Evaluation of Relationship Between C-Reactive Protein, Leukocyte Count and Platelet Indices in Dogs with Leukocytosis

Year 2024, Volume: 17 Issue: 3, 270 - 279, 30.09.2024

Serkan İrfan Köse , Alper Ertürk , Gökhan Uyanık , Aliye Sağkan Öztürk

https://doi.org/10.30607/kvj.1515701

Abstract

A complete blood count and acute-phase protein analyses are the laboratory tests that are used in veterinary medicine practice. Leukocytes, also known as white blood cells (WBCs), are the primary biological components of inflammatory and immunological responses. C-reactive protein (CRP) is a powerful predictor of inflammation and/or infection in veterinary medicine. Starting at that point, the investigation of the alterations and relationship between WBC count, platelet indices, and blood serum CRP levels in dogs with leukocytosis was the aim of this study. A total of 135 bloodwork records, from January 2018 to December 2022, of dogs were analyzed. The inflammatory panel of complete blood count data, including WBC, PLT, MPV, PDW, PCT, and MPV/PLT, and CRP levels in blood serum chemistry analyses were investigated. The inflammatory panel of complete blood count data was categorized according to CRP levels in blood serum chemistry analyses. There was no significant difference in platelet indices according to the blood serum levels of CRP in the dogs’ bloodwork records. The WBC count in dogs with an equal or above 10 mg/dL CRP level was significantly higher than the other levels of CRP. A moderately positive correlation was detected between CRP and WBC in the bloodwork of all dogs, undivided according to inflammatory status, and of dogs with an inflammatory status. Consequently, in veterinary clinical practice, C-reactive protein measures in dogs may be more applicable in cases where an important rise in WBC over the cut-off value is observed in the complete blood count, commonly used to diagnose inflammatory or infectious status.

Keywords

Dog, C-reactive protein, Complete Blood Count, Leukocytosis

Ethical Statement

According to the legislation titled “Working Procedures and Ethics Committees of Animal Experiments’’ numbered 28914 published on February 15, 2014, in Turkey, the 8th article clearly suggested that clinical applications for diagnostic and therapeutic purposes are not subject to ethical committee approval. The data, information and documents presented in this article were obtained within the framework of academic and ethical rules.

Supporting Institution

The authors received no financial support for the research, authorship, and/or publication of this article.

Thanks

We would like to thank all MSc students for their assistance in clinical processes.

Lökositozlu Köpeklerde C-Reaktif Protein, Lökosit Sayısı ve Trombosit İndeksleri Arasındaki İlişkinin Değerlendirilmesi

Abstract

Tam kan sayımı ve akut faz protein analizleri veteriner hekimlik uygulamalarında kullanılan laboratuvar testleridir. Beyaz kan hücreleri (WBC'ler) olarak da bilinen lökositler, enflamatuar ve immünolojik yanıtların birincil biyolojik bileşenleridir. C-reaktif protein (CRP) veteriner hekimlikte enflamasyon ve/veya enfeksiyonun güçlü bir belirleyicisidir. Bu noktadan hareketle, lökositozlu köpeklerde WBC sayısı, trombosit indeksleri ve kan serumu CRP seviyeleri arasındaki değişikliklerin ve ilişkinin araştırılması bu çalışmanın amacını oluşturmuştur. Ocak 2018'den Aralık 2022'ye kadar köpeklere ait toplam 135 kan tahlili kaydı analiz edilmiştir. WBC, PLT, MPV, PDW, PCT ve MPV/PLT dahil olmak üzere tam kan sayımı verilerinin enflamatuar paneli ve kan serumu kimyası analizlerinde CRP seviyeleri araştırıldı. Tam kan sayımı verilerinin enflamatuar paneli, kan serumu kimyası analizlerindeki CRP düzeylerine göre kategorize edildi. Köpeklerin kan serumu CRP seviyelerine göre trombosit indekslerinde anlamlı bir fark bulunmamıştır. CRP seviyesi 10 mg/dL ve üzerinde olan köpeklerde WBC sayısı diğer CRP seviyelerine göre anlamlı derecede yüksekti. Yangı durumuna göre ayrılmamış tüm köpeklerin ve yangı durumu olan köpeklerin kan tahlillerinde CRP ve WBC arasında orta düzeyde pozitif bir korelasyon tespit edilmiştir. Sonuç olarak, veteriner klinik uygulamalarında, köpeklerde C-reaktif protein ölçümleri, enflamatuar ya da enfeksiyöz durumu teşhis etmek için yaygın olarak kullanılan tam kan sayımında WBC'de kesme değerinin üzerinde önemli bir artış gözlendiği durumlarda daha uygulanabilir olabilir.

