentrations of acute phase proteins, cholesterol, and total thyroxine in cats with panleukopenia

Abstract

Background Feline parvovirus (FPV) is a common and potentially lethal infectious agent in cats. Objective To assess the prognostic value of age, neuter status, serum concentrations of serum amyloid A (SAA), haptoglobin, cholesterol and total thyroxine (tT4), and the presence of systemic inflammatory response syndrome (SIRS) in cats with panleukopenia. Animals Client‐owned cats with FPV infection diagnosed by a positive fecal ELISA test, positive PCR on feces or blood or both. Methods Retrospective cohort study. The electronic medical database was searched for cats with FPV infection presented between January 2010 and January 2018. Cats were divided into survivors and nonsurvivors according to their survival status 28 days after hospital admission. The prognostic importance of each variable was investigated univariately and by multivariable Cox's proportional‐hazards regression. Finally, receiver operator characteristic (ROC) curve analysis was used to identify the best cutoff value for discriminating survivors from nonsurvivors for the statistically significant prognostic predictors identified by multivariable analysis. Results Seventy cats were enrolled in the study. Multivariable analysis determined that only serum tT4 concentration at hospital admission was significantly (P = .01) associated with survival. A cutoff value of 0.82 μg/dL was identified by ROC curve analysis for serum tT4 concentration in discriminating survivors from nonsurvivors. Sensitivity at this cutoff was 73.9% and specificity was 82.9% (area under the curve, 0.783; 95% confidence interval, 0.668‐0.873; P < .0001). Conclusion and Clinical Relevance Serum tT4 concentration at hospital admission has prognostic value in cats with FPV infection.

Serum thyroxine and thyrotropin concentrations decrease with severity of nonthyroidal illness in cats and predict 30‐day survival outcome

“…12,16,22,[24][25][26] Few studies have examined the relationship between thyroid function and mortality in cats with NTIS. [27][28][29][30] In 2 studies that examined cats with a variety of nonthyroidal diseases, 27,28 cats that died or were euthanized had lower serum T 4 concentrations than did cats that survived, suggesting that serum T 4 concentrations may also be indicative of survival outcome. Similarly, a recent study of cats with panleukopenia reported that low serum T 4 concentrations were associated with poor outcome.…”

“…Similarly, a recent study of cats with panleukopenia reported that low serum T 4 concentrations were associated with poor outcome. 30 To our knowledge, no study has evaluated if serum T 3 or TSH concentrations can help predict survival outcome in cats with NTIS.…”

Treatment with Class A CpG Oligodeoxynucleotides in Cats with Naturally Occurring Feline Parvovirus Infection: A Prospective Study

“…It is interesting to note that, in the present study, the presence of antibodies against FPV in serum samples collected on admission was positively associated with survival, with higher loads on admission in cats that died compared to survivors; similar results have already been described in the literature in cats infected with feline herpesvirus-1, feline calicivirus, and FPV [31]. Considering that one inclusion criterion was that cats were not vaccinated for FPV, the presence of antibodies on admission might suggest a previous contact with the virus or false positives due to nonspecific binding to the test reagents [31]; however, these hypotheses are less probable since the presence of antibodies is a strong predictor of protection against FPV reinfection and subsequent clinical disease, and since the slides for immunofluorescence assays were tested for potentially contaminating other feline viruses [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Because all cats came from a shelter where FPV is endemic, it is more likely that cats with neutralizing antibodies were admitted at a later stage of the infection; in fact, it has been shown that FPV antibodies production starts 8 days post-infection and precedes leukocytes improvement by several days [32].…”

“…The prevalence of subclinical infections remains unknown [2]. Body weight, the severity of clinical signs, thrombocytopenia, hypoalbuminemia, hypokalemia, glucose administration, total T4 have been identified as negative prognostic factors in cats infected by FPV, whereas leukopenia has been inconstantly recognized as a negative outcome predictor [3][4][5]. So far, no specific antiviral therapy against FPV infection has been tested in cats, and its management relies upon supportive treatment.…”

“…So far, no specific antiviral therapy against FPV infection has been tested in cats, and its management relies upon supportive treatment. Plasma or whole blood transfusion may be required in case of severe hypoproteinemia or anemia, respectively [3][4][5][6]. Recently, feline interferon regulatory factor-1 has been found to reduce the replication of FPV on Crandell-Rees feline kidney cells [7], but no information is yet available in vivo.…”