In‐hospital mortality in dogs with protein‐losing enteropathy and associated risk factors

Abstract

AbstractBackgroundRisk factors associated with negative outcomes in dogs with protein‐losing enteropathy (PLE) are well documented. However, mortality before hospital discharge and associated risk factors are not well described.Hypothesis/ObjectivesReport the percentage of dogs with PLE that do not survive to hospital discharge and identify associated risk factors.AnimalsOne‐hundred and seven dogs presented to a referral hospital and diagnosed with PLE caused by inflammatory enteritis, intestinal lymphangiectasia or both.MethodsRetrospective cross‐sectional study assessing hospital records. Data on in‐hospital mortality and cause were assessed, and presenting signs, treatments prescribed, neutrophil count, lymphocyte count, serum albumin, globulin, and C‐reactive protein (CRP) concentrations, and histopathologic findings were compared between survivors and non‐survivors.ResultsIn‐hospital mortality was 21.5% with the most common causes including financial limitations, failure to improve and aspiration pneumonia. Factors associated with mortality during hospitalization included longer duration of hospitalization (P = .04), longer duration of clinical signs (P = .02) and an increase in serum CRP concentration after 1–3 days of in‐hospital treatment (P = .02). Higher mortality was identified in Pugs (odds ratio [OR], 4.93; 95% confidence interval [CI], 1.41–17.2; P = .01) and was a result of presumptive aspiration pneumonia in 5/6 of these dogs.Conclusions and Clinical ImportanceProtein‐losing enteropathy in dogs has substantial mortality during hospitalization. Monitoring for improvement in CRP concentration after treatment during hospitalization may help predict survival to discharge. Pugs have increased in‐hospital mortality because of aspiration pneumonia; measures to prevent, recognize, and promptly treat this complication may improve outcomes in this breed.