Keywords

Köpek, C-reaktif protein, Tam Kan Sayımı, Lökositoz

Ethical Statement

Türkiye'de 15 Şubat 2014 tarihinde yayımlanan 28914 sayılı “Hayvan Deneyleri Çalışma Usulleri ve Etik Kurulları” başlıklı mevzuata göre 8. maddede teşhis ve tedavi amaçlı klinik uygulamaların etik kurul onayına tabi olmadığı açıkça belirtiliyordu. Bu makalede sunulan veri, bilgi ve belgeler akademik ve etik kurallar çerçevesinde elde edilmiştir.

Supporting Institution

Yazarlar bu makalenin araştırılması, yazarlığı ve/veya yayınlanması için herhangi bir mali destek almamıştır.

Thanks

Klinik süreçlerdeki yardımlarından dolayı tüm yüksek lisans öğrencilerimize teşekkür ederiz.

References

• Alves, A. E., Mota, F. C. D., Fujimoto, T. A. S., Sousa, W. M. R., & Di Filippo, P. A. (2020). Acute Phase Proteins response and their clinical application in veterinary medicine. Veterinária Notícias, 26(1), 82–111. https://doi.org/10.14393/VTN-v26n1-2020-53216
• Anziliero, D., Bassi, E., Pain, K. M., Valle, S. D. F., & Kreutz, L. C. (2013). Serum C-reactive protein (CRP) measurement in dogs with altered hematological parameters. Ciência Animal Brasileira, 14(2), 265–272. https://doi.org/10.5216/cab.v14i2.9054
• Başbuğ, O., Aydoğdu, U., & Ağaoğlu, Z. T. (2020). Evaluation of C-reactive protein, albumin, neopterin, urokinase type plasminogen activator receptor and leukocyte count as prognostic parameters in dogs with parvoviral enteritis. Kocatepe Veterinary Journal, 13(4), 375–382. https://doi.org/10.30607/kvj.736869
• Burton, S. A., Honor, D. J., Mackenzie, A. L., Eckersall, P. D., Markham, R. J. F., & Horney, B. S. (1994). C-Reactive protein concentration in dogs with inflammatory leukograms. American Journal of Veterinary Research, 55(5), 613–618. https://doi.org/10.2460/ajvr.1994.55.05.613
• Casella, S., Fazio, F., Russo, C., Giudice, E., & Piccione, G. (2013). Acute phase proteins response in hunting dogs. Journal of Veterinary Diagnostic Investigation, 25(5), 577–580. https://doi.org/10.1177/1040638713495851
• Cerón, J. J., Eckersall, P. D., & Martínez‐Subiela, S. (2005). Acute phase proteins in dogs and cats: current knowledge and future perspectives. Veterinary Clinical Pathology, 34(2), 85–99. https://doi.org/10.1111/j.1939-165X.2005.tb00019.x
• Christensen, M. B., Langhorn, R., Goddard, A., Andreasen, E. B., Moldal, E., Tvarijonaviciute, A., Kirpensteijn, J., Jakobsen, S., Persson, F., & Kjelgaard-Hansen, M. (2014). Comparison of serum amyloid A and C-reactive protein as diagnostic markers of systemic inflammation in dogs. Canadian Veterinary Journal, 55(2), 161–168.
• De Laforcade, A. M., Rozanski, E. A., Freeman, L. M., & Li, W. (2008). Serial Evaluation of Protein C and Antithrombin in Dogs with Sepsis. Journal of Veterinary Internal Medicine, 22(1), 26–30. https://doi.org/10.1111/j.1939-1676.2007.0021.x
• Eckersall, P. D., & Bell, R. (2010). Acute phase proteins: Biomarkers of infection and inflammation in veterinary medicine. Veterinary Journal, 185(1), 23–27. https://doi.org/10.1016/j.tvjl.2010.04.009
