Changes in canine C-reactive protein levels following orthopaedic surgery: a prospective study

C-reactive protein (CRP) is a powerful biomarker for inflammation, infection and sepsis. However, no reports have investigated canine CRP (c-CRP) concentration changes after orthopaedic procedures. If c-CRP changes were better characterized, it may be possible to identify postoperative complications more quickly. The purpose of this study was to clarify the characteristic changes in serum c-CRP after orthopaedic surgery in dogs. Blood samples were collected from 98 dogs on Day 0 (preoperatively), and then on Days 1, 4, 7, 10 and 13 postoperatively. Day 1 blood sampling was performed 12-24h postoperatively. We classified the dogs into four groups based on changes in c-CRP pre- to postoperatively. Group 1 dogs showed a peak c-CRP concentration on Day 1, followed by decreases of 1mg/dL. Group 2 dogs showed changes in c-CRP concentration by Day 4 that were within +/- 1mg/dL compared with Day 1. Dogs in Group 3 showed a peak c-CRP concentration on Day 4, followed by decreases of 1mg/dL. Group 4 dogs showed an initial decrease in c-CRP, then an increase of 1mg/dL. Group 1 was the largest group, with 63 dogs. c-CRP on Days 0, 1, 4, 7, 10 and 13 was 0.83 +/- 1.03mg/dL, 8.10 +/- 3.15mg/dL, 3.76 +/- 1.94mg/dL, 1.63 +/- 0.92mg/dL, 0.96 +/- 0.70mg/dL and 0.68 +/- 0.51mg/dL, respectively. Serum c-CRP concentration on Day 1 was significantly higher than at every other timepoint (P<0.001). In Group 2, surgical site complications were confirmed in 9/15 dogs. In Group 3, surgical site complications were confirmed in 7/14 dogs. In Group 4, two surgical site problems and three surgical site infections were observed, and visceral disease was found in one dog. In Group 1, peak c-CRP was seen on Day 1 postoperatively in 63 dogs (64%), with c-CRP level decreasing by half at each subsequent measurement, which may describe a typical c-CRP change in orthopaedic patients. If deviation from this typical change is observed postoperatively, as in Groups 2-4, this may suggest possible complications.