Association of chronic enteropathy activity index, blood urea concentration, and risk of death in dogs with protein-losing enteropathy

BACKGROUND: Malnutrition is associated with increased risk of premature death in humans with inflammatory bowel disease.

HYPOTHESIS/OBJECTIVE: To determine if historical, clinical, and laboratory markers of malnutrition in dogs at the time of histologic diagnosis of protein-losing enteropathy (PLE) caused by chronic enteropathy (CE) or lymphangiectasia are associated with increased risk of death.

ANIMALS: Seventy-one client-owned dogs diagnosed with PLE.

METHODS: The medical records were retrospectively searched for cases of PLE, diagnosed with CE or lymphangiectasia on the basis of histopathology of intestinal biopsies at a referral hospital. For each case, various variables at the time of diagnostic investigation were recorded and follow-up obtained by telephone contact with the referring veterinarian.

RESULTS: A multivariable cox model indicated that canine chronic enteropathy activity index (CCEAI) and blood urea concentration were significantly associated with death (P values <.01). For each unit increase in CCEAI, the hazard of death increased by 22.9% (confidence interval [CI]: 6.9%-41.2%). Dogs with a CCEAI of ≤8 and dogs with urea ≤7 mmol/L survived 256 days longer (P = .001, CI: 106.7-405.4 days) and 279 days longer (P = .009, CI: 70.0-488.7 days) than those with a CCEAI of >8 and urea >7 mmol/L on average, respectively, when followed up for 647 days.

CONCLUSIONS AND CLINICAL IMPORTANCE: Increased CCEAI and blood urea concentration at the time of diagnosis might be predictive of death in dogs with PLE caused by CE or lymphangiectasia.