• Fielder, S. E. (2022, November). Hematology Reference Ranges. Merck Veterinary Manual Online. https://www.merckvetmanual.com/special-subjects/reference-guides/hematology-reference-ranges Friedrichs, K. R., Jensen, A. L., & Kjelgaard‐Hansen, M. (2022). Reference Intervals and Decision Limits. In M. B. Brooks, K. E. Harr, D. M. Seelig, K. J. Wardrop, & D. J. Weiss (Eds.), Schalm’s Veterinary Hematology (7th ed., pp. 1273–1284). Wiley. https://doi.org/10.1002/9781119500537.ch140
• Galezowski, A. M., Snead, E. C. R., Kidney, B. A., & Jackson, M. L. (2010). C-Reactive Protein as a Prognostic Indicator in Dogs with Acute Abdomen Syndrome. Journal of Veterinary Diagnostic Investigation, 22(3), 395–401. https://doi.org/10.1177/104063871002200308
• Gebhardt, C., Hirschberger, J., Rau, S., Arndt, G., Krainer, K., Schweigert, F. J., Brunnberg, L., Kaspers, B., & Kohn, B. (2009). Use of C‐reactive protein to predict outcome in dogs with systemic inflammatory response syndrome or sepsis. Journal of Veterinary Emergency and Critical Care, 19(5), 450–458. https://doi.org/10.1111/j.1476-4431.2009.00462.x
• Hillström, A., Hagman, R., Tvedten, H., & Kjelgaard‐Hansen, M. (2014). Validation of a commercially available automated canine‐specific immunoturbidimetric method for measuring canine <scp>C</scp> ‐reactive protein. Veterinary Clinical Pathology, 43(2), 235–243. https://doi.org/10.1111/vcp.12150
• Hindenberg, S., Bauer, N., & Moritz, A. (2020). Extremely high canine C-reactive protein concentrations > 100 mg/l – prevalence, etiology and prognostic significance. BMC Veterinary Research, 16(1), 147. https://doi.org/10.1186/s12917-020-02367-7
• Hindenberg, S., Keßler, M., Zielinsky, S., Langenstein, J., Moritz, A., & Bauer, N. (2018). Evaluation of a novel quantitative canine species-specific point-of-care assay for C-reactive protein. BMC Veterinary Research, 14(1), 99. https://doi.org/10.1186/s12917-018-1415-2
• Honda, T., Uehara, T., Matsumoto, G., Arai, S., & Sugano, M. (2016). Neutrophil left shift and white blood cell count as markers of bacterial infection. In Clinica Chimica Acta (Vol. 457). https://doi.org/10.1016/j.cca.2016.03.017
• Jaheen, A. H., Kubesy, A. A., Rakha, G. M., Salem, S. I., & El-Sherif, M. A. (2022). Diagnostic value of procalcitonin, C-reactive protein, and leukocyte count in canine ehrlichiosis and canine demodicosis. Comparative Clinical Pathology, 31(3), 529–536. https://doi.org/10.1007/s00580-022-03350-4
• Kjelgaard‐Hansen, M. (2010). Comments on measurement of C‐reactive protein in dogs. Veterinary Clinical Pathology, 39(4), 402–403. https://doi.org/10.1111/j.1939-165X.2010.00276.x
• Klenner, S., Bauer, N., & Moritz, A. (2010). Evaluation of Three Automated Human Immunoturbidimetric Assays for the Detection of C-Reactive Protein in Dogs. Journal of Veterinary Diagnostic Investigation, 22(4), 544–552. https://doi.org/10.1177/104063871002200408
• Kocaturk, M., Martinez, S., Eralp, O., Tvarijonaviciute, A., Ceron, J., & Yilmaz, Z. (2010). Prognostic value of serum acute‐phase proteins in dogs with parvoviral enteritis. Journal of Small Animal Practice, 51(9), 478–483. https://doi.org/10.1111/j.1748-5827.2010.00965.x
• Köse, S. İ., Köse, A. M., Ürer, E. K., Bahan, O., Gözer, A., & Ambarcıoğlu, P. (2023a). Diagnosis of Transmissible Venereal Tumors in Bitches - Platelet Indices Are a Remarkable Marker? Acta Scientiae Veterinariae, 51(1921). https://doi.org/10.22456/1679-9216.132008
