Evaluation of Serum Apolipoprotein A1 in Canine Sepsis

Decreased serum apolipoprotein A1 (Apo-A1) concentration is associated with mortality in human sepsis. The diagnostic and prognostic role of serum Apo-A1 concentrations in canine sepsis was evaluated. Serum samples from septic dogs (n= 91) and healthy controls (n= 15) were retrospectively analyzed. According to the sepsis origin, four categories were identified: parvoviral enteritis (n= 26), pyometra (n= 20), septic peritonitis (n= 19), and miscellanea (n= 26). The canine acute patient physiologic and laboratory evaluation fast score (APPLE(fast)), serum C-reactive protein (CRP) and albumin concentrations were reviewed in all enrolled dogs. Increased CRP (252.6 +/- 119.2 mg/L; Reference Interval: 0-8.5 mg/L) and significant lower serum albumin and Apo-A1 concentrations were documented in dogs with sepsis (22.8 +/- 5.3 g/L and 1.17 +/- 0.27 g/L, respectively) compared to healthy ones (33.1 +/- 2.5 g/L and 1.32 +/- 0.05 g/L, respectively) (P< 0.0001). According to the origin of sepsis, only the subgroup of dogs with septic peritonitis had significantly lower Apo-A1 (1.03 +/- 0.26 g/L) concentrations compared to healthy dogs (P< 0.001). No significant differences were found in serum albumin and CRP concentrations, and in APPLE(fast)score values among the different subgroups of sepsis. Diagnosis of septic peritonitis was associated with a higher frequency of death (P= 0.006). In septic dogs, significant lower Apo-A1 concentrations were detected in non-survivors (1.02 +/- 0.28 g/L;n= 27) compared to survivors (1.23 +/- 0.24 g/L;n= 64;P= 0.0007). Moreover, significant higher values of the APPLE(fast)score were calculated in non-survivors (26 +/- 4;n= 19) compared to survivors (23 +/- 4;n= 51) (P= 0.0114). According to the area under the ROC curve analysis, Apo-A1 <96 mg/dl had a fair accuracy (AUC = 0.72) to correctly predict mortality (P= 0.0004). Apo-A1 might support a diagnosis of canine septic peritonitis with a potential prognostic significance. Further prospective studies are warranted.