• Köse, S. İ., Özer, B., Gönenci, R., & Cantekin, Z. (2023b). The Effect of Cefovecin Sodium in Shelter Dogs with Bacterial Lower Respiratory Disease. Brazilian Archives of Biology and Technology, 66, e23230096. https://doi.org/10.1590/1678-4324-2023230096
• Köse, S., Maden, M., & Sayın, Z. (2021). Clinical and bacteriological analysis of respiratory tract infections in sheltered dogs and determination of antibacterial treatment options. Journal of the Hellenic Veterinary Medical Society, 72(4), 3491–3502. https://doi.org/10.12681/jhvms.29441
• Kritsepi-Konstantinou, M., & Oikonomidis, I. L. (2016). The interpretation of leukogram in dog and cat. Hellenic Journal of Companion Animal Medicine, 5(2), 62–68.
• Kubesy, A. A., Rakha, G. M., Salem, S. I., & Jaheen, A. H. (2019). Altered blood procalcitonin, C-reactive protein, and leucocytes count in association with canine parvovirus (CPV) enteritis. Comparative Clinical Pathology, 28(4), 1095–1099. https://doi.org/10.1007/s00580-019-02941-y
• Llewellyn, E. A., Todd, J. M., Sharkey, L. C., & Rendahl, A. (2017). A pilot study evaluating the prognostic utility of platelet indices in dogs with septic peritonitis. Journal of Veterinary Emergency and Critical Care, 27(5), 569–578. https://doi.org/10.1111/vec.12628
• Malin, K., & Witkowska-Piłaszewicz, O. (2022). C-Reactive Protein as a Diagnostic Marker in Dogs: A Review. In Animals (Vol. 12, Issue 20, p. 2888). https://doi.org/10.3390/ani12202888
• Martínez‐Subiela, S., Cerón, J. J., & Ginel, P. J. (2004). Effects of different glucocorticoid treatments on serum acute phase proteins in dogs. Veterinary Record, 154(26), 814–817. https://doi.org/10.1136/vr.154.26.814
• McCourt, M. R., & Rizzi, T. E. (2022). Hematology of Dogs. In M. B. Brooks, K. E. Harr, D. M. Seelig, K. J. Wardrop, & D. J. Weiss (Eds.), Schalm’s Veterinary Hematology (7th ed., pp. 969–982). Wiley. https://doi.org/10.1002/9781119500537.ch108
• Moritz, A., Walcheck, B. K., & Weiss, D. J. (2005). Evaluation of flow cytometric and automated methods for detection of activated platelets in dogs with inflammatory disease. American Journal of Veterinary Research, 66(2), 325–329. https://doi.org/10.2460/ajvr.2005.66.325
• Moruzi, R. F., Morar, D., Văduva, C., Boboc, M. G., Dumitrescu, E., Muselin, F., Puvača, N., & Cristina, R. T. (2023). Leukogram patterns significance and prevalence for an accurate diagnosis in dogs. Journal of the Hellenic Veterinary Medical Society, 74(1), 5193–5202. https://doi.org/10.12681/jhvms.28696
• Murata, H., Shimada, N., & Yoshioka, M. (2004). Current research on acute phase proteins in veterinary diagnosis: an overview. The Veterinary Journal, 168(1), 28–40. https://doi.org/10.1016/S1090-0233(03)00119-9
• Nakamura, M., Takahashi, M., Ohno, K., Koshino, A., Nakashima, K., Setoguchi, A., Fujino, Y., & Tsujimoto, H. (2008). C-Reactive Protein Concentration in Dogs with Various Diseases. Journal of Veterinary Medical Science, 70(2), 127–131. https://doi.org/10.1292/jvms.70.127
• Ok, M., Er, C., Yıldız, R., Çöl, R., Aydoğdu, U., Şen, İ., & Güzelbekteş, H. (2015). Sepsisli Köpeklerde Akut Faz Proteinler, Bazı Sitokinler ve Hemostatik Parametrelerin Değerlendirilmesi. Kafkas Universitesi Veteriner Fakultesi Dergisi, 21(5), 761–766. https://doi.org/10.9775/kvfd.2015.13418
• Oliveira, P. L. de, Souza, S. L., Bonatto, N. C. M., Silva, N. L. T. da, Mancebo, A. M., Bosculo, M. R. M., Barros, L. D. de, Floriano, B. P., & Almeida, B. F. M. de. (2020). Effect of food intake on complete blood count of healthy dogs. Revista Agraria Academica, 3(6), 105–116. https://doi.org/10.32406/v3n62020/105-116/agrariacad
• Otabe, K., Sugimoto, T., Jinbo, T., Honda, M., Kitao, S., Hayashi, S., Shimizu, M., & Yamamoto, S. (1998). Physiological levels of C-reactive protein in normal canine sera. Veterinary Research Communications, 22(2), 77–85. https://doi.org/10.1023/A:1006071211779
• Rejec, A., Butinar, J., Gawor, J., & Petelin, M. (2017). Evaluation of Complete Blood Count Indices (NLR, PLR, MPV/PLT, and PLCRi) in Healthy Dogs, Dogs With Periodontitis, and Dogs With Oropharyngeal Tumors as Potential Biomarkers of Systemic Inflammatory Response. Journal of Veterinary Dentistry, 34(4), 231–240. https://doi.org/10.1177/0898756417731775
• Smith, J. R., Smith, K. F., & Brainard, B. M. (2014). Platelet parameters from an automated hematology analyzer in dogs with inflammatory clinical diseases. The Veterinary Journal, 201(3), 406–411. https://doi.org/10.1016/j.tvjl.2014.07.009
• Tecles, F., Spiranelli, E., Bonfanti, U., Cerón, J. J., & Paltrinieri, S. (2005). Preliminary Studies of Serum Acute-Phase Protein Concentrations in Hematologic and Neoplastic Diseases of the Dog. Journal of Veterinary Internal Medicine, 19(6), 865–870. https://doi.org/10.1111/j.1939-1676.2005.tb02779.x
• Trub, S. A., Bush, W. W., Paek, M., & Cuff, D. E. (2021). Use of C‐reactive protein concentration in evaluation of diskospondylitis in dogs. Journal of Veterinary Internal Medicine, 35(1), 209–216. https://doi.org/10.1111/jvim.15981
• Weltan, S. M., Leisewitz, A. L., & Goddard, A. (2008). A case‐controlled retrospective study of the causes and implications of moderate to severe leukocytosis in dogs in South Africa. Veterinary Clinical Pathology, 37(2), 164–172. https://doi.org/10.1111/j.1939-165X.2008.00037.x
• Wood, R. D. (2022a, October). Leukogram Abnormalities in Animals. Merck Veterinary Manual Online. https://www.msdvetmanual.com/circulatory-system/leukocyte-disorders/leukogram-abnormalities-in-animals?query=white%20blood%20cell%20counts
• Wood, R. D. (2022b, October). Overview of Leukocyte Disorders in Animals. Merck Veterinary Manual Online. https://www.msdvetmanual.com/circulatory-system/leukocyte-disorders/overview-of-leukocyte-disorders-in-animals
• Yilmaz, Z., Eralp, O., & Ilcol, Y. O. (2008). Evaluation of platelet count and its association with plateletcrit, mean platelet volume, and platelet size distribution width in a canine model of endotoxemia. Veterinary Clinical Pathology, 37(2), 159–163. https://doi.org/10.1111/j.1939-165X.2008.00023.x
• Yuri Gasparyan, A., Ayvazyan, L., P. Mikhailidis, D., & D. Kitas, G. (2011). Mean Platelet Volume: A Link Between Thrombosis and Inflammation? Current Pharmaceutical Design, 17(1), 47–58. https://doi.org/10.2174/138161211795049804